The National Consumer Protection Technical Resource Center: The Center of Service & Information for SMPs

Health Care Fraud

Medicare Part A (Hospital Insurance)

Benefits

Helps cover:

  • Inpatient Hospital Care – covers most things medically necessary for a hospital stay.
  • Inpatient Skilled Nursing Care – covers necessary daily skilled care after a three-day hospitalization, must be under doctor’s plan of care, day 1-20 free, days 21-100 require co-payment.
  • Home Health Care – covers intermittent skilled services required after a hospitalization for homebound patients.
  • Hospice Care – covers services required for an individual with a prognosis of 6 months or less to live, pain medication and “comfort care” now covered.

Part A Costs

  • Most people receive Part A premium-free.  It can be purchased if someone has not worked enough Social Security Quarters to be eligible.
  • A deductible for hospital services must be paid for each benefit period.  Daily co-payments for services may apply.

Non-covered Services

  • Long-term care
  • In-home services, custodial care
  • Medically unnecessary stays
  • Private rooms unless medically necessary


Your Rights in the Hospital

If you feel you are being discharged from the hospital too soon – get your discharge In Writing.Appeal the decision through your state’s Quality Improvement Organization (QIO).

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