While Medicare Part A covers many aspects of your healthcare needs, it’s not a magic cure-all. Created in 1965 as part of the original Medicare legislation, Medicare Part A includes:
- Inpatient hospital care
- Limited home healthcare
- Skilled nursing facility care, in cases where custodial care isn’t the only care necessary
- Hospice care
In this blog post, we’ll take a closer look at the things covered by Medicare Part A.
Who is eligible for Medicare Part A?
You can receive Medicare Part A coverage if:
- You are 65 and older and a U.S. citizen or permanent legal resident for at least five years in a row.
- You already receive retirement benefits
- You are disabled and receive disability benefits
- You have end-stage renal disease or ALS (Lou Gehrig’s Disease)
Hospital Coverage
Medicare Part A covers things that are critical to your hospital stay, including meals, nursing care, medications and other supplies and services.
It applies to stays in acute care and critical access hospitals, inpatient rehab, long-term care hospitals, mental health care and qualifying clinical research studies.
Note that Medicare Part A doesn’t cover private rooms – unless they are a medical necessity – private-duty nurses, personal care supplies and extra charges like phones or TV. It does not cover the cost of blood, unless of course the hospital gives you blood from a blood bank that they get for free.
Home Health Care
Medicare Part A covers home health care services when ordered by your doctor because they are medically necessary.
These services can include:
- Physical and occupational therapy
- Speech pathology
- Part-time/intermittent skilled nursing care
- Part-time/intermittent home health aides
- Medical social services
- Durable medical equipment
Note that if your doctor orders durable medical equipment and it meets eligibility requirements, this equipment is covered under Medicare Part B.
Medicare Part A does not cover 24-hour home care, meals or homemaker services unconnected to your treatment, nor does it cover personal care services like bathing and dressing if this is the only care required.
Nursing Home Coverage
Medicare Part A covers stays in skilled nursing facilities following a qualifying inpatient hospital stay for a related injury or illness.
You must first stay in the hospital for at least three days, starting the day you’re formally admitted. The day you’re discharged will not count towards the three-day minimum, nor does time spent in the hospital under observation.
Skilled nursing care must be given at a Medicare-approved facility. Medicare-covered skilled nursing care can include:
- Semi-private rooms
- Meals and dietary counseling
- Skilled nursing services
- Rehabilitation services, if they are medically necessary to treat your illness
- Medical social services
- Medications, medical supplies and equipment while in SNF care
- Ambulance transportation to nearest provider if you need services not provided at the SNF
Medicare Part A Hospice Coverage
Patients who have been given a terminal diagnosis and have six or fewer months to live may be eligible for hospice care, where the focus is on palliative care – making the patient comfortable as possible – rather than curing an illness.
Patients can qualify for Medicare Part A hospice care if:
- They are enrolled in Medicare Part A.
- Their doctor or health care provider has certified that they are terminally ill with six or fewer months to live.
- They’ve given up curative treatments in favor of palliative care.
- They receive hospice care from a Medicare-approved facility.
These services can include:
- Doctors services and nursing care
- Pain relief medication
- Social services
- Durable medical equipment and medical supplies
- Hospice aide and homemaker services
- Physical and occupational therapy
- Dietary counseling
- Short-term inpatient care (for managing pain or symptoms)
- Short-term respite care
In hospice care, Medicare Part A may also cover some costs that aren’t normally covered under Medicare, such as spiritual or grief counseling.
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