Part A covers inpatient hospitalizations, care in skilled nursing facilities, palliative care, and some home health care. In general, Medicare Part A helps pay for the hospital care you receive in hospitals, critical access hospitals, and skilled nursing facilities. It also helps cover palliative care and some home health care. Original Medicare generally doesn't cover the cost of a nursing home, assisted living, or long-term care facility. Medicare Part A covers care provided in a skilled nursing facility with certain conditions and time limitations.
People who already receive Social Security or RRB benefits at least 4 months before they qualify for Medicare and who reside in the United States (except residents of Puerto Rico) are automatically enrolled in Part A and Part B. People who automatically enroll in Part B have the option of keeping or refusing Part B coverage. People who live in Puerto Rico and are eligible for automatic enrollment are only enrolled in Part A without a premium; they must actively enroll in Part B to get this coverage. Medicare Part A doesn't cover more than 100 days of stay in a skilled nursing facility. This means that after 100 days in the hospital, the person is responsible for the full cost.
Part A helps cover inpatient care, care in skilled nursing facilities, palliative care and home health care. Medicare parts A and B don't cover long-term care, prescription drugs, dental services, or hearing aids. Consider Medicare Advantage or Medigap to avoid out-of-pocket costs. According to the Centers for Medicare and Medicaid Services (CMS), most people don't pay a monthly premium for Medicare Part A coverage.
Eligibility requirements to receive Medicare Part A for people 65 and older include those who receive Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) benefits for at least 24 months due to a disability. Keep in mind that Medicare generally doesn't pay for the full cost of your care and you're likely responsible for a portion of the shared costs (deductibles, coinsurance, and copays)) of services covered by Medicare. Although a person may qualify for Medicare Part A without premiums, they will have to pay certain deductibles for some services. For example, if you're hospitalized and need dental services to treat a condition, such as a fractured jaw, or if dental exams are needed to prepare for certain surgeries, such as kidney transplant surgery or heart valve replacement, Medicare may cover them.
Original Medicare doesn't usually cover routine eye exams or eyeglasses, so if you just need to get checked to buy new glasses, you'll have to pay for them yourself. For example, Original Medicare generally doesn't cover long-term care, most dental care, eye exams to buy prescription eyeglasses, hearing aids, or cosmetic surgery. Medicare Part B (health insurance) helps cover the cost of medically necessary durable medical equipment if a doctor prescribes it for use in the home. People who use Medicare Part A coverage to hospitalize inpatients must still meet their deductible before Medicare pays for any treatment. Original Medicare focuses on short-term care for recovery, rather than ongoing support, so it doesn't cover long-term care, which is often needed to continuously help with daily activities, such as bathing, dressing and eating.
For example, Medicare doesn't cover breast augmentation for cosmetic reasons, but reconstructive surgery after a mastectomy does. Keep in mind that Medicare can include coverage for preventive services, management of transient care (TCM) after hospitalization, chronic care management (CCM) for current illnesses, and discussions about advance care planning, which are crucial for effective health management and avoiding unexpected costs. Medicare is federal health insurance for people age 65 and older and for younger people with disabilities. Medicare Part A (also known as hospital insurance) can generally cover inpatient hospital care, nursing facility care, nursing home care, palliative care, and home health care.
Medicaid offers benefits, such as nursing facility services, home health care services, and assistance paying Medicare premiums and other costs. There you'll find more information about ways to prepare for Medicare, when and how you should enroll, what to do if you plan to work after age 65, options to supplement Medicare, and resources for more information and assistance.
