Questions and Answers
What does Medicare Part A cover?
Enrollment in Medicare Part A for people over 65 and covered by Social Security is automatic and free.
True
What does Medicare Part A's inpatient hospital coverage include?
Meals, supplies, medical services, drugs taken as an inpatient, a semi-private room.
Medicare Part A's inpatient hospital coverage does NOT cover _____ duty nursing.
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A benefit period for Medicare Part A starts over after 60 days of hospital discharge.
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How many days of hospital care does a Medicare Part A beneficiary receive per benefit period?
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Intermediate Care and Custodial Care are covered by Medicare.
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For Medicare Part A to cover skilled nursing facility care, the SNF stay must begin immediately after a hospital stay of at least ____ days.
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What are the coverage details for days in a skilled nursing facility under Medicare Part A?
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What does Medicare Part A's home health care benefit cover?
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Medicare Part A's home health care benefit includes coverage for meals, shopping, cleaning, or laundry.
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A patient could have up to _______ days of Medicare coverage for a single hospital stay if they have not tapped into the lifetime reserve days.
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Study Notes
Medicare Part A Overview
- Covers inpatient care, including hospitals, skilled nursing facilities, hospice, and home health care.
Enrollment
- Automatic and free for individuals over 65 who are covered by Social Security.
Inpatient Hospital Coverage
- Includes meals, supplies, medical services, drugs administered during inpatient stays, and semi-private rooms.
- Excludes private duty nursing, the first three pints of blood, and non-medical services like room, phone, and TV.
Benefit Periods
- Based on benefit periods instead of a calendar year.
- A benefit period begins upon hospital admission and ends 60 days after discharge; readmission within 60 days does not start a new period.
Coverage Limits
- Each benefit period allows for 90 days of hospital care.
- A deductible applies, and full coverage is provided for the first 60 days.
Care Not Covered
- Intermediate and custodial care are not covered by Medicare.
Skilled Nursing Facility (SNF) Care
- Covered if care is received at a Medicare-approved facility and starts immediately after a hospital stay of at least three days.
- Coverage and cost-sharing:
- Days 1-20: Fully paid by Medicare.
- Days 21-100: Medicare pays the majority, with a daily co-pay required.
- Day 100+: No coverage from Medicare.
Home Health Care Benefit
- Covers part-time nursing care, physical, occupational, or speech therapy, and visits by home health aides.
- Pays 80% of the cost for durable medical equipment, such as hospital beds or wheelchairs.
Home Health Care Exclusions
- Does not cover meals, shopping, cleaning, or laundry services.
Additional Coverage Exclusions
- First three pints of blood, private duty nursing, non-medical services, intermediate care, and custodial care are not covered.
Lifetime Reserve Days
- Patients with unused lifetime reserve days can have up to 150 days of Medicare coverage for a single hospital stay.
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Test your knowledge about Medicare Part A with these flashcards. Learn about its coverage, enrollment process, and benefits for those over 65. Perfect for anyone looking to understand Medicare better.
