Medicare - How Does It Work? Part A
Service benefits for Medicare Part A
- Semi-private hospital room and board
- Skilled nursing and rehabilitative services
- Blood transfusions during hospital stay
- Pain relief and symptom management during the hospital stay
- Physical, occupational and speech therapy
- Medical social services
- Skilled nursing facility care
- Part-time in-home skilled nursing care
- Hospice services
Medicare pays for 90 days of hospital care “per spell of illness,” plus an additional lifetime reserve of 60 days. A single “spell of illness” begins when the patient is admitted to the hospital or other covered facility, and ends when the patient has gone 60 days without being readmitted to a hospital or other facility. There is no limit on the number of spells of illness. However, the patient must satisfy the deductible before Medicare begins paying for treatment. Medicare will not pay for treatments or procedures that it considers medically unproven or experimental.
Part A is premium free for most people (those who have worked or who have/had a spouse who worked at least 10 years in Social Security and/or Medicare covered employment). However, people enrolled in Medicare must pay deductible fees for services. For hospitalization, Medicare Part A has a deductible for each hospital stay during the year.
If you are hospitalized, Part A could potentially pay secondary to Pace University coverage through active employment. Contact Medicare for more information about secondary coverage through Parts A, B and/or D.
When to Apply for Medicare Part A
Many individuals apply for Medicare Part A when they are first eligible since it is free. There is a 7 month Initial Enrollment Period – 3 months prior to your 65th birthday, the month you turn 65, and the 3 months following your 65th birthday. It is best to enroll on-line or by phone three months prior to the month in which you turn 65 in order for coverage to be effective the month you turn 65. Persons who wait until the last 4 months to sign up will have delayed effective dates.
Note: If a person does not sign up for Part A and/or B when first eligible, they may sign up during a General Enrollment Period which runs from January 1 through March 31 of each year. Coverage becomes effective July 1.
How to Apply for Medicare Part A
- Apply online at Social Security
- Visit your local Social Security Office
- Call Social Security at 1-800-772-1213
Note: Original Medicare (Parts A and B) does not provide coverage for services rendered outside of the United States. See Medicare Supplemental Insurance (Medigap) for additional coverage options.