Medicare Parts A and 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