What is Hospital Insurance (Part A)?

Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care.

What is Covered?

• Hospital stays
  • Semi-private room, meals, nursing, supplies, medication
• Skilled Nursing Facility
  • Up to 100 days with 3 day inpatient hospital stay
  • Skilled level care only (short term, rehabilitative)
• Home Health Care
  • Part time skilled nursing care, therapies, aide services, supplied
• Hospice
  • Pain and symptom relief and supportive services for terminally ill and their families

Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition.

If you are in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare.

Medicare Coverage is Based on Three Main Factors

1. Federal and state laws.
2. National coverage decisions made by Medicare about whether something are covered.
3. Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

How Much Does Part A Cost?

Most people do not pay a Part A premium because they paid Medicare taxes while working. This is called "premium-free Part A."

If you are not eligible for premium-free Part A, you may be able to buy Part A if you meet one of these conditions:

• You are 65 or older, and you have (or are enrolling in) Part B, and you meet the citizenship or residency requirements.
• You are under 65, disabled, and your premium-free Part A coverage ended because you returned to work. (If you are under 65 and disabled, you can continue to get premium-free Part A for up to 8.5 years after you return to work.)

Two Ways to Find Out if Medicare Covers What You Need

1. Talk to your doctor or other health care provider about why you need certain services or supplies, and ask if Medicare will cover them. If you need something that is usually covered and your provider thinks that Medicare will not cover it in your situation, you will have to read and sign a notice saying that you may have to pay for the item, service, or supply.
2. Find out if Medicare covers your item, service, or supply.

If you have questions about Medicaid, you can call your State Medicaid office for more information.

Visit www.medicare.gov/contacts or call 1-800-MEDICARE (1-800-633-4227) to get the telephone number. TTY users should call 1-877-486-2048.