Medicare Part A Eligibility, Explained

Medicare Part A eligibility is Medicares first type of insurance plan which includes

inpatient care in hospitals, nursing homes, skilled nursing facilities, and critical access hospitals. It does not include long-term or custodial care. And, an individual is found eligible once he meets the specific requirements which include age 65 and meet the citizenship requirement.

In instances like, if you are under 65 and you are disabled, you will automatically receive Part A once youve received Social Security disability benefits. And, there is an exemption for those with amyotrophic Later Sclerosis, who automatically receive Part A the same month that disability benefits start.

Keep in mind; you should sign up when you are first eligible for Medicare Part A to avoid a

penalty increase on your premium. Delays when you are first eligible makes you pay more for your premiums later on. Another advantage once you become eligible for Part A is you become eligible for Medicare Part B as well.

This insurance plan is provided with no out of pocket costs, or premium, if you or your spouse has made payroll contributions to Social Security for at least 10 years or forty quarters. The coverage helps cover only the medically necessary services including the following:

Blood Transfusions

This is blood (pints) that you receive during a covered stay in a hospital, critical access hospital, or a skilled nursing facility.

Hospital Stays

Part A covers hospital stays, which includes a semi-private room, meals, general nursing, and miscellaneous hospital services and supplies.

Nursing Home or Skilled Nursing Facility

Nursing home or skilled nursing facility stays must be related to diagnosis during a hospital stay. For instance, your hospital stay was for a stroke. It is limited to a maximum of 100 days in a benefit period. The first 20 days are paid in full, and the remaining 80 days will require a co-payment.

Home Health Services

Home health services include limited reasonable and only medically necessary part-time care and services such as skilled nursing care, physical or occupational therapy, home health aide service, speech language pathology, and medical social services.

Hospice Care

Hospice care is for the terminally ill who have six months or less to live. Coverage includes pain relief and symptom control drugs, medical and support services, grief counselling, and other services. Medicare will continue to cover your palliative care as long as your doctor or a hospital medical director for Hospice re-certifies you are terminally ill.

by: Diana Ross

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