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 article, we are going to focus on Medicare Part A: hospital insurance. We'll talk about the enrollment process; provide the most recent premium information, as well as deductibles and coinsurance payments.
We've already covered Medicare Eligibility rules in a previous article, but we never 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.
Taxpayers become eligible for Medicare starting on the first day of the month they turn 65. For example, if Bertha was born on September 15, 1952, then she is eligible for Medicare benefits starting on September 1, 2017. Citizens already receiving Social Security benefits will be automatically enrolled in Medicare Part A and Part B.
The enrollment period is a six-month timeline that starts three months prior to an individual's 65th birthday. Therefore, going back to our example, if Bertha was born on September 15, 1952, then she will be mailed an enrollment package on June 1, 2017, three months prior to the month in which she turns 65. Her enrollment period would conclude at the end of November 2017.
If someone is not receiving Social Security benefits, they should call the Social Security Administration at 1-800-772-1213 three months prior to their 65th birthday. Individuals can also visit a local Social Security office for more personal assistance with an enrollment question.
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. This means most people in the United States do not have to pay a monthly premium to enjoy the benefits of Medicare Part A.
This insurance provides coverage for 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.
If an individual or their spouse worked for at least 40 quarters in Medicare covered employment, then it is very likely they will not have to pay any Medicare Part A premiums. For those not meeting this requirement, the 2016 and 2017 premiums are listed below:
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."
The Medicare Part A deductible for each benefits period is $1,288 in 2016 and $1,316 in 2017. This means that each time a hospital stay is required, a deductible of $1,316 will apply. The deductible is the only out-of-pocket expense during the first 60 days of any benefits period.
If a benefits period lasts longer than 60 days, then a coinsurance payment is required. For in-patient hospital stays, the coinsurance amounts in 2016 and 2017 are as follows:
In 2016 and 2017, the Skilled Nursing Facility Coinsurance is as follows:
It's possible to 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: Hospital Insurance (Last Reviewed on November 23, 2016)