Medicare Part A

Medicare Part A New YorkMedicare Part A is also known as “hospital insurance” in Medicare terms. Normally Medicare Part A covers  five main things:

  1. Inpatient care in a hospital
    • You’re admitted to a hospital for inpatient care after you receive an official order from your doctor which says you need inpatient care for treatment of your injury or illness.
  2. Skilled nursing facility care
    • Covers skilled nursing care provided in a Skilled Nursing Facility (SNF) in certain conditions for a short term basis if you meet certain criteria.
  3. Inpatient care in a skilled nursing facility (SNF) (not custodial or long-term care)
    • Nursing homes are not covered by Medicare if that care is custodial. Medicare may cover a SNF if it is deemed medically necessary for you to have skilled nursing care such as changing your bandages.
  4. Hospice care
    • You can get hospice care if you meet certain conditions: meaning you’re terminally ill and have a life expectancy of 6 months or less, accept palliative care for comfort, not treatment of your illness, you agree to hospice care instead of receiving other Medicare benefits.
  5. Home health care
    • In home health services such as intermittent skilled nursing care, physical therapy, occupational therapy, speech pathology, medical social services or intermittent home health aide services.

What Determines Medicare Part A Coverage?

Eligibility for Medicare Part A coverage is determined by 3 main factors:

  1. Federal & State law
  2. National coverage decisions made by Medicare about whether something is or is not covered by Medicare
  3. Local decisions made by companies in each state that process claims for Medicare. These companies may decide whether something is medically necessary and should be covered in a certain area.

What Else Should I Know About Medicare Part A?

In order to be eligible for a Medicare Supplement Insurance Plan, you need Medicare Part A and Part B first. Once you have enrolled in Medicare Part A & B, you’ll select the Medicare Supplement Insurance Plan that is right for you.

Need help navigating your Medicare and understanding the Medicare options available to you? We’re here to help. Our agency has dedicated ourselves to helping Medicare eligible customers understand their Medicare Insurance and helping them find a supplement plan that works for them. Please give us a call.