People who are eligible for the Medicare program must make certain choices about the types of coverage they want. Generally, those who are eligible can take advantage of Medicare Part A at the very least. Medicare Part A benefits provide coverage for inpatient hospital care, certain types of preventative and home health care, and nursing facility care.
All United States citizens who are over 65, retired, and have paid employment or self-employment taxes at some point during their lives are eligible to apply for Medicare Part A benefits. These benefits are part of the hospital insurance section of Medicare. Along with Medicare Part B, these comprise the original Medicare program set up and administered by the federal government. Medicare Part A benefits can also be obtained via a private insurance company.
Medicare Part A benefits range from certain types of preventative healthcare, to hospital and nursing home care. Note that Part A does not cover doctor’s visits, nor does it cover outpatient hospital care. These services, along with most types of preventative healthcare, are covered by Medicare Part B.
Services covered by Medicare Part A include the costs of surgery, such as surgeon and technical staff costs, anesthesia and other drug costs, blood transfusions, and inpatient hospital care before and after surgery. In general, hospital inpatient care is covered as long as a doctor confirms that hospital care is needed, and the hospital accepts Medicare patients.
Some treatments can be covered by either Medicare Part A or Part B depending on circumstances. Chemotherapy and radiotherapy, for example, are covered by Medicare Part A benefits when these treatments are received on a hospital inpatient basis. If the treatment is carried out on an outpatient basis in a hospital, clinic, or doctor’s office, it is covered by Medicare Part A. Treatments such as dialysis and diabetes care are covered by Part A if they are performed on an inpatient basis in hospital; otherwise they are covered by Part B.
Home healthcare services are covered by Medicare Part A provided that several criteria are met. Medicare eligibility criteria for home healthcare include doctor approval for home care, the use of a Medicare-approved care agency, and the requirement for skilled nursing care, physical or speech therapy, or ongoing occupational therapy. Finally, the person requiring care must be housebound, defined as being unable to leave the house without assistance.
Medicare Part A covers nursing hospice care in certain cases. Eligibility criteria require that the patient choose to receive palliative rather than curative care, and that the patient’s doctor confirm that the patient has less than six months to live. The patient must also sign a statement confirming their treatment choice.
Medicare Part A benefits also cover certain types of mental health services. Generally, all inpatient mental health care is covered by Part A. These services may be received in hospitals, psychiatric units in hospitals, or in specialized psychiatric hospitals.
Part A Medicare costs are generally minimal, apart from reasonably small co-pays for hospital and nursing care facility visits. Generally these co-payments are under $1,000 US Dollars (USD) for a single period stay. People who choose to purchase Medicare plans from private insurance companies will pay higher costs, including premiums and possibly other out-of-pocket expenses.
