What is Part A Hospital & Part B MD Visits
How does it work, what is covered?

Medicare is a Health Insurance Program for people 65 years of age and older…, it’s the nation’s largest health insurance program and  covers nearly 40 million Americans.   

Medicare Part A
(#Hospital Insurance)

Medicare Part A Hospital coverage helps pay for care in hospitals as an inpatient,... skilled nursing facilities, hospice care, and some home health care (see publication # 10969) but not Long Term Care.  

Most people get Part A automatically when they turn age 65 at no charge, since they or a spouse paid Medicare taxes while they were working.  You need to sign up close to your 65th birthday, even if you will not be retired by that time. (If you are getting Social Security benefits when you turn 65, your Medicare Hospital Benefits - Part A - start automatically.) 

Here's a chart it's just a illustration and is NOT official  that shows what Medicare pays, the gaps in Medicare and what you may get when you add a Medi Gap Plan or Medicare Advantage to cover those gaps.

Medicare Part A

Medi Gap – Supplement Plans 

Part B (Medical #Insurance)

Part B - Outpatient helps Pay For Doctors' services, outpatient hospital care, and some other medical services that Part A does not cover, such as the services of physical and occupational therapists, and some home health care see publication 10969, but not Long Term Care. Part B helps pay for these covered services and supplies when they are medically necessary.

The chart below is a very brief summary.  Check the actual Evidence of Coverage for the plan you want to enroll in, Medicare & You or actual Medicare documents.

What part b pays and what you get with Medi Gap or MAPD

21 comments on “What’s Covered in Part A Hospital & B Doctor Visits?

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  1. If I stay overnight in a hospital, doesn’t that make me an inpatient, so that I can then qualify for Skilled Nursing care, etc?

    • Am I an inpatient or outpatient?

      Staying overnight in a hospital doesn’t always mean you’re an inpatient. Your doctor must order your hospital admission and the hospital must formally admit you for you to be inpatient. Without the formal inpatient admission, you’re still an outpatient, even if you stay overnight in a regular hospital bed, and/or you’re getting emergency department services, observation services, outpatient surgery, lab tests, or X-rays. You or a family member should always ask the hospital and/or your doctor if you’re an inpatient or an outpatient each day during your stay, since it affects what you pay and can affect whether you’ll qualify for Part A coverage in a skilled nursing facility.

      A “Medicare Outpatient Observation Notice” (MOON) is a document that lets you know you’re an outpatient in a hospital or critical access hospital. You must receive this notice if you’re getting observation services as an outpatient for more than 24 hours. The MOON will tell you why you’re an outpatient receiving observation services, rather than an inpatient. It will also let you know how this may affect what you pay while in the hospital, and for care you get after leaving the hospital. Citation Medicare & You 10050 or Medicare Benefits 10116 See links above

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