Medicare Part A: What It Covers and How to Enroll in Nevada
As you get older, having reliable healthcare coverage becomes increasingly essential. You deserve peace of mind knowing that your medical costs are manageable, particularly if you need intensive inpatient care.
Medicare is a government health insurance program that helps seniors and adults with certain disabilities get coverage for essential medical expenses. Part A is a foundational part of Original Medicare and provides coverage for hospital stays and related expenses.
At Senior Insurance Agency, we help our clients navigate the Medicare enrollment process and find appropriate health coverage. We’re here to support you and provide you with the information you need to make educated decisions.
In this guide, we’ll break down how Medicare Part A works and how Nevada residents can enroll.
What is Medicare Part A?
Medicare Part A and Part B coverage combine to form Original Medicare, which provides healthcare coverage to qualifying beneficiaries at low costs. Part A is hospital insurance, while Part B is medical insurance.
Medicare Part A covers hospital stays and other forms of inpatient care. In addition to traditional hospital stays, this also includes skilled nursing, hospice, and some forms of in-home health care. This differs from Medicare Part B, which covers outpatient services and medical items.
Breaking Down Medicare Part A Coverage
What does Medicare Part A cover? There are several different types of inpatient services that fall under the Part A umbrella.
Inpatient Hospital Care
Medicare Part A is best known for covering inpatient hospital care. Inpatient care is when patients are admitted to a facility for at least one overnight stay. This type of care is often required for serious illnesses or injuries in order to heal properly.
Older adults account for approximately 40% of all hospitalizations, highlighting just how important Part A coverage is.
Part A covers hospital fees for the treatment itself, as well as other associated expenses. This could include lodging fees, meals served during your stay, and any drugs given to you directly in the hospital. Note that Part A does not provide outpatient prescription drug coverage, as this is covered under add-on Part D plans or Medicare Advantage plans.
Skilled Nursing Facility Care
Skilled nursing facilities provide rehabilitation and ongoing medical care after a stay in the hospital. Hospital patients are often transferred to skilled nursing facilities when they aren’t yet ready to return home.
Part A covers skilled nursing after a qualifying hospital stay of at least three inpatient days. In most cases, you must enter the skilled nursing facility within 30 days of your hospital stay, as directed by your doctor.
Note that skilled nursing is different from long-term custodial care, which Medicare Part A does not cover. Custodial care provides help with personal care, such as bathing, dressing, and eating, in addition to medical care.
Hospice Care
Medicare Part A also covers hospice care or palliative care. This form of care is for patients with serious medical conditions who are nearing the end of their life. It focuses on relieving symptoms and keeping the patient comfortable. This form of care can happen in your home or at a hospice care center.
Part A covers a variety of services associated with hospice care, including pain and symptom management, blood transfusions, and drugs administered while in hospice. Part A also provides some support services for the patient’s family members.
To qualify for hospice care coverage, both your hospice and primary care doctors must certify that you are terminally ill, and you must sign a form consenting to palliative care.
Home Health Care
Medicare Part A helps cover home health services in certain situations. These services are particularly helpful for patients with mobility issues who cannot leave their homes.
Some examples of covered services include part-time skilled nursing care, physical therapy, occupational therapy, or speech-language services.
To qualify for home health coverage, a doctor must certify that this care is medically necessary. Medicare Part A does not cover full-time home health care services must be “intermittent” to qualify for coverage.
Enroll in Nevada’s Medicare Part A!
How to Enroll in Medicare Part A Coverage in Nevada
Beneficiaries can enroll in Medicare Part A at age 65 or as part of disability benefits. Here’s how to do so:
Automatic Enrollment
Some beneficiaries are automatically enrolled in Medicare when they meet certain conditions. People who already receive Social Security or Railroad Retirement Board benefits will be automatically enrolled when they turn 65.
People who are under the age of 65 and have already received disability benefits for 24 months will also be automatically enrolled in Original Medicare.
Manual Enrollment
If you don’t qualify for automatic enrollment, you will need to enroll in Original Medicare on your own. You can do this when you turn 65 or if you develop a certain qualifying condition, such as end-stage renal disease.
You can sign up for Medicare by filling out forms on the Social Security Administration website, by calling the SSA, or by visiting an SSA office. A Medicare insurance agent can also help you through the process.
To enroll, you will need documents such as your birth certificate and proof of residence. You will also need access to your recent tax and earnings information.
Enrollment Periods
For most beneficiaries, the first opportunity to enroll in Medicare Part A is during the initial enrollment period (IEP), which starts three months before your 65th birthday. This includes your birthday month, and continues for three months afterward.
If you miss your IEP and qualify for premium-free Part A, you can still enroll at any time. If you do not qualify for premium-free Part A, you will need to enroll during a special enrollment period to avoid penalties.
Costs Associated With Medicare Part A
Most people will qualify for premium-free Part A, which means you won’t need to pay a monthly premium for coverage. However, you will still need to pay coinsurance, copays, and deductibles associated with Medicare Part A.You will only need to pay a premium for Part A if you and your spouse did not pay enough Medicare taxes while working. According to the Centers for Medicare and Medicaid Services, only 1% of Part A beneficiaries pay a premium. Premiums are currently set at $278 or $505 per month, depending on the amount of taxes you paid while working.
Get Started with Medicare Part A Now!
Need Guidance on Medicare Part A? We’re Here to Help
Understanding how Medicare Part A works is crucial for seniors approaching age 65. It’s one of several key components of the broader Medicare program and provides essential coverage for inpatient services. Enrolling in a Medicare plan can help you get the healthcare services you need at reasonable prices.
If you’re interested in learning more about Medicare Part A and other types of Medicare coverage, Senior Insurance Agency can help. Our team of knowledgeable Nevada-based insurance specialists helps clients learn about Medicare plans, make informed decisions, and navigate the enrollment process. Check out this blog post to learn more, and reach out to our team for personalized guidance and support.
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FAQs About Medicare Part A in Nevada
Most people pay $0 monthly for Part A, regardless of which state they are in. Those who did not pay Medicare taxes while working may need to pay a monthly premium for Part A.
Most people will have 100% of monthly premium costs covered with Part A. However, Medicare Part A does not cover 100% of your inpatient medical costs.
Emergency room visits are not considered inpatient care and are covered under Medicare Part B. However, Medicare Part A covers hospital stays that last more than one night.
Medicare Part A does not cover outpatient care or custodial care. It also does not cover inpatient services that happen outside of the United States.