Medicare Part A Coverage is the basic element of the federal health insurance program that was enacted as an amendment to the existing Social Security legislation in 1965. It was enacted to create an insurance program for people age 65 or older and people with certain disabilities.

Originally, the program was created in two parts -A for hospital coverage, and B for medical coverage. Activity involved with Medicare Part A Coverage includes both copayments and coinsurance applicable in any kind of Medicare-covered situation.

Medicare Part A coverage is hospital insurance. It will provide inpatient healthcare for people in hospitals, nursing homes, or other skilled nursing facilities. It does not include any long-term custodial care. People who meet certain types of requirements may also be eligible for both home health care and hospice care. An important aspect to understand about Medicare coverage is that it does not cover everything. Medicare Part A Coverage helps to pay for the necessary medical services up to your copayment amount. These include:

• Blood – Transfusions are covered for necessary services needed in a hospital, or skilled nursing facility, after receiving the first three pints. Insureds pay the total cost for the first three pints and 20 percent for every pint thereafter.
• Hospital confinement – Medicaid Part A Coverage includes hospital admissions to a semi-private room, general nursing charges, miscellaneous services and supplies as well as meals. Copayment includes none for the first 20 days. Out-of-pocket expenses include $128 a day when confined from 21 to 100 days, plus all of costs for every day past 100.
• Stay in a Nursing Home or Skilled Nursing Facility – Medicare Part A Coverage for people admitted to a nursing home or skilled nursing facility will cover charges if the diagnosis warrants such a stay, for example, if a person had a stroke. A stay in these facilities for rehabilitation purposes would be covered including charges for a semi-private room, the actual rehabilitative and nursing services, as well as meals. Out-of-pocket expenses for a stay in a nursing home or skilled nursing facility are the same as they are for admission to a hospital.
• Medicare Part A Coverage for Hospice Care will partially pay for program services for patients with a terminal illness expecting to live for six months or less. The plan will cover medical care, drugs and support services from certified providers. Copayment for this part of the program is up to you five dollars for prescription drugs and five percent copayment for inpatient care. Room and board fees may not be covered.

Applying for Medicare

People already receiving Social Security or disability benefits should apply for Medicare as well. Typically, people will have been determined eligible for Social Security or disability will receive information about and rolling in the Medicare program several months before that eligibility takes place. If you live within the United States, or the District of Columbia, enrollment is automatic for both parts A and B. Residents of U.S. territories or Puerto Rico must request Medicare coverage beyond Part A. However, participation in Part B requires premium payments and this is optional. People are not yet receiving retirement benefits should contact the Medicare office three months prior to reaching the age of 65 to request information about program coverage. Special enrollment situations include:

• A disabled widow or widower between the ages of 50 and 65 who have not applied for any disability benefits due to receiving other Social Security coverage.
• Government employee who has become disabled before the age of 65.
• Have a spouse or dependent child with permanent kidney failure.
• You once had Medicare coverage but have since dropped it.

Costs Skyrocketing

The annual cost to administer the Medicare program is expected to hit $480 billion. This is more than one fifth of the total national spending on personal healthcare. It also represents 13 percent of the federal budget and is close to 3.5 percent of the nation’s gross domestic product. The program is financed through a combination of payroll taxes and general tax revenues plus interest earned on an investment trust fund set up to help pay for the program.

Participants in the Medicare federal insurance program will receive a red, white, and blue card that will designate the participant and either Medicare Part A Coverage, Part B or both.