Medicare Part A and Part B
- Original Medicare consist of Part A, Part B and as of 2006 Part D.
- On July 30, 1965 President Lyndon B. Johnson made Medicare law by signing H.R. 6675 in Independence, Missouri. Former President Truman was issued the very first Medicare card during the ceremony. In 1965, the budget for Medicare was around $10 billion.
- In 1966, Medicare’s coverage took effect, as Americans age 65 and older were enrolled in Part A and millions of other seniors signed up for Part B. Nineteen million individuals signed up for Medicare during its first year.
- Currently there are close to 64 million people on Medicare and that number is expected to rise to 80+ million by 2030.
What does Medicare Part A cover?
- Inpatient care in a Hospital : Original Medicare Part A has a deductible. It covers 90 days of hospital stay with a 60 day lifetime reserve. It also cover Mental Health Inpatient Stays.
- Skilled nursing facility care: Medicare Part A covers 20 days at a SNF at no cost and a co-pay for days 21-100. Utilized primarily for rehab after a minimum 3 day hospital stay for an illness or surgery such as a Total Knee Replacement.
- Home health care: Very much like a skilled nursing facility Medicare Part A requires a minimum 3 day stay in the hospital. Otherwise Home Health is a Part B benefit.
- Hospice care: Hospice care is an unlimited benefit if deemed necessary by your provider.
What does Medicare Part B cover?
- Inpatient hospital care: This includes all care you receive after being admitted into a hospital by a physician. Medicare covers up to 90 days each benefit period in a general hospital. In addition, you receive 60 lifetime reserve days. It also covers up to 190 lifetime days in a Medicare-certified psychiatric hospital.
- Skilled nursing facility care: Medicare covers your room, board, and certain services provided in a skilled nursing facility. This includes medications, tube feedings, and wound care. It covers up to 100 days each benefit period. To qualify, you must have spent at least three consecutive days in the hospital within 30 days of admission to a skilled nursing facility and must have needed skilled nursing or therapy services.
- Home health care: Though it is normally covered by Part B, Part A coverage will kick in if you have spent at least three consecutive days as a hospital inpatient within 14 days of receiving home care. Up to 100 days of daily care are covered or an unlimited amount of intermittent care.
- Hospice care: Hospice care is covered for as long as your provider certifies it is necessary.
Am I eligible for Medicare Part A and Part B?
If you are 65 or have been on SSDI for 24 months you most likely qualify. There are other conditions like End Stage Renal Disease and ALS which qualify for Medicare. If you are not a U.S. citizen give us a call and we will help you determine if you are eligible.
How much does it cost?
Part A is free if you have worked 10 years or 40 quarters in your life and have paid Medicare taxes deducted from your pay. That includes if you are a spouse who has never worked, but your spouse meets the requirements. In some instances if you do not meet the requirements you can purchase Part A for a premium.
Part B does have a premium. It is $148.50 in 2021 and can be deducted from your social security check if you are receiving social security. There are a couple of exceptions based on income. If you are single making greater than $87,000 or married greater than $174,000 there is a sliding scale. If you are on Medicaid you might be able to get the premium paid for you.
Speak with one of our Medicare specialists for the latest premium costs.