Medicare is a federal health insurance program designed for those aged 65 or over in addition to younger individuals who have certain disabilities or end-stage renal disease. The program is composed of several parts, each addressing different elements of the health plan. Here we focus on Medicare Part A to provide a broad idea of what it covers.
A Quick Look at Medicare Part A
Inpatient Hospital Care
Inpatient hospital care refers to the care you receive once admitted to a hospital by a physician and spend at least one night in the care of hospital personnel. One example of this is being admitted for planned events such as surgery or specialized neurological or cardiology procedures, but it also applies to unplanned events like illness or traumatic injuries.
Part A of Medicare coverage applies to stays in a general hospital that last up to 90 days per benefit period, and there is an additional lifetime reserve of 60 days. Part A also covers stays in a Medicare-certified psychiatric hospital for up to 190 lifetime days.
Home Health Care
Generally speaking, Medicare considers certain individuals to be homebound if they require the help of another person to leave their home, making it very difficult for them to do so. It also applies in cases where a doctor believes that leaving home will cause illness or general health to worsen. Part A covers the cost of skilled health care for those who are certified as homebound.
Daily care is covered for up to 100 days, and patients may receive unlimited intermittent care. It’s important to note that to qualify for this coverage, patients must have been a hospital inpatient for at least three consecutive days within 14 days of receiving home health care. If these requirements cannot be met, it is possible to qualify for home health care through Medicare Part B.
Skilled Nursing Facility Care
A skilled nursing facility (SNF) is an inpatient medical treatment or rehabilitation center that is staffed with a variety of skilled medical professionals such as physical therapists, licensed nurses, and speech pathologists. SNFs typically function as temporary residences for patients who are undergoing medical rehabilitation and require health care assistance around the clock.
Part A of the Medicare plan covers room, board, and multiple services that are offered at a skilled nursing facility for up to 100 days each benefit period. These include things like wound care, tube feeding, and medication. In addition to being in need of skilled nursing or therapy care, patients must have been a hospital inpatient for at least three consecutive days within 30 days of being admitted to the SNF.
Prescription Drug Coverage
While Medicare Part D covers most prescription drug costs, Part A provides coverage for drugs that patients require during any Medicare-covered stay in a general hospital or skilled nursing facility. Importantly, if a patient is receiving SNF care that is not covered by Part A, costs for necessary drugs may be covered by Part D.
This is a general overview of what is covered in Part A of the Medicare health insurance program. Contact Booker Medicare if you have any additional questions to seek expert assistance in all things related to Medicare.