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Home » Medicare Part A – What are the Basics to Know to Choose and Enroll in the Right Plan?

Medicare Part A – What are the Basics to Know to Choose and Enroll in the Right Plan?

Medicare is a health insurance program that is eligible for all recipients who are either more than 65 years of age or disabled. It consists of Part A, Part B, Part C, and Part D which you need to understand prior to enrolling in Medicare plans and benefits. 

Medicare Part A generally covers the cost of inpatient hospital stays, hospice care, qualified nursing care, and limited home healthcare services. The majority of the population is automatically eligible for Part A at the age of 65 if they are already accumulating retirement benefits from the Social Security Administration. A person may be eligible for Part A before 65 years of age if he/she has a disability, end-stage renal disease, or any life-threatening health problem. 

Medicare Part A

Medicare Part A – Hospital Care Coverage 

Under this, a person will receive coverage for necessary medical expenses that are important for his/her care, including a semi-private room, nursing services, nutritional meals, medications, and other services from the hospital. This inpatient care is received through critical access hospitals, inpatient rehabilitation agencies, long-term care hospitals, and mental healthcare. 

Benefits of Home Healthcare 

The perks of home healthcare services involving Medicare Part A are offered when considered medically necessary and suggested by the healthcare practitioner. Some home healthcare services may consist of: 

  • Physical therapy 
  • Part-time or long-term nursing care 
  • Occupational therapy 
  • Medical social services 
  • Durable medical equipment, only if it meets certain eligibility requirements 

The home healthcare services must be provided by a Medicare-certified agency and a healthcare practitioner must approve that a person is homebound. A person is said to be ‘homebound,’ if: 

  • He/she cannot leave home or do so would need a substantial effort. 
  • It is medically advised not to leave home without the help of the other person, transportation, or special equipment. 

Medicare Part A – Nursing Home Coverage 

Skilled nursing care is given after a qualifying hospital inpatient stays for a specific illness or injury. To be eligible for such service, the hospital must be a minimum of 3 days. The benefits of skilled nursing care include: 

  • Semi-private room 
  • Skilled nursing care services 
  • Rehabilitation services, if necessary 
  • Medical social services 
  • Medical equipment and supplies utilized in a skilled nursing facility 
  • Transportation services 
  • Dietary counseling 

Medicare Part A – Hospice Coverage 

If a Healthcare practitioner has approved that a person has a terminal illness with an estimated time of six months or less, he/she may be eligible for hospice care coverage. It concentrates on palliative care, not particularly curing the illness. The purpose is to reduce pain and make a comfortable environment for a patient as possible. The benefits may include, but are not limited to: 

  • Doctor services 
  • Pain relief medicines 
  • Durable medical supplies and equipment 
  • Social services 
  • Nursing care 
  • Medical supplies 
  • Homemaker services 
  • Physical therapy 
  • Occupational therapy 
  • Short-term inpatient care, if necessary 
  • Nutritional guidance 

Medicare Part A – Special Enrollment Period 

You can use Medicare’s 5-star Special Enrollment Period to switch from your existing Medicare plan to a 5-star quality rating Medicare program. This is the eight-month period that starts the month after the enrollment or when the other group coverage finishes. Part A coverage will start the first of the month after you enroll and your Medicare receipt/card will arrive within 30 days of your enrollment. 

It is crucial to understand your Medicare coverage choices and their benefits thoroughly to make a feasible selection and receive the best possible care. You can use the Special Enrollment Period once between December 8 and November 30. 

If you would like to take a closer look at some of the Medicare plans with a 5-star rating in your area, consider using the information provided by member satisfaction surveys, plans, and Healthcare providers to gain accurate performance outcomes.