Friday, April 26, 2013
A Explanation of Medicare Part A
Part A of Medicare coverage includes qualified inpatient care that is received in a hospital. It will also cover for limited skilled nursing facility care, and 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 $1,184 out of pocket deductible.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 - Skilled nursing facility benefits provided by Part A includes the cost of a room (semi-private), and the insured's meals. Medicare Part A also covers skilled nursing and rehabilitative services, and many other medically necessary skilled nursing facility services and supplies. Medicare does not cover long term nursing facility stays, and coverage terminates after a 20 day stay. Home Health Care Services - Home health services are fully 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 pay up to 100% of all medically required home healthcare costs
Hospice Care - Part A of Medicare will cover a variety medications that are used for symptom control and pain relief in a hospice care facility. It may also provide coverage for 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?
Medicare Part A does cover a numerous health care expenses, there are still many gaps in the coverage. For example, Part A does not cover for private duty nursing. Also, Medicare Part A does not cover for inpatient mental health care in a psychiatric hospital for more than 190 days in an insured's lifetime. Medicare Part A will not cover long-term care that is considered to be "custodial" or basic care, meaning that assistance with basic daily living activities such as dressing and bathing are not funded 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.
How Are Medicare Part A Benefits Calculated?
Medicare Part A calculates its coverage in terms of reserve days and benefit periods. A benefit period is considered to be on the day that a Medicare Part A insured enters the hospital. The insured's benefit period will terminate when the participant has been out of the hospital for at least 60 consecutive days.
Other than hospice care benefits, a Medicare Part A provides unlimited benefit periods. Here is how to 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 do I 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 other Medicare Part A enrollees must submit an enrollment application 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 insurer will usually pay the claim up to its coverage limits. Then, the secondary insurer will make a payment on the amount that the primary insurer did not pay, if any.
As an example, if the insured party filed a claim through their primary health insurance carrier and the claim was 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 age 65 or older, and 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 chooses to buy Medicare Part B, they must also be enrolled in Medicare Part A.
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 $1,184 out of pocket deductible.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 - Skilled nursing facility benefits provided by Part A includes the cost of a room (semi-private), and the insured's meals. Medicare Part A also covers skilled nursing and rehabilitative services, and many other medically necessary skilled nursing facility services and supplies. Medicare does not cover long term nursing facility stays, and coverage terminates after a 20 day stay. Home Health Care Services - Home health services are fully 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 pay up to 100% of all medically required home healthcare costs
Hospice Care - Part A of Medicare will cover a variety medications that are used for symptom control and pain relief in a hospice care facility. It may also provide coverage for 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?
Medicare Part A does cover a numerous health care expenses, there are still many gaps in the coverage. For example, Part A does not cover for private duty nursing. Also, Medicare Part A does not cover for inpatient mental health care in a psychiatric hospital for more than 190 days in an insured's lifetime. Medicare Part A will not cover long-term care that is considered to be "custodial" or basic care, meaning that assistance with basic daily living activities such as dressing and bathing are not funded 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.
How Are Medicare Part A Benefits Calculated?
Medicare Part A calculates its coverage in terms of reserve days and benefit periods. A benefit period is considered to be on the day that a Medicare Part A insured enters the hospital. The insured's benefit period will terminate when the participant has been out of the hospital for at least 60 consecutive days.
Other than hospice care benefits, a Medicare Part A provides unlimited benefit periods. Here is how to 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 do I 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 other Medicare Part A enrollees must submit an enrollment application 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 insurer will usually pay the claim up to its coverage limits. Then, the secondary insurer will make a payment on the amount that the primary insurer did not pay, if any.
As an example, if the insured party filed a claim through their primary health insurance carrier and the claim was 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 age 65 or older, and 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 chooses to buy Medicare Part B, they must also be enrolled in Medicare Part A.
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