MEDICARE PARTS A AND B


Medicare Part A and Part B

Medicare Part A:

  • Covers only in the hospital.
  • Part A also helps cover:
    • Blood
    • Hospice care
    • Home health care
    • Skilled nursing and rehabilitative care only after a three day hospital stay, up to 100 days in a benefit period (as defined by Medicare), but not custodial or long-term care
    • Inpatient psychiatric care (up to 190 lifetime days)
  • Covers up to around 75 percent of medical costs.
  • You must have paid up to 40 quarters via payroll taxes.
  • Most individuals automatically get Part A coverage without having to pay a monthly payment. This is because they or a spouse paid Medicare taxes while working. These individuals receive Part A coverage without paying a Part A premium.
  • For those individuals who do not automatically qualify for Part A coverage, the Part A premium is $443 a month in 2009.
  • Individuals with disabilities who are under age 65 are automatically enrolled in Part A after they have received Social Security or Railroad Retirement disability benefits for 24 months.

Medicare Part B:

  • Helps cover cost outside the hospital.
  • Covers up to around 75 percent of medical costs.
  • Does not cover prescriptions.
  • You must have Medicare Part A to get Medicare Part B.
  • At Age 65, most individuals who file an application for Social Security or Railroad Retirement benefits 3 months before they turn age 65 or later are automatically enrolled in Part B unless they refuse Part B coverage.
  • Individuals with disabilities who are under age 65 are automatically enrolled in Part B:
    • the month they turn 65 if they have received Social Security or Railroad Retirement benefits for at least 4 months before they turn age 65, without having to fill out any additional application for those benefits. They are also given an opportunity to refuse Part B coverage.
    • after they have received Social Security or Railroad Retirement disability benefits for 24 months. They are also given an opportunity to refuse Part B coverage. [Note: Exception for ALS disease.]
  • Beneficiaries enrolled in Part B must pay a monthly premium. Most beneficiaries pay the standard monthly premium for Part B - $96.40 in 2009. Individuals with income over $85,000, or filing jointly with incomes over $170,000, pay more, up to $308.30 a month in 2009.
  • Part B premiums are deducted from Social Security checks, Railroad Retirement checks, or Office of Personnel Management benefits.

Not Covered by Medicare Part A & B

  • Acupuncture
  • Dental care/dentures
  • Cosmetic surgery
  • Custodial care
  • Health care while traveling outside the US
  • Hearing aids/exams
  • Orthopedic shoes
  • Outpatient prescription drugs (this is covered under Part D)
  • Routine foot care
  • Routine eye care and eyeglasses
  • Routine physical exams, except the one-time Welcome to Medicare physical
  • Some screening test and labs
  • Vaccines, except as previously listed (those not covered under Part B are covered under Part D)
  • Syringes and insulin unless used with an insulin pump (this is covered under Part D)


Other Medicare Information

2009 Medicare Information

2008 Medicare Information

2007 Medicare Information

Medicare Home
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