What is Medicare Part A?
Medicare Part A, also known as hospitalization insurance, is a part of Original Medicare provided by the federal government. It is recommended that you sign up for Part A when you turn 65, even if you do not plan to retire immediately.
What Does Medicare Part A Cover?
Medicare Part A helps cover the costs of hospital care, skilled nursing facility care, some nursing home care, hospice and home health care services. It doesn't include prescription drug coverage, long-term care or routine dental and vision care.
Eligibility for Medicare Part A
You become eligible for Medicare Part A starting three months before your 65th birthday, known as your initial enrollment period (IEP). If you already receive benefits from Social Security or the Railroad Retirement Board (RRB), you will be automatically enrolled in Original Medicare on the first day of the month you turn 65.
To be eligible for Part A, you must:
- Have both Medicare Part A and Part B. (Note: You must continue to pay your Medicare Part B premium once you enroll.)
- Be a permanent Michigan resident and reside in our service area for at least six months of the year.
You can't be denied for pre-existing conditions unless diagnosed with end-stage renal disease (ESRD). In this case, see the Medicare & You handbook for additional eligibility opportunities.
When can you enroll in Medicare Part A?
Initial Enrollment Period (IEP): This period includes the three months before and after your birthday, along with your actual birthday month. During this time, you can apply for different Medicare plans, including Part A. If you're already receiving benefits from Social Security or the RRB, you'll automatically be enrolled in Original Medicare (Parts A and B) on the first day of the month you turn 65. Watch for your red-white-and-blue Medicare card to arrive in the mail. Enrolling during this period can prevent any delays in coverage.
Enrolling for Part A during this period may be beneficial, as it can prevent any delays in coverage.
Annual Election Period (AEP): The annual election period runs from October 15 to December 7. During this time, you can make necessary changes to your supplemental Medicare coverage, reevaluate your current and future health care needs, and ensure your plan is a good fit for the upcoming year.
You can also change to a different Medicare Advantage or MAPD (Part D) plan or return to Original Medicare, provided you were previously enrolled in an Advantage or MAPD plan.
Special Enrollment Period (SEP): In some situations, you’ll have a special enrollment period during which you can change your Part C or D plans, or switch back to Part A.
How to apply for Medicare Part A
If you are in an enrollment period for Medicare, you can obtain Part A by:
- Calling the Social Security Administration at 800.772.1213 (TTY: 800.325.0778)
- Visiting your local Social Security office
- Signing up at ssa.gov
Can I buy Medicare Part A coverage?
If you or your spouse paid Medicare taxes while working, actually obtaining Part A coverage may not cost anything. If you aren't eligible for premium-free Part A, you may be able to buy a Part A plan if you meet one of the following conditions:
- You're 65 or older and you have (or are enrolling in) Part B and meet the citizenship and residency requirements.
- You're under 65, disabled, and your premium-free Part A coverage ended because you returned to work. In this case, you can continue to get premium-free Part A for up to 8 ½ years after returning to work.
What is the Deductible for Medicare Part A?
When receiving hospital-based care through Part A, there is usually a deductible that needs to be paid before the plan itself kicks in. The deductible cost depends on the specific type of care being received.
Medicare Part A penalty
If you aren't eligible for premium-free Medicare Part A, and you don't buy it when you're first eligible, your monthly premium may increase by 10% if you sign up later. You'll have to pay the higher premium for twice the number of years you could have had Medicare Part A but didn't. For example, if you were eligible for three years but didn't sign up, you'll pay the higher premium for six years.
You usually won't have to pay the penalty if you meet certain conditions that allow you to sign up for Part A during an SEP. In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both.
Special situations for Medicare eligibility
In some situations, you may be eligible for Medicare before you turn 65, or you may need some parts of Medicare to keep your current health plan or add other coverage.
For those with a particular disease
- If you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you automatically get Part A and Part B the month your disability benefits begin.
- If you have End-Stage Renal Disease (ESRD), you can apply for Part A and Part B.
For those who live outside the U.S.
- If you live in Puerto Rico and get benefits from Social Security or the RRB, you'll automatically get Part A.
For those with alternative Medicare coverage
- If you have Part A and TRICARE (insurance for active duty military or retirees and their families), you must have Part B to keep your TRICARE coverage unless the service member who carries the coverage is on active duty.