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En español | Part A is one of Medicare’s four main parts.

Part A helps pay for inpatient stays in hospitals and skilled nursing facilities, some home care, and end-of-life hospice care.

Part B covers doctor and outpatient services. Part A and Part B, both included in the bill that President Lyndon B. Johnson signed into law in 1965, are known as original Medicare.

Part C, also known as Medicare Advantage, is a private health insurance alternative to federally run original Medicare, enacted as the Medicare+Choice program in 1997 and changing to Medicare Advantage in 2003. If you choose to get coverage from a Medicare Advantage plan, you still need to sign up for Medicare Parts A and B.

Part D is prescription drug coverage, which you can get from a stand-alone private policy or a Medicare Advantage plan. 

What services does Medicare Part A cover?

The following services are included.

Hospital services coverage. Medicare Part A helps pay for many of your expenses if you’re admitted as an inpatient to a hospital that accepts Medicare, such as:

  • A semiprivate room and meals
  • General nursing services
  • Drugs, supplies and other hospital services
  • Some blood transfusions
  • Inpatient rehabilitation services

You have no copayment for the first 60 days of an inpatient hospital stay for each benefit period. You pay a portion of the cost after that, called Part A coinsurance. A benefit period begins the day you are admitted to a hospital as an inpatient or become a patient in a skilled nursing facility and ends when you’ve been out of the hospital or skilled nursing facility for 60 days in a row.

Home health care coverage. Part A covers some part-time skilled home care for people who are homebound and meet other requirements. A doctor must certify that you need intermittent skilled nursing care, physical therapy, continued occupational therapy or speech-language pathology services. A Medicare-approved home health agency must provide the care.

Hospice care coverage. Medicare Part A covers hospice care for people who are terminally ill. Your doctor must certify that you have a life expectancy of six months or less. Hospice provides comfort care, also known as palliative care, rather than medical treatment to cure your illness.

You may receive hospice care in your home, an inpatient hospice center, a nursing home or other facility. You may have to pay room and board if you live in a place that is not a hospice facility, such as a nursing home.

Skilled nursing facility coverage. Part A covers the first 20 days in a Medicare-certified skilled nursing facility, which provides specialized nursing care and rehabilitation after being hospitalized. You generally need to have been an inpatient in a hospital for at least three days to qualify, and your doctor has to certify that you need daily skilled care from or under the supervision of skilled nursing or therapy staff.

Coverage in a skilled nursing facility may include:

  • A semiprivate room and meals
  • Skilled nursing care
  • Physical therapy, occupational therapy, or speech-language pathology services if needed to meet your health goal
  • Medications, medical equipment and supplies used in the facility
  • Medical social services and dietary counseling
  • Ambulance transportation if needed to receive necessary services that aren’t available in the facility

What services does Medicare Part A not cover?

Medicare Part A doesn’t cover all hospital-related services.

  • A private hospital or skilled nursing center room unless it’s medically necessary
  • Hiring your own nurse, also called private-duty nursing care
  • Television or telephone in your room if there’s a separate charge
  • Personal items such as razors or slipper socks unless provided to all patients at no extra charge
  • The first three pints of blood unless the hospital gets it from a blood bank at no charge, you arrange to replace it through donating your own or somebody else’s blood, or you have additional insurance such as Medigap that covers this cost.
  • The cost of a skilled nursing facility where you might go for rehabilitation after being discharged from a hospital if you have not spent at least three days as an inpatient in the hospital. If you were in the hospital “under observation,” you do not qualify for Medicare coverage for a skilled nursing facility stay.
  • The cost of a long-term stay in a nursing home or assisted living center. Medicare will cover your medical needs, but it won’t pay for custodial care — help with everyday activities such as bathing, dressing, feeding or using the bathroom — or for your room or meals.
  • Physicians’ services, which are covered under Part B. This includes the services of doctors, anesthetists or surgeons provided in a hospital or skilled nursing center.

How much does Medicare Part A cost?

Even though Medicare Part A covers many of your expenses if you are hospitalized or qualify for skilled nursing facility coverage, you may still have some out-of-pocket costs.

Premiums. Most people don’t pay premiums for Medicare Part A because they or their spouse had Medicare taxes deducted from their paychecks for at least 40 quarters of work, the equivalent of 10 years. You’ll pay $274 a month in 2022 if you or your spouse paid Medicare taxes for 30 to 39 quarters, or $499 a month if you paid Medicare taxes for fewer than 30 quarters.

Deductible. You must pay a deductible before Part A coverage begins. In 2022, the Part A deductible is $1,556 per benefit period.

Copayments or coinsurance. This is the portion of the cost that you pay after you’ve met your deductible. Part A has no copay for hospital stays of up to 60 days in one benefit period. In 2022, copays for a longer stay may include:

  • $389 a day for days 61 to 90
  • $778 a day after day 90 for up to 60 lifetime reserve days
  • All costs beyond your lifetime reserve days. Each lifetime reserve day may be used only once, but you may apply the days to different benefit periods.

Copays for skilled nursing facility stays in 2022

  • $0 for days 1 to 20
  • $194.50 a day for days 21 to 100
  • All costs beyond day 100

If you’re receiving hospice care, you may have a copayment of up to $5 per prescription for pain and symptom management. You may also pay 5 percent of the cost of inpatient respite care, such as a short-term stay in a nursing home to give your caregiver a break.

You can buy Medicare supplement insurance, known as Medigap, to cover the deductible and many of these out-of-pocket costs.

Keep in mind

If you choose to get coverage through a private Medicare Advantage plan, you will receive at least as much coverage as original Medicare, but you may have different out-of-pocket costs. For example, a Medicare Advantage plan may have a daily copayment for the first few days in the hospital, such as $325 for each of the first five days as a hospital inpatient, rather than the Part A deductible.

You may also have to use certain in-network hospitals or facilities to receive coverage. Or if you use out-of-network facilities, you may have to pay more, depending on the type of Medicare Advantage plan.

Updated July 15, 2022

     

        


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