En español | Medicare Part A doesn’t cover everything. Also, some services that you might expect to be covered by Part A are instead covered under Part B.
Part A does not cover the following:
- A private room in the hospital or a skilled nursing facility, unless medically necessary.
- Private nursing care.
- A television or telephone in your room, and personal items like razors or slipper socks, unless the hospital or skilled nursing facility provides these to all patients at no additional charge.
- The first three pints of blood, unless the hospital gets it from a blood bank at no charge, or you arrange to replace it by donating your own or somebody else’s blood, or you have additional insurance (such as Medigap) that covers this cost.
- The cost of staying in a skilled nursing facility (where you might need to go for continued nursing or rehab work after being discharged from the hospital) if you are enrolled in the original Medicare program and have not spent at least three days in the hospital as a properly admitted inpatient. If you have been in the hospital “under observation” — even for longer than three days — you do not qualify for Medicare coverage of a stay in a skilled nursing facility.
- The costs of staying as a long-term resident in a nursing home or assisted living facility. Medicare will cover your medical needs in the usual way, but it won’t pay for custodial care — which means help with everyday activities such as dressing, feeding, bathing, going to the bathroom — or for your room or meals. (But long-term care may be paid for under your state Medicaid program if you have exhausted your own savings.)
The following services are paid for under Part B instead of Part A:
- All physicians’ services — including those provided by doctors, surgeons and anesthetists in the hospital or a skilled nursing facility, or as part of the home health care or hospice benefits.
- Any care that you receive in the hospital if you are there “under observation” and not as an officially admitted inpatient — even if you are in a hospital bed and receiving the same kind of care as any other patient. In this situation, your care is still covered, but Medicare pays for it under Part B, not Part A. Depending on the circumstances, this could cost you more or less than coverage under Part A.