Ohio Medicare Part A Overview
As part of Original Medicare, Ohio Medicare Plan A is one portion of a federal health insurance program that assists eligible patients in paying for healthcare. Although each portion of Medicare is responsible for a different aspect of health coverage, Medicare Part A plans in Ohio specifically cover inpatient hospital care with some allowance for home care, if deemed medically necessary. Other coverage within Original Medicare (Medicare Parts A and B) can range from inpatient care at a hospital to medical procedures and medication prescribed by a doctor. Most beneficiaries have been automatically enrolled into an OH Medicare Part A plan, but some patients will need to submit an application before receiving benefits. To review different aspects of Medicare Plan A and how new applicants can become beneficiaries, continue on to the topics below.
What is Ohio Medicare Part A?
Medicare Part A is also known as “hospital insurance.” Ohio Medicare Part A plans cover any inpatient medical care deemed necessary by the beneficiary’s doctor, as part of Original Medicare. Plans under Medicare Part A will also cover other qualifying medical treatments and facilities such as home health care, hospice and Skilled Nursing Facilities (SNF), should these be deemed medically needed by the patient’s doctor. Note that plans in Medicare Part A will only cover treatment and not observation, so participants should be sure to ask about their status as ‘inpatient’ before incurring charges. Learn more about Medicare Part A in Ohio by downloading our free guide.
Ohio Medicare Part A Coverage and Services
Although Medicare Plan A is considered insurance for the patient’s hospital visit, there are allowances that will enable some patients to receive home health care services and hospice care. Part A Medicare in Ohio generally includes the following faculties:
- Inpatient hospital care
- Skilled nursing care
- Home health care
- Hospice care
Under Medicare Plan A in Ohio, inpatient hospital care will cover some hospital services, such as hospital meals, a semi-private room which may be shared with other patients, lab tests and X-rays, inpatient drug treatments and medical supplies as part of treatment. Not covered under Plan A Medicare are services rendered by a doctor, as these services are typically covered under Medicare Plan B. Generally, however, skilled nursing care is covered under Plan A. Within an OH Medicare Part A plan, this would include services rendered by a registered nurse.
Plans in Medicare Part A also cover limited home health care services and palliative treatment for qualifying patients. In order to receive home health care services, the beneficiary’s doctor must consider it medically necessary, either due to the patient’s condition or the inability to leave the house. Palliative hospice treatment may also be covered for some patients under Medicare Part A, depending on the condition of the patient’s terminal illness. Note, however, that hospice treatments within an Ohio Part A Medicare plan are intended only to relieve pain, and not directly address the cause(s) of the condition. As such, the patient must certify his or her decision to receive hospice care with a doctor before receiving benefits.
Within Medicare Part A in Ohio, home health care services generally include intermittent skilled nursing care, limited physical therapy and some speech-language pathology services. Note that Medicare Plan A does not cover 24-hour home care or personal services such as bathing, dressing or using the bathroom. Similarly, hospice care services are dependent on the patient’s illness and cover many of the same services as home health care. Download our comprehensive guide to read more about Medicare Part A coverage.
Ohio Medicare Part A Cost and Fees
Medicare Part A costs in Ohio are dependent upon the patient’s condition and the type of care being received. At the minimum, however, OH Medicare Part A costs are covered when receiving services within the scope of Original Medicare. These services include all of those previously listed as covered services.When receiving care for inpatient hospital treatment, the Medicare Part A costs will vary depending on the length of the patient’s stay. Overall, there is a deductible for each benefit period, and then an additional coinsurance fee per each day within that period. This Medicare Plan A fee is typically a percentage based on the cost of services, reflecting the portion of the treatment for which the patient is responsible. Similarly, Ohio’s Part A Medicare costs for skilled nursing care follow a payment structure based on the duration of treatment and a fee based on the patient’s deductible.
The cost of Medicare Part A in Ohio when receiving home health care and palliative hospice treatment is based on the original cost of inpatient care and equipment used, respectively. This number will be a percentage of the original price, and may also require a copayment for prescription medication coverage. To read more about the Medicare Part A cost and fees, download our complimentary guide
How to Enroll in Medicare Part A in Ohio
While most beneficiaries have been automatically enrolled into an Ohio Medicare Part A plan, other patients will need to complete an application before receiving benefits for medical care. Acceptance of an application will depend on the candidate’s initial eligibility, which is determined by his or her age and disability status.Candidates that have not been automatically enrolled into a plan in Medicare Part A will be able to sign up during a General Enrollment Period, should they have not already done so when they initially became eligible. Note that some candidates will need to sign up during a Special Enrollment Period, depending on a spouse’s coverage and own employment. New applicants can enroll into Ohio Medicare Part A either online through the Social Security Administration’s website or in person at a Social Security office.