PART A
Yes, there are some really big gaps in Medicare that does expose you financially, but before we can even begin the discussion on the gaps in Medicare, let's take a closer look at what Medicare is and how it works. First, Medicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Medicare works with Social Security to form a safety net for American workers who are either to old to work or unable to work because of illness, injury, or disability. Medicare and Social Security are different sides of the same coin, Medicare provides health benefits and Social Security provides income.
What Is Part A and How Much Does Part A Cost?
The different parts of Medicare help cover specific services: Medicare Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care. If you buy Part A, you'll pay up to $451 each month in 2012. In 2013, you'll pay up to $441 each month. But, most people get premium-free Part A.Most people don't pay a Part A premium because they paid Medicare taxes while working. This is called "premium-free Part A." If you aren't eligible for premium-free Part A, you may be able to buy Part A if you meet one of these conditions:
How Do I Get Part A? As stated before, some people get Part A & Part B automatically. You may qualify for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) if one of the following applies to you:
What Does Part A Cover?
To find out if Part A covers something specific, talk to your doctor or other health care provider about why you need a specific service or supplies, and ask if Medicare will cover them. If you need something that's usually covered and your provider thinks that Medicare won't cover it in your situation, you'll have to read and sign a notice saying that you may have to pay for the item, service, or supply. In general, Medicare Part A covers:
What Is Part A and How Much Does Part A Cost?
The different parts of Medicare help cover specific services: Medicare Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care. If you buy Part A, you'll pay up to $451 each month in 2012. In 2013, you'll pay up to $441 each month. But, most people get premium-free Part A.Most people don't pay a Part A premium because they paid Medicare taxes while working. This is called "premium-free Part A." If you aren't eligible for premium-free Part A, you may be able to buy Part A if you meet one of these conditions:
- You're 65 or older, you're entitled to (or enrolling in) Part B, and you meet the citizenship or residency requirements.
- You're under 65, disabled, and your premium-free Part A coverage ended because you returned to work. (If you're under 65 and disabled, you can continue to get premium-free Part A for up to 8.5 years after you return to work.)
How Do I Get Part A? As stated before, some people get Part A & Part B automatically. You may qualify for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) if one of the following applies to you:
- You're already getting benefits from Social Security or the Railroad Retirement Board (RRB).
- You're under 65 and disabled.
- You have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease).
- You live in Puerto Rico and get benefits from Social Security or the RRB.
What Does Part A Cover?
To find out if Part A covers something specific, talk to your doctor or other health care provider about why you need a specific service or supplies, and ask if Medicare will cover them. If you need something that's usually covered and your provider thinks that Medicare won't cover it in your situation, you'll have to read and sign a notice saying that you may have to pay for the item, service, or supply. In general, Medicare Part A covers:
- Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals)
- Inpatient care in a skilled nursing facility (not custodial or long term care)
- Hospice care services
- Home health care services
- Inpatient care in a Religious Non-medical Health Care Institution