medicare part A – hospital insurance

inpatient coverage from hospital beds to hospice care

No one plans to end up in the hospital, but it's reassuring for millions of enrollees to know that Part A covers so much of hospitalization expenses. It's also comforting to know that most folks who are eligible for Medicare do not have to pay a Part A premium.

Part A coverage – or "hospital insurance" – pays for a broad range of inpatient care in hospitals, skilled nursing facilities and critical access hospitals. And, while it does not include long-term care, Part A may cover some hospice or home health care.

More specifically, the list of expenses covered by Part A includes:

• Inpatient care in hospitals that provide critical care, including a semi-private room (unless a private room is medically necessary), meals and prescription drugs. (Not included: private-duty nursing, a TV or phone in the room)
• Inpatient facilities for rehabilitation and hospitals providing long-term care
• Inpatient care in a nursing facility where skilled but not long-term care is offered
• Hospice care and home health care services when medically necessary (home health care includes intermittent skilled nursing, physical therapy, speech-language pathology, some medical supplies and equipment)
• Inpatient care in a religious nonmedical health care institution
• Blood – If no free blood bank blood is available, Part A pays for patient's blood after the enrollee pays for the first three units.
• Inpatient mental health care in a psychiatric facility (limited to 190 days in the enrollee's lifetime).

medicare part A – how to enroll

If you are receiving Social Security or Railroad Retirement Board benefits and live in one of the 50 states, the government automatically enrolls you in Medicare Part A at no cost when you reach 65. Look for your Medicare card to automatically arrive in the mail three months prior to your 65th birthday (or the 25th month of a disability).

Individuals not eligible for automatic and free Part A enrollment have a seven-month window of time to enroll, beginning three months prior to the month they turn 65. Enrolling beyond that window triggers higher premiums. Those suffering from ALS receive their Medicare Part A card through the mail the month their disability benefits begin.

medicare part A – what's the cost?

How much you pay for Medicare Part A coverage depends on your work history. If both you and your spouse worked and paid into Medicare through taxes for 10 or more years, you pay nothing each month for Part A. If you worked and paid into Medicare less than 10 years, you'll pay $254 a month – and $461 a month if you've paid into Medicare less than 7½ years.

Medicare recipients generally pay 20 percent of the Medicare-approved amount for health care services. For example, if your doctor's visit costs $75, you pay $15. Medicare pays the remainder. However, you must reach a deductible (of $1,024 in 2008) before coverage kicks in.