What Benefit Is Not Included In Medicare Part A

Understanding Medicare Part A

Medicare Part A is a crucial component of the Original Medicare program, often referred to as "hospital insurance." It primarily covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. However, there are specific services and supplies that Medicare Part A does not cover. For those eligible for Medicare, understanding what is and isn't covered can help you make informed decisions about your health coverage.

Medicare Part A Coverage

Medicare Part A covers inpatient care in hospitals, including critical access hospitals and long-term care hospitals. It also covers a limited amount of time in a skilled nursing facility, certain home health care services, and hospice care. However, Medicare Part A does not cover long-term care, also known as custodial care, which includes assistance with daily activities like eating, bathing, and dressing.

Inpatient hospital care
Skilled nursing facility care for a limited time
Hospice care
Some home health care

Eligibility for Medicare Part A

Most people are eligible for premium-free Medicare Part A if they or their spouse paid Medicare taxes for at least 10 years. You typically become eligible for Medicare at age 65, but certain younger people with disabilities or specific conditions may also qualify. It's vital to apply for Medicare as soon as you become eligible to avoid any late enrollment penalties.

Comparing Medicare Part A and Part B

While Medicare Part A focuses on hospital insurance, Medicare Part B is your medical insurance. It covers outpatient care, doctor's services, preventive services, and some home health care. Together, Parts A and B provide comprehensive coverage under Original Medicare, but they may not cover every healthcare need.

Part A: Hospital insurance, covers inpatient care
Part B: Medical insurance, covers outpatient care and doctor visits

Original Medicare: What’s Covered and What’s Not

Original Medicare, which includes Part A and Part B, provides substantial health coverage. However, it does not cover everything. For example, it does not cover most dental care, eye examinations related to prescribing glasses, dentures, cosmetic surgery, acupuncture, and hearing aids. Knowing the gaps in coverage can help you decide whether additional Medicare Plans are needed.

Services and Supplies Not Covered by Medicare Part A

While Medicare Part A covers a wide range of inpatient services, there are specific services and supplies it does not cover. These include:

Long-term care (nursing home care)
Private-duty nursing
Most dental care and dentures
Eye exams related to prescribing glasses
Hearing aids and exams for fitting them

Additional Coverage Options

Since Medicare Part A and Part B may not cover all health care costs, many people choose to enroll in additional Medicare Plans, like Medicare Advantage or Medicare Supplement Insurance. These plans can help cover the costs that Original Medicare will not pay, such as deductibles, coinsurance, and certain services not covered by Medicare.