Medicare Part A:  The Hospital Insurance Portion of Original Medicare

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Full Name
Published on
22 January 2021

Medicare is a federal health insurance program intended primarily for U.S. citizens aged 65 and older. Medicare Part A beneficiaries receive coverage for medical expenses necessary for inpatient hospital care, skilled nursing, and hospice. Anyone eligible for Medicare Part A also qualifies for Medicare Part B. Part A has no monthly premium if you or another qualifying person, like your current or former spouse, paid Medicare taxes for ten years.

If you don’t qualify for premium-free Part A, you might be able to buy it, and depending on how long you or your spouse worked and paid Medicare taxes will depend on how much the Part A premium will cost. Enrolling in Part B is also a requirement to buy Part A. If you don’t buy Part A when you are first eligible for Medicare, usually when you turn 65, a penalty will also be assessed on top of the premium.

Coverages Include:

  • Inpatient Hospital Care
  • Hospice Care
  • Skilled Nursing Facility
  • Nursing Home Care – Provided that Custodial Care is not the Only Care Required
  • Home Health Care – Conditioned Home Health Services

The Costs Associated With Part A:

  • Medicare Part A Monthly Premium – $0 If You or Your Spouse Paid Medicare Taxes For 10 Years
  • Annual Deductible – The Amount Changes Annually
  • Inpatient Hospital & Skilled Nursing Co-Pays
  • 20% Co-Insurance – The Covered Medical Expenses Medicare Does Not Pay

Medicare Part A - Initial Enrollment Period

Medicare's initial enrollment period begins three months before the month of your 65th birthday and continues until three months after the month of your 65th birthday, seven months in total. Medicare enrollment is automatic if you currently receive Social Security benefits or qualify for Medicare insurance because of a disability before age 65. If you are presently not receiving Social Security benefits or do not qualify for Social Security disability, you must enroll in Medicare. The only exception is if you are still working and have a qualified union or employer group health insurance plan from an employer with 20 or more employees. CMS (Centers for Medicare & Medicaid Services) does not consider employer-group health insurance from an employer with less than 20 employees as qualified health insurance.

If you are eligible to delay enrolling into Medicare, it would be best to still enroll in Medicare Part A and only delay enrolling into Medicare Part B. If a catastrophic event happens, where you land up in the hospital, Medicare Part A will act as secondary insurance and may help pay some of the costs not covered by your group's health insurance plan. Remember, Part A does not have a monthly premium if you paid Medicare taxes for ten years.

NOTE: If your employer group plan is attached to an HSA, you must stop the contributions into the HSA six months before enrolling into any form of Medicare or stop the contributions before the initial month of eligibility, or you may incur a tax penalty.

If you do not have access to a qualified group health insurance plan, signing up for Medicare during your initial enrollment period is imperative. Do this as early as possible so your coverage begins on the first of the month of your 65th birthday. Medicare benefits will start on the first day of the month during the month of your 65th birthday as long as you enrolled during one of the three months prior to your 65th birthday. If you wait until the month of your 65th birthday or one of the three months following your 65th birthday, your effective date can be delayed up to six months.

If your Medicare Part A enrollment is not automatic, and you do not have access to a qualified group health insurance plan, and if you don't sign up for Medicare Part A during Medicare's Initial Enrollment Period (IEP), you will be subject to a 10% penalty for every 12 months you delay your enrollment. The Medicare Part A penalty remains in place for twice the number of years you didn't sign up.

Ways To Enroll In Medicare Part A:

  • Create A My Social Security Account At: And Enroll Online
  • Call Social Security: 800-772-1213, Monday-Friday, 7 am To 7 pm EST
  • TTY Users Should Call 1-800-325-0778
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