Medicare Part A is the core component of Medicare that everyone is enrolled in once they sign up for coverage. It covers hospital stays, nursing, and home health care, as well as hospice care. Most people do not pay a premium for Part A and instead only pay a deductible for those covered services. But you may be surprised to learn that some of the things you expect to fall under Part A are not covered at all. These can include private duty nursing costs, certain home health services, and other extra charges. Matthew Bussard, a Medicare specialist, based in Rhode Island, understands that it can be difficult to tell the difference between what is and isn’t covered. Here, he is going to help you learn to determine the difference.
What Is Not Covered by Medicare Part A?
Sometimes it can be difficult to tell which services are not covered by Medicare Part A because some of these services appear to be very similar to covered services. These include private nursing care services (one-on-one medical services either in the hospital or at home) and the custodial costs associated with being a long-term resident at a nursing home. Skilled nursing facilities (like a rehab hospital or continued short-term care center) might not be covered in specific situations.
Home health services that aren’t covered include 24-hour in-home care, meal delivery, and custodial or personal care services. Finally, there are services or items typically included in even a hospital stay that are not covered. A hospital may bill you for private room charges, personal items used in your room, and even for the first three pints of blood in some situations.
What Is Covered by Medicare Part A?
Of course, Medicare Part A covers all inpatient care and treatments during a hospital stay, but other services outside of the hospital are also covered. Nursing home and skilled nursing facility care might be covered so long as it is not intended to be long-term care, and it is needed after a hospital stay. Hospice services are generally covered both in and out of the home.
Some home health care services may also be covered. These covered services include part-time nursing care, physical and occupational therapy, part-time home health aides, and some speech-languages services. It will also cover home visits when they are needed for certain injectable medications.
How to Tell When a Service is Covered
It is always best to find out before you receive a service if it is going to be covered by Medicare Part A. There are a couple of ways to do that quickly. Often your doctor or service provider can tell you if the service they think you need is covered. Usually, if a service is not covered, they are required to notify you in writing. You can also check online to see if Medicare covers your service under Part A by using the coverage checking tool on their website.
While it may not always be possible to know if your service will be covered or not, it is usually best to try to find out in advance before you agree to any service. By staying aware of what Medicare Part A will and will not pay for, you can better manage your medical costs.
About Matthew Bussard
Matthew Bussard is a financial services broker offering support to Medicare users in Rhode Island. He is passionate about creating a difference in his clients’ lives by helping them enroll in Medicare with professionalism and care. Mr. Bussard volunteers with Medicare recipients at Oak Street Health Clinics, providing efficient, continual guidance to clients every step of the way. Matthew also participates in various charitable activities, including The Hunger Project, the MDRT Foundation, local clean-ups, and little league coaching. He donates to local charities and makes a difference in his community in every way possible.