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Medicare Part A
Medicare Part A is a health care plan that is sponsored by the federal government. This coverage covers expenses that are related to hospitalization, otherwise known as inpatient expenses. Almost all Medicare recipients are enrolled in Medicare Part A coverage automatically when first eligible.
Costs Associated with Medicare Part A
Most Medicare Part A participants will not pay a premium for their coverage if they or their spouse paid Medicare taxes while working. This is why Medicare Part A is often considered Premium-Free Part A.How much does Medicare Part A cost?
If you are required to pay a premium for Medicare Part A it may cost you upwards of $413 (2017) each month. Enrollees qualify for Medicare Part A Premium-Free at 65 if:
You are receiving retirement benefits from Social Security or the Railroad Retirement Board or are eligible to but have not filed for them yet
You or your spouse had Medicare-covered government employment
Enrollees qualify for Medicare Part A Premium-Free under 65 at:
You have received Social Security or Railroad Retirement Board disability benefits for 24 months
You have End-Stage Renal Disease (ESRD) & meet certain requirements
More often than not, if a participant chooses to purchase Medicare Part A they must also buy Medicare Part B. A monthly premium will be owned on both.What does Medicare Cover?
Coverage under Medicare covers services that are considered medically necessary in order to provide treatment for a condition or disease. This includes:Lab tests
Participants in Medicare Advantage and Medigap Plans have a different set of rules to follow. This coverage that they offer must be the same as Original Medicare however; certain services may only be covered in certain settings or for patients with certain conditions. In general coverage under Medicare Part A includes:
Home health care
Skilled nursing facility care
Nursing home care (as long as custodial care isn’t the only care you need)
Does Medicare Part A Cover what you need?
In order to determine if the care you need is going to be covered under Medicare Part A you can do one of two things.The most effective way is to talk with the health care provider about why the service or supplies are needed and ask Medicare if they will be covered. You will need to sign a waiver that states you may be required to pay out of pocket if expenses are not covered.
Check out your Medicare coverage online. There is a government sponsored website that can be found at www.Medicare.gov that will give you detailed information into your coverage.
Medicare Coverage is based on 3 Main Factors
Federal and state laws
National coverage decisions made by Medicare
Local coverage decisions made by companies in each state that process Medicare claims. These companies will help decide whether something is medically necessary and should be covered.
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