AARP Hearing Center
Key takeaways
- Understand Medicare Part A coverage — Tricia Sandiego explains it includes hospital, rehab and hospice care.
- Benefit from typically no monthly premium if you or your spouse paid Medicare taxes for 10 years.
- Manage costs by learning about benefit periods, supplemental insurance and Medicare Savings Programs with expert guidance.
Summary
Medicare Part A coverage is a vital part of health care for anyone approaching retirement age. As Medicare adviser Tricia Sandiego explains, Medicare Part A helps cover expenses related to hospital stays, skilled nursing care, rehabilitation, some home health services and hospice care. Understanding what’s included in Medicare Part A can give you peace of mind as you plan for your health needs, especially since hospital stays and related services often come with high costs.
One big advantage of Medicare Part A is that most people don’t pay a premium if they or their spouse paid Medicare taxes for at least 10 years. However, it’s important to know about deductibles and coinsurance, which work differently from private insurance. Instead of following the calendar year, Medicare Part A deductibles are based on a “benefit period,” so you could pay more than one deductible in a single year depending on your hospital stays. For those worried about out-of-pocket costs, supplemental insurance or Medicare Savings Programs may help fill the gaps. Understanding these details ensures you’re prepared — and helps you make the most of your Medicare benefits.
The key takeaways and summary were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
Full Transcript:
[00:00:00] You may be nearing retirement age, which means figuring out how
Medicare fits into the full picture of your medical coverage.
[00:00:07] If you’re feeling overwhelmed, it’s good to start with the basics. Hi, I’m
Tricia Sandiego.
[00:00:12] In my work with AARP, I help people understand the ins and outs of
Medicare.
[00:00:17] Here are a couple questions I get a lot. What does Medicare Part A cover
and what are the costs?
[00:00:27] Let me break it down. Think of Part A covering common expenses related
to a hospital stay. So that’s things like your overall hospital care, your
[00:00:34] room, food and nursing care. Part A also includes rehab. For example,
physical therapy you might
[00:00:41] need after breaking a hip. And it covers some home health services. Like
in-home nursing care and end-of-life hospice care.
[00:00:49] So that’s what’s covered. Now let’s talk about the costs. The good news is
that there are no premiums for Medicare Part A if you
[00:00:57] or your spouse paid Medicare taxes for at least 10 years. But there will still
be out-of-pocket costs, mainly your deductible and coinsurance.
[00:01:06] You might be familiar with these terms from dealing with your private
insurance, but they work differently in Medicare Part A. Here’s what I mean.
[00:01:14] Part A deductibles are out-of-pocket costs you pay before Medicare starts
covering expenses, which is pretty
[00:01:21] standard. But they don’t follow a 12-month calendar and reset every year
like a typical insurance policy does.
[00:01:27] Instead, you’ll pay one deductible per benefit period, and you might have
more than one benefit period a year.
[00:01:35] So that means you may have more than one deductible per year too. OK, so
you’re probably asking, “What is a benefit period?”
[00:01:42] It’s the period of time that begins the day you’re admitted to the hospital
and ends 60 days after you are discharged.
[00:01:49] Let me give you an example. You fall and you’re admitted to the hospital.
After you pay your deductible,
[00:01:56] Medicare will cover the remaining cost of the hospital stay if it’s less than
60 days.
[00:02:02] If you are readmitted to the hospital within 60 days, you won’t have to pay
a new deductible.
[00:02:08] But if you’re readmitted into the hospital after those 60 days, the clock
starts
[00:02:15] over and you’ll pay another deductible. Now, let’s say you have to stay in
the hospital for more than 60 days.
[00:02:22] You may need to pay a portion of that cost, which is called coinsurance.
This is a percentage of the total cost of your stay.
[00:02:30] Yes, I know it seems complicated, so be sure to talk to your health care
provider about the services they’re offering, and always check with Medicare
[00:02:38] to see what’s covered and what’s not. Since Medicare doesn’t cover
everything when it comes to out-of-pocket
[00:02:44] expenses, you may want to consider buying a supplemental insurance plan.
There’s more on that in the description below.
[00:02:51] And depending on your income, you may be eligible for a Medicare Savings
Program if you need financial assistance.
[00:02:58] I hope this video helps you understand your Medicare part A coverage,
and gives you the knowledge you need to make an informed decision.
Commented [FL1]: option to do "want to" in caption
[00:03:05] For more details on this and many other aspects of Medicare, visit
aarp.org/medicare.
