The government doesn't run Medicare under one single program. Instead, it's broken down into different parts for different types of health care — however, this means that the coverage rules change depending on the program.
What does Medicare Part A cover, and is it right for you? Read on to understand your benefits and find out whether this program alone is enough for your health care needs.
What Does Medicare Part A Cover?
Medicare Part A offers hospital coverage. This plan pays for inpatient care when you stay at a hospital or certain other health care facilities, such as a skilled nursing facility or short-term stays in a nursing home. Medicare Part A pays for the cost of room and board as well as your treatment.
However, Medicare Part A does not cover outpatient care, which comes through Medicare Part B. Neither does Medicare Part A cover prescription drugs; for that, you will need for another insurance plan through Medicare Part D.
Is Medicare Part A the Same for Everyone?
The government standardizes Medicare Part A benefits, offering the same hospital coverage for everyone on the program. These benefits do not change depending on where you live. Although location can impact coverage for other Medicare programs, including Part C and Part D, this is not the case for Part A.
What can differ from person to person is whether you need to pay a monthly premium for Medicare Part A. Most people qualify for free Medicare Part A coverage because they either paid for it with their income taxes while working or qualified through their spouse's work.
Those who don't qualify for free Medicare Part A can still choose to enroll. You'll pay a monthly premium of up to $499 per month, depending on how much you previously paid in taxes. Whether you pay a premium or not, the coverage and costs are the same for everyone on Medicare Part A.
Is Medicare Part A Enough To Cover Hospital Care?
Medicare Part A covers a large share of your hospital bills, but it doesn't pay for everything. You'll still be responsible for paying considerable deductibles and co-payments in this program. For example, when you check into a hospital for an inpatient visit, you'll owe an up-front deductible of $1,566. This covers a stay of up to 60 days. If you stay longer than that, you may owe additional daily charges, starting at $389 per day and going up from there over time.
To address these out-of-pocket costs, one option is to save money yourself. However, a long hospital stay can quickly burn through personal savings. Another option is to set up extra private insurance: You pay a smaller monthly premium, and then if you do need medical care, the plan helps cover Medicare costs.
Can Health Insurance Help With Medicare Part A Costs?
There are a couple of ways to cover the expenses associated with Medicare Part A.
First, a Medigap plan, also called Medicare Supplement Insurance, works alongside Medicare Part A and Part B. The government still pays most of your health care bills, whereas the supplemental insurance plan handles your out-of-pocket costs — in other words, the plan fills the gaps.
Another solution is to buy a Medicare Advantage plan, also known as Medicare Part C. These private insurance plans take over from Medicare Part A and Part B to help cover your bills, offering coverage at least similar to what the government provides.
Some of these plans offer more coverage than Original Medicare does. Not only are there plans that charge less out of pocket when you need care, but you may also find Medicare Advantage plans that feature benefits such as dental, vision and prescription drugs. In exchange, plans with more benefits usually charge a higher premium.
Whether you stick with Medicare Part A or opt for a Medicare Advantage plan instead, the key is to understand your coverage before you need to use it. Meeting with a health insurance agent can help you navigate your options for coverage and make sure you have the right benefits for your retirement insurance needs.