What is Medicare Part A?

Medicare Part A is the "hospital coverage" part of Original Medicare that covers inpatient care. With Medicare Part A, 80% of medical and hospital expenses are covered, leaving the patient responsible for the remaining 20% of expenses plus 100% of prescription drug costs. If you have worked for at least 10 years and paid into Medicare coverage, you are automatically enrolled in Medicare. Enrollment occurs three months prior to your 65th birthday and becomes effective on the first day of your birth month. For example: If your 65th birthday is May 13, you'll be automatically enrolled in February and have active Medicare coverage on May 1.

As a Medicare beneficiary, the services covered under Medicare Part A typically include:

  • Hospital care
  • Nursing home care
  • Skilled nursing facility care
  • Hospice
  • Home health services
  • Expenses that are crucial to inpatient hospital care, such as semi-private rooms, meals, nursing services, medications (as part of inpatient treatment), and other services and supplies from the hospital.

 

Who is eligible for Original Medicare?

Medicare Part A, as a portion of Original Medicare, is available without a premium if you worked for 10 years or more and paid Medicare taxes during that time. Others can still enroll in Medicare Part A but will pay a premium.

You may qualify for Medicare Part A if you are:

  • 65+ and U.S. citizen or legal resident
  • Already receiving retirement benefits
  • Disabled and receiving disability
  • Have end-stage Renal Disease (ESRD)
  • Have Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig's disease)

As a Medicare beneficiary, you may be eligible for Medicare Part A. Additional Medicare coverage is available from Blue Cross and Blue Shield of Alabama to help offset your medical expenses. Compare Medicare coverage options to see if Original Medicare is right for you, or if you will need a Medicare Supplement Plan, Prescription Drug PlanMedicare Advantage Plan to manage your medical costs.

Some people may be automatically enrolled in Medicare Part A. If you are automatically enrolled, you will receive your Medicare card in the mail three months before you turn 65, or on your fifteenth month of disability.

 

When can I apply for Medicare Part A?

There are four enrollment periods during which you may choose Medicare coverage.

Initial Enrollment Period: You can sign up for Medicare during a seven-month Initial Enrollment Period (IEP). This period includes the three months before your 65th birthday, the month of your birthday, and the three months after you turn 65.

General Enrollment Period: If you miss your Initial Enrollment Period for Medicare coverage, you may sign up for Medicare between January 1 and March 31 each year during a General Enrollment Period. You could face a late penalty for missing your initial opportunity to enroll in Medicare, but you will be able to apply for coverage during this time.

Annual Election Period: Each year from October 15 to December 7, you may sign up for Medicare coverage or prescription drug coverage to begin January 1 of the following year. Additionally, changes may be made to any existing Medicare plan during this time.

Special Election Period: If you experience a loss of health insurance coverage that was previously covered by your job or union health insurance, you may qualify for a Medicare special enrollment period. This eligibility period will be determined based on the date you lost coverage.

If you fall within one of the four enrollment periods for Medicare coverage, compare Medicare plans with Blue Cross and Blue Shield of Alabama today.

If you miss your Initial Enrollment Period and you do not meet the requirements for premium-free Medicare coverage, you may face an increased premium or late enrollment penalty for Original Medicare coverage.

 

What is not covered by Medicare?

As a Medicare beneficiary, you probably need more coverage than Original Medicare provides — to help you save money on prescription drugs, doctor copays, and other out-of-pocket expenses not covered by Original Medicare.

Even when Medicare Part A does cover a particular medical service or item, you will typically still have to pay your deductible, coinsurance and copayments. Medicare Part A covers only about 80% of approved inpatient expenses. You are responsible to pay the other 20% of your medical and hospital costs, and 100% of your prescription drug costs.

In addition to prescription costs, there are other things that are not covered, such as:

  • Long-term care
  • Most dental care
  • Eye exams related to prescription glasses
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams
  • Routine foot care

Blue Cross and Blue Shield of Alabama offers a variety of Medicare solutions for a variety of needs and budgets. For additional options that cover more of your medical care, services and supplies, Blue Cross and Blue Shield of Alabama offers Medicare Advantage, Medicare Part C and Medicare Part D (prescription drug coverage) plans. We cover what matters. And we share a common goal — your health.

Last Updated: 09/30/2018 18:35