Medicare Part A
Medicare Part A is the hospital insurance component of Original Medicare. Part A covers inpatient care, including stays at hospitals and skilled nursing facilities. It also includes home health and hospice care. Most people do not pay a monthly fee, or premium, for Medicare Part A.
What Does Medicare Part A Cover?
Medicare Part A is emergency insurance. It provides coverage for hospitalization, hospice care, nursing facility care and home health care.
Inpatient Hospital Care Coverage
After you pay your $1,408 deductible, Medicare covers all hospitalization costs for 60 days. You begin paying a portion, called coinsurance, after that.
- Semi-private rooms
- Meals
- General nursing
- Drugs as part of your inpatient treatment
- Other hospital services and supplies
Skilled Nursing Facility Care
Medicare Part A covers skilled nursing facility care under specific circumstances for a limited time. It does not cover extended nursing home stays or long-term care.
To qualify, your doctor must decide you need daily skilled care — such as physical or speech therapy — after hospitalization. Medicare will cover at least some of these costs for up to 100 days.
Home Health Care Coverage
Medicare Part A will cover home health care when your doctor orders these services for you. Services are coordinated through a health care agency.
This doesn’t include around-the-clock in-home care or assistance with tasks of everyday living such as bathing, dressing or using the bathroom.
- Part-time or intermittent skilled nursing
- Physical therapy
- Occupational therapy
- Speech-language services
- Medical social services
- Durable medical equipment
After meeting your deductible, Medicare generally pays for all home health care services. However, there may be a coinsurance payment for durable medical equipment.
Hospice Care Coverage
Most Medicare beneficiaries pay little to nothing for hospice care.
To qualify, you must be terminally ill with a life expectancy of six months or less. You and your family must also work with a hospice team and develop a plan of care that meets your needs.
Medicare Part A Enrollment & Eligibility
If you’re receiving Social Security benefits for at least four months before turning 65, you are automatically enrolled in Medicare Part A and B.
If not, you need to sign up with Social Security. You can do so by visiting the Social Security website or by calling 800-772-1213.
Initial Enrollment
You typically have a seven-month window to enroll in Medicare for the first time.
It begins three months before the month you turn 65, includes your birthday month and extends three months after your 65th birthday. This is called the initial enrollment period.
Open Enrollment
After you’re enrolled, you don’t need to sign up for Medicare each year. However, you get the chance to review your coverage and change plans each year during a period known as general or open enrollment. Open enrollment runs from Oct. 15 through Dec. 7.
Costs of Medicare Part A
Most people get premium-free Part A coverage. But if you worked less than 10 years in the United States before turning 65, Part A may cost you.
If you paid Medicare payroll taxes for less than 30 quarters — about 7.5 years — the standard Part A premium is $458. If you paid Medicare taxes for 30 to 39 quarters, the premium is $252.
Part A includes a $1,408 deductible for everyone. This is the cost you pay before Medicare covers anything.
- Days 1 to 60: You pay nothing after reaching your deductible.
- Days 61 to 90: $352 coinsurance each day per benefit period.
- Days 91 and Beyond: $704 coinsurance per each lifetime reserve day.
- After Lifetime Reserve Days: You pay all costs.
- Days 1 to 20: You pay nothing after reaching your deductible.
- Days 21 to 100: $176 coinsurance each day per benefit period.
- Days 101 and Beyond: You pay all costs.
- 20 percent of the Medicare-approved amount for durable medical equipment.
FAQs
7 Cited Research Articles
- Social Security. (n.d.). How To Enroll In Just Medicare. Retrieved from https://www.ssa.gov/benefits/medicare/
- U.S. Centers for Medicare & Medicaid Services. (n.d.). How hospice works. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-a-covers/how-hospice-works
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Costs at a Glance. Retrieved from https://edit.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Part A coverage: Home health services. Retrieved from https://www.medicare.gov/coverage/home-health-services
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Part A coverage: Skilled nursing facility SNF care. Retrieved from https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Special circumstances: Special enrollment period. Retrieved from https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods
- U.S. Centers for Medicare & Medicaid Services. (n.d.). What Part A Covers. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-a-covers