Wednesday, May 8, 2013

A Explanation of Medicare Part A

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By Vicki Morgan


Part A of Medicare covers qualified inpatient care that is received in a hospital. Medicare Part A will also pay for limited skilled nursing facility care, as well as for some types of home health care and hospice services.

The coverage provided through Medicare Part A would provide of the following:

Hospital - Coverage includes cost of a semi-private room as an inpatient at a hospital, nursing services, and certain other medical supplies and equipment and hospital services. All services are paid for 100% after the insured has paid a deductible of $1,184 in out of pocket expences. Blood - Part A of Medicare covers 100% of the cost of blood transfusions after the first three pints are paid for by the insured.

Skilled Nursing Facility Care - The Skilled nursing facility benefits are provided by Part A includes the cost of a room (semi-private), and the meals for the insured. Medicare Part A also provides coverage of skilled nursing and rehabilitative services, and many other medically necessary skilled nursing facility services and supplies. Medicare doesn't cover long term nursing facility stays, and coverage ceases after a 20 day limit. Home Health Care Services - Home health services are totally covered by Medicare Part A and/or Medicare part B but are limited to reasonable and medically required part-time or intermittent home health aide services, physical therapy, occupational therapy, and speech-language pathology that is ordered by a physician and is provided by a Medicare approved home health agency. Medicare will fund up to 100% of all medically required home healthcare costs

Hospice Care - Part A of Medicare will cover many medications that are used for symptom control and relief of pain in a hospice care situations. It may cover most medical and support services from a Medicare certified hospice agency. Medicare will cover up to 95% of the cost of hospice care services.

What is not covered by Medicare Part A Coverage?

Even though Medicare Part A covers numerous health care expenses, there are still many holes in the coverage. For example, Part A does not offer coverage for private duty nursing. Also, Medicare Part A does not provide coverage for inpatient mental health care in a psychiatric hospital for more than 190 days in an insured's lifetime. Medicare Part A will also not cover long-term care that is considered to be "custodial" or basic in nature, meaning that assistance with basic daily living activities such as dressing and bathing are not covered unless they are part of skilled care services.

While Medicare may not cover all of your needs completely, Medicare supplement plans are available for purchase to help cover the cost of other health care services you might need.

Here is how the Medicare Part A Benefits are Calculated?

Medicare Part A tabulates its coverage in terms of benefit periods and reserve days. A benefit period is considered beginning on the day that a Medicare Part A insured enters the hospital. The insured's benefit period will cease when the enrolled has been released from the hospital for at least 60 consecutive days.

Other than hospice care benefits, a Medicare Part A provides unlimited benefit periods. How do I Qualify for Medicare Part A?

An individual who is suffering from end state renal disease and who requires kidney dialysis or a kidney transplant will also be considered as eligible to enroll in Medicare Part A.

How to Enroll in Part A of Medicare

If a person has not been automatically enrolled, they should enroll in Medicare Part A through their local Social Security office.

All Medicare Part A enrollees must submit an application of enrollment during an "open enrollment" period. Can You Enroll in Medicare Part A If You Have Other Health Insurance Coverage?

If a person has other health insurance, they can also receive Medicare Part A. The primary insurance provider will usually pay the claim up to its coverage limits. Then, the secondary insurance provider will make a payment on the amount that the primary insurer did not pay, if any.

An example, if a insured filed a claim through their primary health insurance carrier and the claim is not paid in a timely manner, the provider may bill Medicare. What is the cost for Medicare Part A?

Most people enrolling in Medicare Part A do not pay a monthly premium. This is the situation if an individual and/or their spouse paid Medicare taxes while they were working. However, if, an individual is not eligible for zero premium Medicare Part A, they may be able to buy this coverage if they meet one of the following conditions:

They are over age 65, are entitled to or are enrolling in Medicare Part B, and they meet United States residency or citizenship requirements

They're under the age of 65 and disabled and their no premium Medicare Part A coverage ended because the individual has returned to their employment.

If a person decides to buy Medicare Part B, they must also be enrolled in Medicare Part A.




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