When you are new to Medicare, it's important to understand the Parts of Medicare. Specifically, what's covered and what's not, what the costs are to you, if you are eligible for benefits and when you are eligible for benefits. Don't worry, I'll keep this simple and quick.
First, Medicare Part A primarily covers your inpatient hospital costs and is often called hospital insurance. It also covers a limited amount of skilled nursing care and hospice care.
If you need inpatient services, first you will pay a deductible ($1,364 in 2019). Then, assuming you are in the hospital for less than 60 days during a benefit period, Medicare will pay for the remainder of the approved services. However, if you are in the hospital for an extended period of time, daily co-pays (as much as $335 per day in 2019) will also be required. Although Medicare does pay a significant amount of the hospital costs, you can see the amount you may have to pay can be significant as well. It’s a good idea to have a Medicare Supplement, Medicare Advantage plan or some other type of coverage to help cover those costs.
Most people think Medicare will pay for all of your skilled nursing care costs but it is actually very limited. You may be entitled to some skilled nursing benefits if you have a qualifying hospital stay prior to needing care but it will not be full coverage. A summary of the skilled nursing care benefits provided by Medicare can be found here.
Keep in mind, the deductibles and daily copay amounts for Medicare services change each year.
Do I qualify?
As long as you have worked 40 quarters, or approximately 10 years, you should be eligible for Medicare Part A at no cost to you. The Medicare taxes you have paid during your working years cover the premium. You may still be eligible for Part A if you did not work that long, however there will be a monthly premium.
When am I eligible?
You are eligible for Part A when you turn 65 regardless if you are retiring or not. Although you should be enrolled automatically, you may want to contact your Social Security office to confirm.
Now that you are more comfortable with what Medicare Part A covers, it’s time to move on to Medicare Part B.
Related Post: What is Medicare Part B and what does it cover?
If you prefer, you can also watch our simple Introduction to Medicare videos.
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