Medicare Part A 2021
Original Medicare encompasses two main components; Part A and Part B. Seniors aged 65 automatically become enrolled in Medicare Part A, and the majority also have their Part B coverage kick-off at the same time. The same case applies to Medicare Part A in 2021.
Part A is essentially referred to as hospital insurance because it focusses on covering costs attached to inpatient medical care. It handles medical expenses concerning inpatient hospital stays, hospice and nursing care, and the partial cost of home care. That includes instances when you are admitted, undergo surgery, use hospital equipment and supplies like IV fluids, and all other related costs.
Most other Medicare products including Medicare Advantage plans (Part C) and Medicare Supplement plans are required to offer Part A as part of all their covers. The Center for Medicaid and Medicare Services (CMS) administer Original Medicare and they also standardize other Medicare products. They contract private insurance providers to underwrite these Medicare products.
Who is Eligible For Medicare Part A in 2021
Going back to Medicare Part A eligibility, U.S. citizens who have consistently contributed to Medicare through their payroll tax automatically receive coverage once they turn 65. There are a few exceptions when adults below 65 can also receive Medicare Part A coverage. Typically people living with disabilities, those suffering from debilitating illnesses, and people already receiving retirement benefits can access this coverage before they turn 65.
How Much Does Medicare Part A Cost?
Also worth noting is that Part A usually free coverage for seniors who become eligible but there are copays, coinsurance, and deductibles payable on it. Seniors who have not paid Medicare payroll taxes for the required 10-year period or 40 quarters have to pay a monthly premium. Your medical condition and your spouse’s employment history also factor in your calculated monthly premiums.
Those who do not qualify for $0 premium Part A usually pay $458 monthly if they contributed t Medicare through employment taxes for below 30 quarters. Seniors who have contributed to Medicare for between 30 to 39 quarters pay premiums amounting to $252 monthly on Part A.
It is also a requirement for seniors who elect to but Medicare Part A to also purchase Medicare Part B. Seniors also have to meet monthly premium payments for both A and B in this case.
Consult a Medicare agent to find out more about your eligibility for Medicare and whether or not you stand to pay premiums on the plan.
What Medicare Part A Covers
The itemized list of medical costs that Medicare Part A covers include:
- Hospital care related to admission for inpatient medical services. This coverage extends to services received at acute care hospitals, mental health care facilities, inpatient rehabilitation centers, long-term care hospitals, and when participating in clinical research studies.
- Home health services in a limited capacity. This service must be deemed necessary by a medical professional. It includes part-time skilled nursing care, intermittent health aide services, physical therapy, medical social services, occupational therapy, and coverage for durable medical equipment.
- Stays at a Skilled Nursing Facility. The coverage extends to access to a semi-private room, meals, medical social services, skilled nursing services, rehabilitation services, medications while at the SNF facility, ambulance transportation, medical social services, medical equipment, meals, and dietary counseling.
- Hospice care for seniors who have been diagnosed with terminal illnesses. Part of the qualifying criteria to received coverage for hospice care includes agreeing to abandon curative treatments for palliative care focussed on pain relief. These are usually people who have been given six months or less to live.
Worth noting is that these expenses are covered on a copayment and coinsurance basis. That means that a fraction of the cost of treatment falls squarely on your shoulders as well as deductibles.
Part A Under Medicare Advantage And Medigap Plans
It is the main reason why seniors go for Medicare Advantage or Medicare Supplement plans so that they can have more medical expenses covered. These plans handle everything Part A does including the deductibles, copayments, and coinsurance costs.
Some seniors can fare well with Part A and Medicare Part B (outpatient) coverage, but as they start succumbing to aging they often find that they need more assistance with their upcoming medical costs. For instance, they may need more prescription medication and they find that they also need Medicare Part D coverage.
It helps to consult your doctor about your health status and also whether you can receive treatment at their facility using your Medicare cover. Another reason seniors go for Advantage and Supplement plans is because they can access a wider network of coverage. That means that they have more options in terms of hospitals, clinics, doctor’s offices, and nursing facilities where they can seek healthcare services.
Enrolling In Medicare Part A
When you turn 65, your Medicare Part A coverage starts immediately as long as you have contributed to Medicare through payroll taxes. This also applies to people who are eligible for Medicare Part A based on the special factors we have mentioned above. If you do not meet this qualification or other eligibility criteria then you must sign up for Medicare manually.
You typically have seven months, also known as the Initial Enrollment Period (IEP), to sign up for Medicare Part A. It is broken down to cover the three months before celebrating your 65th birthday, the month when you celebrate your birthday, and the three months following your birthday.
Failing to enroll in Medicare during this period means that you will have to wait until the next Open Enrollment Period (OEP). The Medicare OEP falls between the 15th of October to the 7th of December annually.
It is beneficial to talk to a Medicare agent to figure where you fall in terms of eligibility and whether or not you have to pay for Medicare Part A. This will also help you determine if you want to go for Medicare Part A in 2021 bundled up in a Medicare Advantage or a Medigap plan.