Medicare Blog Series – Part 1
Understanding Medicare Part A and Part B. What Does Each Cover?
Shanti
7/5/20262 min read
Medicare Blog Series – Part 1
Understanding Medicare Part A and Part B: What Does Each Cover?
If you have recently become eligible for Medicare, you have probably heard the terms Part A and Part B many times. But what is the difference between these two parts, and what services does each one cover?
Understanding these differences can help you make more informed decisions when choosing your Medicare coverage and using your healthcare benefits.
What Is Medicare Part A?
Medicare Part A, also known as Hospital Insurance, primarily covers the costs associated with inpatient care and certain other healthcare services.
Part A covers inpatient care provided by various types of healthcare facilities, including:
General acute care hospitals
Critical Access Hospitals
Inpatient rehabilitation facilities
Long term care hospitals
Skilled Nursing Facility (SNF) Care
If you need skilled nursing or rehabilitation services after being hospitalized, Medicare Part A may cover up to 100 days of care in a Skilled Nursing Facility.
Under Original Medicare, you generally must have a qualifying hospital stay of at least three consecutive inpatient days before Medicare will cover SNF care.
Many Medicare Advantage plans may waive this three day hospital stay requirement.
Hospice Care
If a physician determines that a patient has a terminal illness, Medicare Part A covers hospice services that focus on comfort, pain management, and improving quality of life rather than curing the illness.
Home Health Care
If you require home health services after a hospital stay or a stay in a Skilled Nursing Facility, Medicare Part A may cover up to 100 days of eligible home health care.
Blood
If blood is needed during an inpatient stay, Medicare Part A covers eligible blood services according to Medicare guidelines.
Inpatient Psychiatric Care
Part A also covers inpatient psychiatric hospital care. However, care received in a psychiatric hospital is generally limited to a lifetime maximum of 190 days.
What Is Medicare Part B?
Medicare Part B, also known as Medical Insurance, primarily covers outpatient medical services and physician care.
In general, if your treatment does not require an inpatient hospital stay, there is a good chance that it is covered under Medicare Part B.
In our next blog, we will take a closer look at the services covered by Medicare Part B, including the new Advanced Primary Care Management (APCM) services and how they may benefit Medicare beneficiaries.
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