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Just the Essentials...
Most people get Medicare Part A at no premium cost.
Eligible people can choose to join Medicare Part A only, but it covers only hospital stay expenses.
Delayed enrollment in Part A can mean a 10% increase to your premium when you do sign up. If you sign up for Part A only, a similar penalty applies to delayed enrollment in Part B.
The best time to get Medicare Part A is when first becoming eligible, during the initial enrollment period.
Without Medicare Part B, having Part A by itself means no access to Medicare Advantage or Medigap health plans.
When starting Medicare health insurance for the first time, many first-time enrollees have questions as they make sense of Medicare.
One of the biggest Medicare questions asks whether you can sign up for only Part A, but not the other Parts.
New beneficiaries can choose to sign up for Medicare Part A only. However, without Part B medical insurance, Part A members cannot get Medicare Advantage or Medigap. Further, delaying Part B may cause a penalty to kick in upon sign up.
With only Part A, clearly more is at stake for new Medicare members than just a monthly cost.
Medicare Part A Only
Medicare Part A provides hospital insurance, meaning it covers related services, supplies, and the room itself for a hospital stay.
With that said, Medicare Part A alone leaves a glaring gap in health coverage: medical services for situations outside of a hospital stay remain entirely uncovered.
For most people, Part A is premium-free. Although permissible to sign up for Medicare Part A only, this only comes recommended when group insurance provides medical coverage equal to Part B, or better.
Some retirees continue under insurance from an employer or union when first becoming eligible for Medicare. Without any late enrollment penalty, Medicare allows Part A plus an eligible group medical plan to replace Part B.
Although Part A plus group insurance equal to Part B avoids a late enrollment penalty, more is at stake.
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Original Medicare and Medicare Advantage
Original Medicare, a government program, consists of the combination of Part A hospital insurance with Part B medical insurance.
However, if you sign up for Medicare Part A only, then you do not qualify for other helpful benefits through Medicare health plans, which require having Original Medicare.
A central choice that Medicare beneficiaries make lies between getting health insurance through the government Medicare program, or through a private plan that provides equal or greater coverage than the government program.
Without both Medicare Part A and Part B, a person cannot get any benefits from Part C: Medicare Advantage plans, or the added protection of Medigap.
Medicare Advantage plans can offer more benefits than Original Medicare while possibly costing less. These Part C can even build in the prescription coverage of Part D.
Comparison shopping will help subscribers compare Original Medicare to Medicare Advantage.
In most cases, Medicare Part A comes at no monthly premium cost.
Medicare offers a free online tool to calculate your exact insurance premium for Medicare Part A hospital insurance, if any.
The calculator provides these figures based on work history, and a few other factors.
Medicare pays on a cost-sharing basis, meaning costs are split for services among Medicare, the healthcare provider, and the patient.
Likewise, those with Medicare must pay the difference out-of-pocket between the amount doctors charge, and what Medicare pays for a service. Typically, these out-of-pocket costs come as copays or coinsurance, like with an overnight hospital stay.
In order to protect yourself, know that Medicare Part A sets no annual stop-loss amount. In other words, there is no built-in safety net to protect against excessive financial loss due to hospital expenses.
Beyond that, Medicare Part A and Part B do not have a prescription drug insurance benefit. Medicare Part D offers prescription coverage, as do many Medicare Advantage plans.
Initial Enrollment Period
The initial enrollment period for Medicare is an important time. In fact, your initial enrollment period (IEP) is the best time to apply for Medicare Part A.
A person’s IEP lasts for seven months, beginning 3 full months before and ending 3 full months after the month you become eligible to start coverage.
Coverage can start as early as the month of your 65th birthday, the month marking 2 years of disability benefits. Eligibility comes sooner after diagnosis with Lou Geghrig’s disease or end-stage kidney failure.
Part A represents a vital part of Medicare’s protection: insurance for hospital stays. Should an eligible person decline to join during their first signup window, they could have to pay a late enrollment fee.
The Part A late enrollment fee adds an additional ten percent to the premium when a person delays enrollment in Part A for a full year or longer.
The Part A late penalty lasts for twice the number of full years a person was eligible, but didn’t enroll in Part A.
Payment of the penalty starts at the time a late enrollee signs up, and begins Medicare Part A.
With that in mind, if you sign up only for Part A, you may face a penalty if you do not sign up for Part B right away.
The Part B late penalty adds ten percent to the premium. Then, it multiplies by the number of full years you went without Part B while you were eligible. Further, the Part B penalty lasts for as long as you have Part B.
Even still, some retirees keep their medical insurance through an employer or union. When group insurance provides at least 20 people in the group with medical coverage equal to Part B or better, no Part B late enrollment penalty applies.
In the long run of things, although signing up Part A alone can be permitted, be sure you’re protected from medical expenses and penalties.
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