|
 Medicare is a federally sponsored health insurance program for people aged 65 and over, those with certain disabilities, and individuals with permanent kidney failure. In this publication, we are going to focus on Medicare Part A - hospital insurance. We'll talk about the enrollment process; provide you with the most recent premium information, as well as the information on deductibles and coinsurance payments.
Enrolling in Medicare Part A
We've already covered Medicare Eligibility rules in a previous article, but we've never really talked at length about Medicare enrollment. Essentially, Medicare is broken down into three sections or parts. Medicare Part A is for hospital insurance, but it also helps pay for skilled nursing facilities, hospice care and home health care.
Medicare Part B is medical insurance and that's discussed more thoroughly in a separate publication. In 2006, Medicare Part D - which is a prescription drug plan - was introduced.
Medicare Eligibility
You become eligible for Medicare starting on the first day of the month that you turn 65. For example, if you were born on September 15, 1940, then you are eligible for Medicare benefits starting on September 1, 2005. If you are already receiving Social Security benefits then you will be automatically enrolled in Medicare Part A and Part B.
Your enrollment period is a six month timeline that starts three months prior to your 65th birthday. So, going back to our example, if you were born on September 15, 1940, then you will be mailed your enrollment package on June 1, 2005 - three months prior to the month in which you turn 65. The enrollment period would conclude at the end of November 2005.
If for some reason you are not receiving Social Security benefits, then you should call the Social Security Administration at 1-800-772-1213 three months prior to your 65th birthday. You can also visit a local Social Security office and they can help you decide whether or not you should sign up for Medicare.
Medicare Part A Coverage
Medicare Part A is hospital insurance. If one person in the household paid into the Medicare system while working, then neither person in a household would have to pay premiums to receive this insurance coverage. That means most people in the United States do not have to pay to enjoy the benefits if Medicare Part A.
Medicare Part A helps to cover the cost of inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). Part A also helps cover hospice care and some other forms of home health care.
Medicare Part A Premiums
If you or your spouse have worked for at least 40 quarters in Medicare covered employment, then it is very likely that you will not have to pay any Medicare Part A premiums. For those not meeting this requirement, the 2007 and 2008 premiums are listed below:
- If you have 30 - 39 quarters of Medicare-covered employment, then your Part A premium is $226 per month in 2007 and $243 in 2008.
- If you have less than 30 quarters of Medicare-covered employment, then your Part A premium is $410 per month in 2007 and $423 per month in 2008.
Medicare Part A Deductible and Coinsurance
Medicare Part A is hospital insurance that also pays for skilled nursing facilities and some forms of home health care. Medicare breaks down their deductible or coinsurance payments based on a "benefits period."
Deductibles
The Medicare Part A deductible for each benefits period is $992 in 2007 and $1,024 in 2008. This means that each time you are required to stay in the hospital you must first pay the deductible of $992. The deductible is the only out of pocket expense you will have for the first 60 days of any benefits period.
Coinsurance Payments
If your benefits period lasts longer than 60 days, then you are required to pay a Medicare Part A coinsurance amount. For in-patient hospital stays, the coinsurance amounts in 2007 and 2008 are as follows:
- For benefits periods lasting between 61 and 90 days, you are responsible for coinsurance payments of $248 per day in 2007 and $256 per day in 2008.
- For benefits periods lasting between 91 and 150 days, you are responsible for coinsurance payments of $496 per day in 2007 and $512 per day in 2008.
- For benefits periods lasting longer than 150 days, you are responsible for all costs.
In 2007 and 2008, the skilled nursing facility coinsurance amounts - Skilled Nursing Facility Coinsurance - are as follows:
- For benefits periods lasting between 21 and 100 days, you are responsible for up to $124 in coinsurance payments per day. In 2008 the coinsurance payment rises to $128 per day.
You can also purchase additional insurance beyond Medicare Part A and Part B. For more information on those plans, see our article on Medicare Supplemental Insurance. For more complete rules on Medicare Part A insurance, visit the Medicare website.
About the Author - Medicare Part A
Copyright © 2005 - 2007 Money-Zine.com
Buying Insurance Resources on the Web |
Home 
