Who Qualifies for Medicare Part A Benefits?


Quick Answer

To qualify for Medicare Part A benefits, applicants must be age 65 or older and be a U.S. citizen or legal resident. In addition, applicants must either be receiving retirement benefits, be disabled and receiving disability benefits, have end-stage renal disease, or have amyotrophic lateral sclerosis.

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Full Answer

Medicare Part A, along with Part B, is part of original Medicare. In most cases, beneficiaries are not required to pay a premium for Medicare Part A provided they have worked at least 10 years and paid Medicare taxes during that those working years. If applicants are not eligible for premium-free Medicare Part A, they can still pay a premium and enroll in Part A.

While Medicare generally covers a wide range of services, such as lab tests, surgeries and doctor visits that are considered medically necessary to treat a disease or condition, Part A specifically involves hospital insurance, while Part B involves medical insurance. Specifically, Part A covers inpatient hospital care, home health services, skilled nursing facility care and hospice care. Conversely, Part A does not cover long-term care, most dental care, eye examinations for prescription glasses, cosmetic surgery and hearing aids.

To the extent that required services are not covered by Medicare, recipients must pay expenses out-of-pocket, unless they are otherwise covered by different insurance or they are in a Medicare health plan that covers the required services. Recipients are still required to pay a deductible, coinsurance and copayments, even if covered by Medicare.

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