Part A (Hospital)

Part A (Hospital)

Part A covers inpatient or hospital care.

Hospital care includes:

  • Skilled nursing facility care
  • Nursing home care (as long as custodial care isn’t the only care you need)
  • Hospice
  • Home health services (in limited circumstances)

To compare hospitals, use Medicare’s Hospital Compare tool.

Part A costs

You usually don’t pay a monthly premium for Medicare Part A coverage if you or your spouse paid Medicare taxes while working. This is sometimes called “premium-free Part A.” If you buy Part A, you will pay a premium each month.

You can get premium-free Part A at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You’re eligible to get Social Security or Railroad benefits but haven’t filed for them yet.
  • You or your spouse had Medicare-covered government employment.

If you’re under 65, you can get premium-free Part A if:

  • You’ve received Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.
  • You have ALS (Lou Gehrig’s disease)

Part A coverage

Depending on specific circumstances, the following are health care services which Part A may cover:

infographic showing what medicare covers

Where are you covered under Part A?

Hospital Care can be received at any of the following scenarios:

  • Acute care hospitals
  • Critical access hospitals
  • Inpatient rehabilitation facilities
  • Long-term care hospitals
  • Mental health care
  • Participation in a qualifying clinical research study

 Skilled Nursing Facility (SNF) care

Medicare Part A covers skilled nursing care provided in a skilled nursing facility (SNF) under certain conditions for a limited amount of time.

Skilled nursing facility care includes:

  • Semi-private room (a room you share with other patients)
  • Meals
  • Skilled nursing care
  • Physical and occupational therapy (if they’re needed to meet your health goal)
  • Speech-language pathology services (if they’re needed to meet your health goal)
  • Medical social services
  • Medications
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary counseling

Note: Beware of “observation status.” Observation is a period when you are being observed to see if you need to be admitted to a hospital, and observation days considered outpatient and are not covered under Part A.

Inpatient or outpatient?

See what Medicare will (or won’t) pay in each of these situations:

Nursing home care

Medicare Part A may cover care in a skilled nursing facility (SNF) it’s medically necessary. Most nursing home care falls under custodial care, which is not covered under Part A.

Note: Custodial care, such as bathing and dressing, is not covered if that’s the only care you need.

To find a nursing home and compare nursing homes, search Medicare’ Nursing Home Compare tool.

Hospice care

Hospice care is for people with a life expectancy of 6 months or less. This kind of care is done by a team that includes you and your family, as well as doctors, nurses, social workers, pharmacists, and other team members. You can get hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods (if you are recertified to have a low life-expectancy). To find hospice care, search Medicare’s Hospice Compare site.

Hospice care includes:

  • Doctor services
  • Nursing care
  • Pain relief medications
  • Social services
  • Durable medical equipment
  • Medical supplies
  • Hospice aide services
  • Homemaker services
  • Physical and occupational therapy
  • Dietary counseling
  • Short-term inpatient care (if necessary for managing pain or symptoms)
  • Short-term respite care

Home health services

Home health services are only covered if a doctor certifies that you are homebound, you are under the care of a doctor, and you are in need of the services listed below. Note that Part A will not cover around-the-clock home care except in short-term special circumstances that your condition requires. If in doubt about whether Medicare covers something, talk to your doctor, or search Medicare’s site.

Home Health services include:

  • Intermittent skilled nursing care
  • Physical therapy
  • Speech-language pathology services
  • Continued occupational services, and more.

What will Part A not cover?

Part A will not cover:

  • A private room (unless medically necessary)
  • Private-duty nursing
  • Personal care items, like razors or slipper socks
  • Extra charges, like telephone or TV
  • Non-donated blood
  • Meals delivered to your home
  • 24-hour-a-day care at home
  • Homemaker services
  • Personal care
  • Custodial (long-term) care
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