Claire Smith Last Updated On: June 27, 2023

Medicare Part A Coverage

Enrolling in Medicare Part A in a timely manner is important or else you may pay late penalties. Otherwise, if you’ve worked a certain number of years, paid Medicare taxes, and have reached the age of 65, Medicare Part A is free of charge.

What Is Medicare Part A?

As mentioned, Medicare Part A is designed to give people access to affordable hospital coverage. Medicare Part A is comprised of a few different buckets of service, including:
  • Inpatient hospital care
  • Rehabilitation services in a hospital
  • Hospice
  • Mental health services in a hospital
  • Some home healthcare
  • Stays in skilled nursing facilities, to a certain extent
Each of these buckets has rules, restrictions, and limits in place for use, but Medicare Part A insurance is designed to give you access to normal hospital services should something unexpected come up—and the peace of mind provided by this coverage is priceless.

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Table of Contents

Medicare Part A Enrollment Is Hospital Insurance For The Unexpected

Among the many unexpected expenses in life are hospital stays. With the average hospital stay per day costing $2,607 and the average stay lasting four days, it’s easy to see how even everyday accidents and incidents can become financially devastating. 

But Medicare Part A can help, and we’re going to explain how, starting with a brief overview of Medicare in general and then moving into how to enroll, why to enroll, and what Medicare Part A covers.

What Does Medicare Part A Insurance Not Cover?

Understanding the limits of Medicare Part A coverage is important before you enroll. Essentially, anything that is optional or voluntary is not covered. This includes:

  • Cosmetic surgery
  • Acupuncture
  • Dental care and dentures
  • Eye exams
  • Hearing aids
  • Foot treatments
  • Long-term care
  • And more

Medicare Part A coverage is designed to assist with essential medical care related to the hospital. For these other types of procedures, you’ll need to purchase supplemental insurance or pay for them out-of-pocket.

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The Cost Of Medicare Part A Insurance

The cost of Medicare Part A insurance is broken up into three sections:
  • Premiums
  • Deductibles
  • Coinsurance
The good news is that for many, the monthly premiums of Medicare Part A insurance are free. If you’ve worked for 40 quarters or more (10 years), then you don’t have to pay any monthly premiums for Medicare Part A. If you’ve worked less than 40 quarters, then the monthly premiums start at $259 and go up depending on how many quarters you’ve worked over your lifetime. Deductibles are separate from premiums. If you end up needing Medicare Part A insurance, deductibles are what you’d pay before the Medicare Part A insurance kicks in. After the deductible is paid, you may also be subject to a coinsurance if you’ve received inpatient care for over 60 days. Skilled nursing facilities are subject to coinsurance starting at 20 days.

An important note is that Medicare Part A insurance is not designed for long-term care. If you exceed 90 days of hospital inpatient care, you start using Medicare lifetime reserve days. You are entitled to 60 lifetime reserve days, after which you’ll be required to pay all costs related to your inpatient care. 

Medicare Part A Coverage and Eligibility

Everyone at age 65 typically qualifies for Medicare Part A coverage. You may be eligible for Medicare Part A coverage earlier than that, based on certain health reasons such as a disability or end stage renal disease, for example.

Most people become eligible on their 65th birthday but can enroll at any point over a 7-month period: The three months before their 65th birthday, their birthday month, and the three months after. 

Enrolling during this period is very important, or else you may have to pay late penalties for the rest of the time you have Medicare Part A coverage and it could delay when your coverage takes effect.

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Medicare Part A Enrollment Steps

Enrolling in Medicare Part A insurance is fairly straightforward. You can enroll during the 7-month period around your 65th birthday, or you can enroll during open enrollment in the fall if you miss that period (late penalties may apply). 

To enroll, you have three simple options:

  1. Call the Social Security Administration line (800-772-1213)
  2. Enroll online on the Social Security Administration page
  3. Visit your local Social Security Office

Some people may be automatically enrolled into Medicare Part A coverage by the government if they meet certain criteria or if they’re already receiving Social Security, but most have to enroll themselves through one of the options mentioned above. 

When your coverage starts taking effect depends on when you enrolled; if you enrolled three months before your 65th birthday, for example, then your coverage starts the day of your 65th birthday.

Is Medicare Part A Enrollment Mandatory?

Medicare Part A enrollment is not mandatory, but it’s a bit tricky to opt-out of it. 

You can delay or decline Medicare Part A insurance if you have creditable coverage from another source, such as if you’re still working and receive healthcare coverage from your employer. It’s important to note that some healthcare plans from employers require you to enroll in Medicare at age 65 to help pay for your medical costs, so it’s worthwhile to double-check with your employer/HR. 

If you don’t have creditable coverage and you choose not to enroll, enrolling at a later date can incur significant late penalties that apply for the rest of your life. Not opting into Medicare Part A insurance without another source of creditable coverage is risky, especially as you get older. An unexpected trip to the hospital could be incredibly costly without Medicare Part A insurance in place.

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In Short: Medicare Part A Coverage

Medicare Part A coverage is designed to give those aged 65 and older coverage for unexpected and essential hospital care so that they can receive the care they need without devastating financial repercussions. 

If you don’t have creditable coverage in place already, enrolling in Medicare Part A coverage on time will ensure you have the coverage you may need without paying late penalties. It’s definitely worth consideration if nothing else. 

Start by getting a free Medicare Part A quote from us so you know what to expect.  We can help. Simply request a quote now.

FAQ

Medicare Part A insurance is hospital-related care insurance, covering essential hospital inpatient care, hospice, limited stays in skilled nursing facilities, and more.
Many people do not have to pay any premium for Medicare Part A. This is because they have already paid into it through their Social Security. However, if paying a premium, is required the longer they work towards paying into their Social Security, the lower the amount will be.
No, Medicare Part A does not have any annual deductibles. However, they are applicable only to the hospital benefit period. This period begins when you start receiving treatment and ends when you are discharged.
 
For many, there is no monthly premium for Medicare Part A coverage. If you’ve worked and paid into Medicare taxes for at least 10 years, you’ll likely not have to pay monthly premiums. However, you’ll still need to pay deductibles and coinsurance, as needed.
 
People of at least 65 years of age are eligible for Medicare Part A. Additionally, they have to be a US citizen or a permanent resident in the US for at least five consecutive years. Some may qualify sooner, such as those already receiving social security.
 
You must enroll in Medicare Part A in the 3 months prior to and following your 65th birthday. Alternatively, there are two parts – Medicare Part A and Medicare Part B. Here, you may have to enroll in each of them separately if you are not automatically enrolled.
 
An insured person needs to file a claim within 12 months of receiving hospital care. Some Medicare Advantage plans have a shorter period to submit their claims as opposed to Original Medicare.

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