Medicare Part A

What is Medicare Part A?

Medicare Part A (hospitalization) is Original Medicare that you get through the federal government. You are advised to sign up for Part A when you turn 65, even if you aren’t planning on immediately retiring. 

As mentioned before, Part A is included under Original Medicare. This package helps cover about 80% of your medical expenses, however it doesn’t include prescription drug coverage, long terms care or routine dental and vision care. 

Eligibility for Medicare Part A?

As with most Medicare plans, you are eligible starting the three months before your 65th birthday, otherwise known as your initial enrollment period (IEP). 

If you’re already receiving benefits from Social Security or Railroad Retirement Board (RRB), you don’t need to do anything on this front. You’ll automatically be enrolled in Original Medicare on the first day of the month you turn 65. 

In addition, you must follow these guidelines to be eligible for Part A application:

  • You must have both Medicare Part A and Part B. (Note: You must continue to pay your Medicare Part B premium once you enroll.)
  • You must be a permanent Michigan resident and reside in our service area for at least 6 months of the year.
  • You can’t be denied for pre-existing conditions unless you've been diagnosed with end stage renal disease (ESRD). In this case, see the Medicare & You handbook for additional eligibility opportunities.

Initial Enrollment for Medicare Part A?

Your initial enrollment period (IEP) 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 Railroad Retirement Board (RRB), you'll automatically be enrolled in Original Medicare (Parts A and B) on the first day of the month you turn 65. You don't need to do anything. Watch for your red-white-and-blue Medicare card to come in the mail.
Enrolling for Part A during this period may be beneficial, as it can prevent any delays in coverage.

General Enrollment Period for Medicare Part A?

The most common time to apply for Medicare is during annual enrollment period (AEP). This period runs from Oct. 15 to Dec. 7 each year, and it allows you to make necessary changes to your supplemental Medicare coverage. It’s also a great time to reevaluate your current and future health care needs and make sure that your plan is a good fit for the upcoming year. You may find your current plan is still the perfect fit, but it’s always a good idea to reaffirm your decision. 

These three months also allow you to change to a different Medicare Advantage or MAPD (Part D) plan or just return to back to Original Medicare. Be careful, though, as you must be previously enrolled in an Advantage or MADP plan to even make changes during this time period. 

Special Enrollment Period for Medicare Part A?

In some situations, you’ll have a special election period. During this time, you can change your Part C or D plans, or switch back to Part A.

How to apply for Medicare Part A?

If you find yourself in an enrollment period for Medicare, you should do the following to obtain Part A:

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 (If you’re under 65 and disabled you can continue to get premium-free Part A for up to 8 ½ years after you return to work).

What is covered under Medicare Part A?

Part A covers hospital insurance, including hospital care, skilled nursing facility care and some nursing home, hospice and home health care services. 

What is the Deductible for Medicare Part A?

When it comes to 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, though, will usually depend on the specific type of care being received. 

What does Medicare Part A cost?

Medicare prices can vary for everyone. However, with the Priority Health Cost Estimator tool, you can find out what plans like Part A can cost for you. 

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 go up 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. So, 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 a Special Enrollment Period (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 that 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.

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