What Does Medicare Part A cover?

Medicare Part A covers the hospital charges and many services you receive while you’re admitted as an inpatient in the hospital. Part A may also help cover care in a skilled nursing facility, hospice care for the terminally ill and some skilled in-home care for the homebound. The following list provides examples of what Part A covers.


Medicare Part A covers hospital stays and related services, including:
  • A semi-private room
  • Hospital meals
  • Skilled nursing services
  • Care on special units, such as intensive care
  • Drugs, medical supplies and medical equipment used during inpatient stay
  • X-rays, lab tests, and medical equipment used as an inpatient
  • Operating room and recovery room services
  • Some blood transfusions received while an inpatient
  • Rehabilitation services, including physical therapy, received through home health care
  • Skilled nursing care in your home if you’re homebound and need only part-time care
  • Care to control pain and manage symptoms for the terminally ill (e.g. hospice care)

What Medicare Part A Doesn’t Cover?

If you are in the hospital for observation, the costs may not be covered. Part A also doesn’t cover the doctors’ fees when they provide care for you during your hospital stay; Medicare Part B helps pay those costs.

What Does Medicare Part A Cost?

Medicare Part A shares some costs with you. The table below shows the different costs you may be responsible for. Costs are shown for 2020. You don’t pay a premium for Medicare Part A if you or your spouse worked and paid Medicare taxes for at least 10 years.

Premium:
For most people: $0
If applicable (Up to $458 per month)

Deductible:
Per benefit period: $1,408

Co-payment:
Hospital (per benefit period)
  • Days 1-60: $0
  • Days 61-90: $352 per day
  • Days 91-beyond: $704 per day up to 60 lifetime reserve days
Skilled Nursing Facility (per benefit period)
  • Days 1-20: $0
  • Days 21-100: $176 per day
  • Days 101-beyond: You pay all costs
Hospice
  • Medication for pain and symptoms management: up to $5 per prescription
  • Durable medical equipment for home use: 20% of the cost
  • Respite care: 5% of the Medicare-approved amount

Who can get Medicare Part A?

Eligibility for Part A is the same as for Medicare overall. You must be a U.S. citizen or legal resident living in the U.S. for at least the last five years in a row prior to enrolling. You must also meet one of the following conditions:

  • You are age 65 or older.
  • You are under age 65 and have a qualifying disability
  • You are any age and have End Stage Renal Disease (ESRD)

Enrolling in Medicare Part A

All individuals who already receive Social Security benefits are automatically enrolled in Original Medicare (Parts A and B) when they reach the age of 65. People turning 65 who are not collecting Social Security need to enroll themselves during their Initial Enrollment Period.


People on disability are automatically enrolled in Original Medicare (Parts A and B) after receiving Social Security Disability Income (SSDI) for 24 months. If you have Lou Gehrig’s Disease (ALS), you are automatically enrolled in Original Medicare (Parts A and B) the first month you start to receive SSDI.