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Medicare Part A is the portion of Medicare that covers hospital care and related services. Unlike the other parts, it’s usually available without a premium. Here’s what to know.
What Medicare Part A covers
While Part B generally covers doctor's appointments and preventive care, Medicare Part A is hospital insurance and typically covers costs in four specific areas.
1. Inpatient hospital care
Part A covers hospital services you get when you’re admitted to a hospital on doctor’s orders, including semiprivate rooms, meals, general nursing and drugs for inpatient treatments. If you want care outside of Part A’s coverage, such as a private room or a private-duty nurse, you’re on your own to pay the incremental costs.
It’s also important to note that if you need admittance to a psychiatric hospital for mental health treatment once you’re on Medicare, coverage falls under Part A. You get fewer days of coverage — generally, 190 days over your lifetime.
Fortunately, most hospitals accept Medicare, a criteria for using Part A. Note, however, that Veterans Affairs hospitals and other military hospitals usually take VA and military insurances, not Medicare.
Medicare Part A covers inpatient hospital care in a variety of facilities, including:
Acute care hospitals.
Critical access hospitals.
Inpatient rehabilitation facilities.
Inpatient psychiatric facilities.
Long-term care hospitals.
Inpatient care as part of a qualifying clinical research study.
2. Skilled nursing facility care
Part A covers your short-term care at a certified skilled nursing facility following a qualifying inpatient hospital stay of at least three days. Covered services include a semiprivate room, meals, skilled nursing care and physical and occupational therapy when needed.
Most other services needed for your wellness care are also covered, including:
Speech-language pathology services.
Medical social services.
Medical supplies and equipment used in the facility.
Ambulance transportation to the closest supplier of needed services that aren't available at your facility (if other transport would endanger your health).
Swing bed services.
Your medical team may recommend more services outside the scope of Part A. You would be responsible for those costs.
3. Hospice benefits
Hospice is the end-of-life care you receive if you're terminally ill. Part A covers all costs for a wide range of support care, pain medications and symptom management to make the patient more comfortable. All medical team members are covered under the Part A hospice benefits as well. The exact plan for care is determined by the hospice doctor and your medical doctor. Costs incurred for grief and loss counseling for you and your family as well as respite care for your main caregiver are also included.
Whether you're using Original Medicare or a Medicare Advantage plan, Medicare Part A covers the full range of hospice care and costs. Coordinate with your specific insurance plan for entry into hospice.
4. Home health services
People on Medicare who are homebound may get certain health care services provided right in their homes. Generally, a doctor must approve the situation and you must use a Medicare-certified agency. Covered services include part-time skilled nursing and home health aide care, occupational therapy, physical therapy, speech-language pathology services, medical social services and injectable osteoporosis drugs for women, among other things.
Use caution when planning for home health services. Medicare doesn't pay for 24-hour-a-day care at home, meal delivery, homemaker services (if that's the only care you need) or personal care — such as bathing or dressing (if that's the only care you need). And there is a lot of research necessary to make sure you know which services are covered under Part A and which ones would be your responsibility.
How much Medicare Part A costs
You may qualify for premium-free Medicare Part A if you or your spouse has worked and paid Medicare taxes for at least 10 years, earning 40 quarters. To determine your eligibility, use Medicare's eligibility calculator.
If you don't qualify for premium-free coverage, you may be eligible to purchase Part A coverage. If you must pay for Part A, the premium is as much as $499 per month in 2022 ($506 in 2023), depending on you and your spouse's work and Medicare tax history.
“If you’re over 65 and you can afford it, it makes sense to pay for Part A,” says Joseph Schneier, CEO and co-founder of Trusty.care — a Medicare quoting and enrollment tool for brokers — acknowledging that the premiums aren't cheap. “Original Medicare plus a supplement is probably going to be the best insurance you have,” he notes, referring to Medigap plans.
Once you have your Part A plan in place, there are still other costs based on how you use the health care system. The table below summarizes your share of costs when in the hospital or skilled nursing care. Depending on the specifics of your Medigap plan or Medicare Advantage policy, these costs may be covered by that insurance instead.
Inpatient hospital care
Skilled nursing facility care
Home health services
*Your share of Part A costs if you don't have supplemental insurance that covers these deductibles and coinsurance charges.
Other parts of Medicare — including Part C (Medicare Advantage plans), Part D (prescription drug coverage) and Medigap plans — are available through private insurers approved by Medicare. If you sign up for a Medicare Advantage plan, an alternative to Original Medicare, it will include at least the same coverage provided in Original Medicare. However, you may be limited to a certain network and different rules may apply.
Medicare Part A eligibility
Generally, you're eligible for Medicare Part A if you meet one of the following requirements, according to Medicare:
You're age 65 or older.
You've received disability benefits from Social Security or the Railroad Retirement Board for 24 months.
You receive disability benefits because you have Amyotrophic Lateral Sclerosis, also called ALS or Lou Gehrig’s disease.
You have end-stage renal disease and meet certain requirements.
» MORE: How do I sign up for Medicare?