Medicare Part A - Hospital Insurance
Medicare Part A covers you if you’re a patient in a hospital or in a skilled nursing facility. Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. Part A coverage is available for most people for no additional premium and is funded by Social Security payroll taxes.
Hospital Services Under Medicare Part A
- Medicare Part A helps pay for a semi-private room, meals and certain other services for up to 90 days per benefit period. A benefit period begins the day you go into a hospital or skilled nursing facility and ends when you haven't received any inpatient or skilled care in a skilled nursing facility for 60 days in a row.
- If you go into a hospital or skilled nursing facility after one benefit period has ended, a new one begins.
Skilled Nursing Facility Care Under Medicare Part A
- Medicare Part A helps pay for up to 100 days for eligible services in a Medicare-certified facility after a hospital stay of at least three covered days.
Hospice Care Under Medicare Part A
- Costs for services related to a terminal illness are covered by hospice care. Services not related to the terminal illness are covered by other payment methods from Medicare.
- Hospice coverage includes drugs, medical and support services from a Medicare-approved hospice and other services not otherwise covered by Medicare such as grief counseling.
- Hospice care is generally available for people with a terminal illness who are expected to live six months or less if the disease runs its normal course.
Medicare Part A Eligibility
- Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States.
- Medicare Part A coverage is free for most people because it is funded by Social Security payroll taxes, but Medicare Part A does have a deductible and copayments.
Medicare Part A Enrollment
- People collecting Social Security are enrolled in Medicare Part A automatically on the first day of the month they turn 65.
- If you don’t receive an enrollment notice, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
- If you’re not collecting Social Security benefits you will need to sign up for Medicare Part A. You should contact Social Security three months prior to, during the month of, or three months after your 65th birthday to sign up for Part A.
- The enrollment age for Medicare is age 65 whether you are retired or not. If you don’t receive an enrollment notice, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. (Railroad retirees should call 1-800-808-0772; TTY users call 312-751-4701; or visit the U.S. Railroad Retirement Board Web site* )
Medicare Part A (Hospital Insurance)
|Service||In 2012 You Pay||In 2012 Medicare Pays|
|First 60 days of an admission||You pay $1,156† each benefit period.||Medicare covers the rest.|
|61st to 90th day||You pay $289† a day.||Medicare covers the rest.|
|91st to 150th day**||You pay $578 † a day.||Medicare covers the rest.|
|Beyond 150 days||You pay 100% of expenses.||Medicare pays nothing.|
|Skilled Nursing Facility Care||In 2012 You Pay||In 2012 Medicare Pays|
|First 20 days||You pay nothing.||Medicare covers 100%.|
|21st to 100th day||You pay $144.50† a day.||Medicare covers the rest.|
|Beyond 100 days||You pay 100% of expenses.||Medicare pays nothing.|
† This is the 2012 deductible and copay for Medicare Part A (Hospital and Skilled Nursing Facility care) and may change on January 1, 2013.
** After 90 consecutive days of hospitalization, Medicare benefits are paid from a one-time lifetime reserve of 60 days that are not renewable each benefit period.
Blue Cross and Blue Shield of Texas is not connected with or endorsed by the US Government, the Federal Medicare Program or any other governmental agency.
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