When you turn 65, one of the first things you have to do is sign up for Medicare Part A. But what does that mean? In 2022, what does Medicare Part A cover?
Part A of Medicare pays for your care while you are an inpatient in a hospital, a critical access hospital, or a skilled nursing facility. It also helps pay for care in a hospice and some home health care. To get these benefits, you must meet certain requirements. In 2022, the out-of-pocket cost for a Part A hospital stay will be $1,556.
We’ll look at what Medicare Part A pays for and what it doesn’t. We will also tell you how to make the most of your coverage. So whether you’re turning 65 in a few months or a few years, keep reading to learn more about Medicare Part A.
Does Everyone Automatically Get Medicare Part A?
After 24 months of getting Social Security or certain disability benefits from the RRB, you are automatically eligible for Parts A and B. After you sign up for Medicare, you’ll get your card in the mail 3 months before you turn 65 or 25 months after you become disabled.
You will need to apply for Medicare if you have End-Stage Renal Disease (ESRD).
Most people who are eligible get Part A for free, but some have to pay a premium. You might have to pay a Part A premium if:
- You didn’t pay Medicare taxes while working and are not otherwise eligible for free Part A coverage.
- You’re a Medicare beneficiary under age 65 who has ESRD and you’ve had a kidney transplant or need dialysis.
- You’re a Medicare beneficiary under age 65 and purchased Part A coverage.
- You’re a Medicare beneficiary of any age who’s voluntarily enrolled in Part A coverage.
Medicare Part A covers:
- Care for hospital patients
- Hospitals with limited access
- Skilled nursing facilities, given that custodial care is not the sole type of care needed
- Hospice care
- Some home health care services
Keep in mind that several of the above advantages are only available in particular scenarios and under certain circumstances.
What is Medicare Part A Deductible for 2022?
In 2022, the Part A deductible will be $1,556. From $1,484 in 2021, this is a $72 rise. Being a Medicare Part A beneficiary, you are also responsible for paying the inpatient hospital deductible. Medicare Part A has a deductible for inpatient hospital care that patients are responsible to pay for the first 60 days this type of coverage is used during a benefit period. In 2022, beneficiaries will have to pay coinsurance of $389 per day for the 61st to 90th day of a hospital stay, which is up from $371 in 2021, and $778 per day for lifetime reserve days, which is up from $742 in 2021. In 2022, beneficiaries in skilled nursing facilities will have to pay $194.50 (nearly $185) per day for extended care services from day 21 to day 100 of a benefit period.
What is Not Covered Under Medicare Part A?
The following are not paid for by Medicare Part A:
- Unless absolutely necessary, a private hospital or nursing home room.
- Private nursing care.
- Care received while an inpatient in a hospital that is not Medicare certified.
- Expenses associated with living in a nursing home or hospital.
- Comforts of home, like a TV and a phone, provided in your room.
- Home health services beyond Medicare’s covered services.
- Outpatient prescription drugs.
- Custodial or long-term care. Rehab stays in a nursing home, home health care, and hospice care may also be partially covered by Medicare Part A.
There is a deductible that must be paid before Medicare Part A coverage kicks in.
Does Medicare Part A Cover 100 Percent?
Most in-hospital care is paid for by Medicare Part A. Medicare Part A will cover 100% of your stay in a hospital, hospice, or skilled nursing facility for the first 60 days after you reach your yearly deductible.
Medicare Part A does not cover custodial or long-term care, meaning any type of personal care such as help with bathing, dressing, eating, or using the restroom. Medicare also does not cover cosmetic surgery or any type of routine dental, vision, or hearing care. However, routine dental, vision, and hearing care may be covered by some Medicare Advantage plans.
What Happens if You don’t Enroll in Medicare Part A at 65?
It’s highly unlikely that you’ll incur any costs associated with enrolling in Medicare Part B after the deadline if you qualify for a premium subsidy for Part A. Add 10% to your current monthly premium to account for the Part A penalty. If you are eligible for Medicare Part A and you wait longer than the enrollment period to sign up, you will be charged the late enrollment fee.
Medicare Part A enrollment begins three months prior to the month you turn 65 and continues for a total of seven months. When you turn 65 and are already receiving Social Security benefits, you will be enrolled in both Parts A and B of Medicare automatically.
Those who put off enrolling in Medicare Part A after the Initial Enrollment Period ends may be subject to a late enrollment penalty. If you are eligible for Medicare Part A but wait more than 12 months to enroll, you will be charged 10% of the standard yearly premium for each year you missed out.
If you are already covered by another health insurance plan or are eligible for a Special Enrollment Period when you turn 65, you will not be subject to the late enrollment penalty. Examples of other health insurance include employer-sponsored health insurance, COBRA continuation coverage, Medicare Advantage Plan, Medicaid, TRICARE, and certain types of Veterans Affairs health care coverage. If you want to enroll in Medicare Part A and have other health insurance, you should contact your benefits administrator to see how enrolling in Medicare will affect your other coverage.
Part A of Medicare can be joined during the annual General Enrollment Period, which runs from January 1 to March 31. This is because many people delay signing up for Medicare until they are first eligible because they are already covered by other health insurance. Medicare Parts A and B coverage can begin as early as July 1 if you enroll during the General Enrollment Period.
Is Medicare Part A Free at Age 65?
It’s likely that you won’t have to pay a premium for Medicare Part A if you or your spouse have already paid into the system for at least 10 years. Part A of Medicare is available to those who do not qualify for premium-free coverage but are willing to pay a monthly fee to do so.
If you or your spouse have worked and paid Medicare taxes for longer, your monthly Part A premium could be as low as $274 or as high as $499 in 2022. The Part A premium is $274 if you have 30-39 Medicare-covered quarters. With less than 30 quarters of employment qualifying for Medicare coverage, the standard Part A premium is $499 per year.
If you are subject to the Medicare recapture tax, you may also be required to pay a higher Part A premium. The Medicare recapture tax is a federal income tax that applies to higher-income Medicare beneficiaries who enroll in Part A late. If your AGI from two years ago was higher than a certain threshold, you may also have to pay a monthly adjustment amount based on your income.
To see if you’ll have to pay the Medicare recapture tax, your Medicare agent can give you an estimate of your Part A and Part B premiums.
Does Medicare Supplement Cover Part A Deductible?
Most Medigap policies pay for at least half of your Part A deductible. Additional Medicare supplement insurance pays for your Part A deductible, copayment, and hospitalization costs for an additional 365 days after you’ve paid your Medicare premiums for that year. Medicare supplement plans that cover the Part A deductible are typically more expensive.
Is Medicare Part A Mandatory?
Medicare Part A is not mandatory, but most people choose to enroll in it because it helps cover important costs associated with hospitalization and other medical care. If you don’t enroll in Medicare Part A, you must withdraw from all federal benefit programs. You will no longer be qualified to receive benefits from the Social Security Administration or the Railroad Retirement Board.
