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Medicare Part A covers hospitalization, and short-term nursing home or home health care for rehabilitation. Refer to the Franklin County Law Library Medicaid guide for information on long term nursing home or in home care through the Passport program.
Part A is financed through FICA taxes, these are the payroll taxes we all pay during our working years. There are no monthly premiums for Part A, but there are deductibles.
Source : Kaiser Family Foundation
42 USC 426
Entitlement to hospital insurance benefits (Medicare Part A) when a person reaches age 65, if they are entitled to Social Security.
42 USC 1395d
Part A covers services provided to beneficiaries in qualified hospitals participating in the Medicare program for up to 90 days in any one "spell of illness". In addition, each beneficiary has a lifetime reserve of 60 days that can be used after the 90 days is exhausted.
42 USC 1395e
Deductibles and co-pays
42 U.S. Code § 1395m–1
Improving policies for clinical diagnostic laboratory tests
42 USC Sec. 1395x
Definitions of covered services
42 CFR 406.5
Eligibility for Medicare Part A. Medicare Part A is also available on a voluntary basis, for a premium, to individuals over 65 who are not eligible for Social Security.
42 CFR 406.6
Individuals electing to receive Social Security before age 65 are automatically enrolled in Medicare Part A when they turn 65. Individuals waiting till age 65 or later to receive Social Security need to file an application for Medicare.
42 CFR 406.10
Entitlement begins with the first day of the first month in which the individual meets the requirements of paragraph (a) of this section. Entitlement continues until the individual dies or no longer meets the requirements of paragraph (a) of this section.
42 CFR 406.12
Individuals under age 65 are also entitled to benefits under Part A if they have been entitled to Social Security disability or railroad retirement disability for at least the previous 24 months.
42 CFR 406.13
Individuals with end stage renal disease are entitled to Part A benefits.
42 CFR 409.11
Part A pays for a semi-private hospital room unless the patient's condition requires him or her to be isolated or the hospital has no semiprivate rooms available.
Notice, 81 Fed. Reg. 80060
In 2017, the Part A deductible is $1316 for each "spell of illness". There can be more than one "spell of illness", and, hence, more than one deductible in a year.
The 2017 hospital co-pay varies based on the length of your hospital stay:
1 through 60 days: $0
61 through 90 days: $329 per day
91 days and beyond: $658 per day coinsurance for each lifetime reserve day (you may get up to 60 lifetime reserve days in your lifetime)
After lifetime reserve days are used up: Medicare typically doesn’t cover your inpatient hospital stay.
The 2017 skilled-nursing facility co-pays you pay per benefit period also varies based on the length of your stay:
1 through 20 days: $0
20 through 100 days: $164.50 per day
101 days and beyond: You are responsible for all costs unless you have a separate insurance policy that covers these costs.
42 CFR 483.10
Nursing home residents' rights.