What Is Aetna Medicare Part A?
Medicare Part A is a health insurance plan funded and administered by the federal government. Together with Medicare Part B, it makes up what’s called “Original Medicare.” Most people who are 65 or older and some people younger than 65 are eligible for Medicare Part A coverage.
Learn more about Medicare Part A coverage today.
What Does Medicare Part A Cover?
Your coverage may vary depending on where you live, but Medicare Part A coverage can be divided into four main areas:
Inpatient Hospital Care
If you’re eligible for Medicare Part A, you may receive coverage for a number of inpatient hospital services and supplies, such as:
- In-patient medical or surgical treatment
- Semi-private room stays
- Nursing services
- Drugs and medications that are part of your inpatient treatment
- Hospital meals
- Mental health care
- Participation in qualifying clinical research studies or “demonstrations”
Nursing Home Care
Usually, Medicare Part A covers your services at a skilled nursing facility (SNF) after any Medicare-covered inpatient stay at a hospital of three days or more. Examples of covered services may include:
- Semi-private room
- Medically necessary rehabilitation services
- Meals
- Dietary counseling
- Medical social services
- Drugs and medications
- Medical equipment and supplies
Home Health Services
If you are “homebound” and your doctor determines you need home health care services, Medicare Part A may help pay for them. Some covered services may include (but are not necessarily limited to):
- Physical or occupational therapy
- Part-time skilled nursing care
- Durable medical equipment ordered by your doctor
- Home health aide services
- Medical social services
- Speech-language pathology services
Keep in mind, the following services and supplies are NOT covered:
- 24-hour home care, meals, or housekeeping services that are unrelated to your treatment
- Personal care services, such as bathing, dressing, or preparing meals if it’s the only care you need
Hospice Care
If your doctor diagnoses you with a terminal illness or condition and estimates that you have six or fewer months to live, Medicare Part A may cover your hospice care. This may include (but is not necessarily limited to):
- Medical treatment (not treatment to cure your condition, but to decrease symptoms or ease suffering)
- Nursing care
- Pain management services
- Pain relief medications
- Medical supplies
- Durable medical equipment
- Social services
- Hospice aide services
- Housekeeping services
- Physical or occupational therapy
- Meals
- Dietary counseling
- Short-term respite care
To find out whether a health care service you need is covered by Medicare Part A, talk to a licensed agent. Your agent can tell you whether the service is covered by Medicare and which health care providers offer it in your area.
What Are the Costs of Medicare Part A?
Most people who are eligible for Medicare Part A don’t have to pay a monthly premium. Some people call this “premium-free” Medicare Part A.
If you’re 65 or older
You may qualify for premium-free Medicare Part A coverage if one of the following describes your situation:
- You receive Social Security or Railroad Retirement Board benefits
- You’re eligible for Social Security or Railroad Retirement Board benefits, but you haven’t filed for them yet
- You or your spouse worked for the government in a job that was covered by Medicare
If you’re less than 65
You may still qualify for premium-free Medicare Part A coverage if one of the following situations applies to you:
- You received Social Security or Railroad Retirement Board disability benefits for 24 months
- You suffer from end-stage renal disease (ESRD)
- You suffer from amyotrophic lateral sclerosis (also called Lou Gehrig’s disease or “ALS”)
If you need to purchase Medicare Part A, the maximum monthly premium for the year 2020 is $458. You may pay less, depending on how long you’ve paid Medicare taxes. Generally, if you choose to buy Medicare Part A coverage, you must also have Medicare Part B insurance and pay a Part B premium, too.
Is There a Medicare Part A Deductible?
The deductible for Medicare Part A health insurance is $1,408 per benefit period for inpatient hospital care.
You may also have to pay coinsurance for your care. Your coinsurance goes according to the following scale:
- $0 per benefit period for the first 60 days you spend in an inpatient care facility
- $352 per day if you spend 61 to 90 days in an inpatient care facility during your benefit period
- $704 per “lifetime reserve day” if you spend 91 or more days at an inpatient care facility during your benefit period
Am I Eligible for Medicare Part A?
Generally speaking, you’re eligible for Medicare Part A benefits if one or more of the following descriptions applies to you:
- You’re 65 years or older and are a US citizen or have been a US permanent legal resident for at least five years in a row
- You’re eligible for retirement benefits
- You’re currently receiving government disability benefits
- You suffer from end-stage renal disease (also known as catastrophic kidney failure or “ESRD”)
- You suffer from amyotrophic lateral sclerosis (also called Lou Gehrig’s disease or “ALS”)
When Can I Enroll in Medicare Part A?
If you’re enrolling in Medicare for the first time, you can enroll during your Initial Enrollment Period (IEP). Your Initial Enrollment Period begins three months before the month of your 65th birthday and ends three months after your birth month.
If you’re already on Original Medicare and want to enroll in an Aetna Medicare Advantage plan, you can do so during the Annual Enrollment Period (AEP), which starts October 15 and ends December 7 every year.
Under some circumstances, you may be able to enroll in an Aetna Medicare Advantage plan during a Special Enrollment Period. For example, if you’ve recently moved or if you’re currently living in a nursing home. Talk to one of our licensed agents today to see if your life circumstance applies.