Colorado Medicare Part A

Colorado Medicare Part A For most people, Medicare Part A has a premium of $0 and a $1,316 deductible. However, if you have worked and paid Medicare taxes for less than 10 years (or 40 quarters), you may be required to pay a higher premium. Additionally, if you do not enroll in Original Medicare during the Initial Enrollment Period (when you turn 65), you may be subject to a Late Enrollment Penalty Fee.

Hospitalization

Medicare Part A Hospitalization Coverage


Your benefit period for hospitalization starts the first day you receive a Medicare-covered service as an inpatient in a qualified hospital.

The benefit period ends when you have been out of a hospital for 60 days in a row. If you enter a hospital again after that 60 days, a new benefit period will start.

Please not that if a benefit period lasts longer than 60 days, the co-insurance charges will increase, and increase again after an additional 30 days.

Typically, Medicare Part A covers the following services: Semi-private room and board, meals, nursing services, medications that are part of your inpatient treatment, and other hospital services and supplies.

Please note that Medicare Part A will not cover the costs for a private room (unless medically necessary), private-duty nursing, personal care items, or other charges such as TV and telephone usage while at a hospital.

Skilled Nursing
Home Health
Hospice Care
Blood

Eligibility for Colorado Medicare Part A

In general, you are eligible for Medicare Part A if:

  • You are age 65 or older and a U.S. citizen or permanent legal resident of at least five years in a row.
  • You are already receiving retirement benefits.
  • You are disabled and receiving disability benefits.
  • You have end-stage renal disease (ESRD).
  • You have amyotrophic lateral sclerosis (Lou Gehrig's disease or ALS).

Most beneficiaries do not pay a premium for Colorado Medicare Part A if they have worked at least 10 years (or 40 quarters) and paid Medicare taxes during that time.  Individuals who aren't eligible for premium-free Medicare Part A can still enroll in Part A and pay a premium.  Beneficiaries who delay enrollment after they first become eligible for Medicare Part A may be subject to a late enrollment penalty once they sign up.

Initial Enrollment in Colorado Medicare Part A

If you turn 65 and are already receiving Social Security retirement benefits or benefits from the Railroad Retirement Board (RRB), enrollment in Medicare Part A is usually automatic. Medicare Part A benefits begin the first day of the month you turn 65. If your birthday is on the first day of the month, your benefits will begin the month before you turn 65.  If you enrolled in Colorado Medicare Part B when you applied for retirement, your Part B coverage will begin at the same time.  Your red, white, and blue Medicare card will arrive about three months before your 65th birthday.

If you do not qualify for Social Security retirement benefits or benefits from the Railroad Retirement Board (RRB) then you must enroll in Medicare Part A manually during your Initial Enrollment Period(IEP).  You can do so through the Social Security website, by visiting a local Social Security office, or by calling 1-800-772-1213 (TTY users 1-800-0778), Monday through Friday, from 7 AM to 7 PM.

The seven-month IEP begins three months before your 65th birthday includes the month you turn 65, and ends three months later.  The start of your coverage depends on which month you enroll during your IEP.  Be careful not to wait until the last minute to enroll.  If you do not enroll during your seven-month IEP, you will be required to wait until the next general enrollment period (January 1 to March 31) to enroll.

If you are disabled, enrollment in Medicare Part A hospital insurance (and Medicare Part B medical insurance) will begin after you have been receiving Social Security disability benefits for 24 months.  Your coverage will begin in the 25th month. Your Medicare card will arrive about three months before your coverage begins.

If you have ALS (also known as Lou Gehrig's disease), your Medicare Part A hospital insurance (and Medicare Part B medical insurance) will automatically begin the same month that your Social Security disability benefits begin.  Your Medicare card will arrive about one month after you sign up for Social Security disability benefits.

If you have end-stage renal disease (ESRD) and require dialysis, your Medicare effective date is usually the first day of the fourth month of your dialysis treatments. However, you need to apply for Medicare benefits; you’re not automatically enrolled if you're younger than 65.

General Enrollment Period for Colorado Medicare Part A

If you delayed enrolling in Colorado Medicare Part A, you may enroll during the next available General Enrollment Period, unless you are eligible for a Special Enrollment period (see below). The General Enrollment Period occurs each year from January 1 to March 31. If you sign up during general enrollment, your coverage will begin July 1 of that year, and your Medicare card will arrive about three months before your coverage begins.

If you are not eligible for premium-free Medicare Part A and did not enroll when you were first eligible, you may be subject to a late-enrollment penalty when you do sign up.

Special Enrollment Period for Colorado Medicare Part A

If you (or your spouse) lose your employer- or union-sponsored group hospital insurance, or if you were a volunteer serving in a foreign country, you may enroll in Medicare Part A immediately or during a Special Enrollment Period (SEP). This is the eight-month period that begins the month after your employment or other group coverage ends (whichever happens first). If your employment ends during what would be your IEP, you would follow the standard rules for initial enrollment in Medicare Part A. You usually do not have to pay the late-enrollment penalty (if you pay a premium for Part A) if you qualify for an SEP.  Your Medicare Part A coverage will begin the first of the month after you enroll, and your Medicare card should arrive within 30 days of your enrollment.

Would you like to take a look at some of the Medicare plans available in your area?  Give us a call at 1-844-252-6400 or email at medicare@heathycoloradoinsurance.com

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