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Written byMichelle Lambright Black
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Michelle Lambright Black is a credit expert, freelance writer, and founder of CreditWriter.com. She has over 20 years of experience writing and speaking about credit and money, and focuses on helping families and small business owners make smart, informed decisions about their credit, money, and financial products (including insurance). Michelle's work has appeared in publications such as Yahoo! Finance, Reader's Digest, Parents, FICO, Forbes, Bankrate, The Seattle Times, MarketWatch, BuySide from Wall Street Journal, USA Today, and more. She's also a three-time finalist for the best personal finance freelancer award from the Plutus Foundation. When she isn't writing or speaking about credit and money, Michelle loves to travel with her family or read a good book. You can connect with Michelle on Instagram or Twitter.
Michelle has been a contributor at Insurify since September 2023.
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Edited byChris Schafer
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15+ years in content creation
7+ years in business and financial services content
Chris is a seasoned writer/editor with past experience across myriad industries, including insurance, SAS, finance, Medicare, logistics, marketing/advertising, and many more.
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Updated July 16, 2024
Reading time: 4 minutes
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Table of contents
Medicare Part A is one part of the broader federal health insurance program Medicare, servicing older adults and other eligible Americans.[1] Part A can provide financial coverage for hospital stays and related expenses.
If you have Medicare Part A or are thinking about applying, it’s important to understand how this type of coverage works. Below are some key details you should know, including the costs associated with Medicare Part A, the expenses it covers, and how it compares to private insurance.
Coverage under Medicare Part A
Medicare Part A coverage falls into four primary categories: inpatient hospital care, skilled nursing facility care, home healthcare, and hospice care. Below is a deeper look at the coverage Part A provides to Medicare recipients in each of these areas.
Inpatient hospital care: Medicare Part A will cover your hospital stay and all eligible hospital services if a doctor admits you for inpatient care. To be eligible for coverage, the hospital must accept Medicare.
Skilled nursing facility care: Part A covers short-term stays in skilled nursing facilities (up to 100 days per benefit period) if you have a qualifying inpatient hospital stay and meet other criteria. If you’re eligible for coverage, Medicare will pay for the cost of your room and board, as well as a range of medical services during your stay.[2]
Home healthcare: If you can’t leave your home due to a medical condition, illness, or injury, Medicare Part A will cover your eligible home health services. This may include physical therapy, part-time skilled nursing care (as medically necessary), occupational therapy, medical equipment, medical supplies, and more.
Hospice care: Medicare Part A also covers hospice care for terminally ill patients who meet eligibility criteria. If you qualify for coverage, you shouldn’t have to pay costs associated with doctor’s services, nursing and medical services, medical equipment, or supplies. Grief counseling for you and your family members and aide and homemaker services are also available.
Medicare Part A eligibility
In general, you’re eligible for Medicare Part A if you meet any of the following criteria:
You’re age 65 or older and meet citizenship and residency requirements.
You receive disability benefits from Social Security or the Railroad Retirement Board (minimum of 24 months required).
You have end-stage renal disease — a type of permanent kidney failure that requires dialysis and sometimes a kidney transplant.
You receive disability benefits due to ALS, or Lou Gehrig’s Disease.
Costs associated with Medicare Part A
Around 99% of eligible recipients don’t have to pay a monthly premium for Medicare Part A.[3] If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), you should enjoy premium-free coverage. You can use the Medicare eligibility calculator to estimate your Part A premium.
The maximum premium for Medicare is $505 per month. But rates can change from year to year.
It’s also important to understand that even Part A recipients who enjoy premium-free coverage may have other out-of-pocket Medicare costs to cover, including the following:
Inpatient hospital deductible: $1,632
Daily hospital co-insurance (days 61–90): $408
Daily hospital co-insurance (days 91 and beyond up to 60 lifetime reserve days): $816
Skilled nursing facility co-insurance (days 21–100): $204
These costs constitute current Medicare rates, but they’re subject to change and often adjust from year to year.
Good to Know
Medigap, a Medicare Supplement Insurance plan, can provide you with additional protection to pay for costs that Medicare Part A and Part B don’t cover. Some people also consider Medicare Advantage plans. These plans are a private alternative to Original Medicare that include additional benefits such as dental and vision care.
Medicare Part A and the other parts of Medicare
In addition to Medicare Part A, other parts of Medicare can help you cover different medical needs.
Part B
Medicare Part B helps provide coverage for eligible outpatient services and procedures. This includes services from doctors and other medical professionals, ambulance services, mental health services, preventative services, and more. Medicare Parts A and B together are known as Original Medicare.
Part C
You have the option to set up your Medicare coverage as a Medicare Advantage Plan (Part C) rather than using Original Medicare. Medicare Advantage plans are an alternative private medical insurance plan that may include additional benefits like prescription drug coverage and dental and vision care. But there are restrictions to consider when you choose a plan, and you’ll typically need to use doctors and hospitals in your plan’s network.
Part D
Medicare Part D is the program’s prescription drug benefit, and it’s available through private companies. You have the option to join a Medicare drug coverage plan as an add-on to your Original Medicare plan or by joining a Medicare Advantage Plan that includes prescription drug coverage.
Medicare Part A coverage FAQs
Below, you’ll find more helpful information about Medicare Part A.
What are the specific medical services Medicare Part A covers?
Medicare Part A helps pay for eligible inpatient care in hospitals and skilled nursing facilities. But it doesn’t cover long-term or custodial care. Part A also covers some types of home healthcare and hospice care if you meet the eligibility requirements to qualify for these benefits.
Are prescription drugs covered under Medicare Part A?
No. Prescription drugs aren’t part of the Medicare Part A program. If you want prescription drug coverage, you’ll need to apply for Medicare Part D, an add-on supplement to Original Medicare. Another option you can consider is to join a Medicare Advantage Plan that includes prescription drug coverage.
Does Medicare Part A cover any long-term care services?
No. Neither Medicare Part A nor Medigap pays for long-term care services. In general, most long-term care (also called custodial care) isn’t medical care but rather consists of assistance with everyday personal tasks like eating, dressing, and visiting the bathroom.
You might be able to qualify for long-term care services through Medicaid. But it could also be wise to consider private long-term care insurance if you can afford it.
How does Medicare Part A coverage work for hospital stays and services?
Medicare Part A is primarily hospital insurance that covers most inpatient hospital stays if your doctor admits you to treat an illness or injury, as long as the medical facility accepts Medicare. You may be responsible for paying the Part A deductible based on the length of your stay. If your hospital stay is longer than 60 days, you’ll owe co-insurance as well.
What types of home healthcare are included in Medicare Part A coverage?
If you have Medicare Part A, it can provide coverage for a variety of home health services if you’re eligible. These services may include physical therapy, part-time skilled nursing care, occupational therapy, speech therapy, a part-time home health aid (under certain conditions), medical supplies, and more.
Sources
- Medicare.gov. "What's Medicare."
- NC Department of Insurance. "Basics of Medicare - Parts A, B, C, & D."
- Centers for Medicare and Medicaid Services. "2024 Medicare Parts A & B Premiums and Deductibles."
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Michelle Lambright Black
Michelle Lambright Black is a credit expert, freelance writer, and founder of CreditWriter.com. She has over 20 years of experience writing and speaking about credit and money, and focuses on helping families and small business owners make smart, informed decisions about their credit, money, and financial products (including insurance). Michelle's work has appeared in publications such as Yahoo! Finance, Reader's Digest, Parents, FICO, Forbes, Bankrate, The Seattle Times, MarketWatch, BuySide from Wall Street Journal, USA Today, and more. She's also a three-time finalist for the best personal finance freelancer award from the Plutus Foundation. When she isn't writing or speaking about credit and money, Michelle loves to travel with her family or read a good book. You can connect with Michelle on Instagram or Twitter.
Michelle has been a contributor at Insurify since September 2023.
15+ years in content creation
7+ years in business and financial services content
Chris is a seasoned writer/editor with past experience across myriad industries, including insurance, SAS, finance, Medicare, logistics, marketing/advertising, and many more.
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