Medicare Part A: What It Covers, What It Costs

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Medicare Part A refers to the hospital insurance section of Medicare. It is premium-free for most people.

Medicare Part A covers hospital care and other related services. It is usually offered without a premium, unlike the other parts. Here are some facts.

What Medicare Part A Covers

Original Medicare — the government-run part of Medicare that you can enroll in through Social Security — is made up of two parts: Medicare Part A and Medicare Part B.

Part B covers preventive and doctor’s visits, but Medicare Part A covers hospital care.

Inpatient hospital care

Hospital services include semiprivate rooms, meals and general nursing. The hospital must accept Medicare.

Medicare Part A provides inpatient hospital care at a number of facilities including:

  • Acute care hospitals.
  • Hospitals with critical access.
  • Rehabilitation facilities for inpatients
  • Inpatient psychiatric facilities.
  • Long-term care hospitals.
  • As part of a qualified clinical research study, inpatient care.

Skilled nursing facility care

Short-term care can be obtained at a certified skilled nursing facility after a minimum three-day qualifying hospital stay. You can get a semiprivate room and meals as well as skilled nursing care.

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The following services are also covered:

  • Speech-language pathology services.
  • Services for medical social assistance
  • Medicines
  • Equipment and supplies for medical purposes are used in the facility.
  • If you are unable to transport yourself, an ambulance will transport you to the nearest supplier of services.
  • Consultation on diet.
  • Swing bed services

Hospice benefits

Hospice is end-of-life care that you receive when you are terminally ill. The covered services include the care of doctors, nurses, and aides; certain prescription drugs; occupational therapy and physical therapy; as well as grief and loss counseling for yourself and your family.

Services for home health

Part-time skilled nursing, home health aide, occupational therapy and physical therapy are all covered. Also, there is medical social services, injectable osteoporosis medications for women, and speech-language pathology and speech-language pathology. Medicare doesn’t pay for 24-hour care at home, meal delivery, or homemaker services (if this is the only type of care you require), or personal care such as bathing and dressing (if this is the only kind of care you need).

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Medicare Part A eligibility

Generally, you’re eligible for Medicare Part A if you meet one of the following requirements, according to Medicare:

  • Are you 65 years old or older?
  • You have been receiving disability benefits from Social Security and Railroad Retirement Board for at most 25 months.
  • Amyotrophic Lateral Sclerosis (ALS) is a condition that results in disability benefits.
  • You are suffering from End-Stage Renal Disease, (ESRD), and you meet certain criteria.

Costs of Medicare Part A

Premium-free Medicare Part A may be available to you if your spouse has worked for Medicare taxes for more than 10 years. To determine your eligibility, use Medicare’s eligibility calculator.

You may be eligible for Part A coverage if you aren’t eligible for premium-free coverage. The monthly premium for Part A is $259 or $471 depending on your spouse’s Medicare tax history and work.

“If you’re over 65 and you can afford it, it makes sense to pay for Part A,” says Jo Schneier, CEO and co-founder of Trusty.care, a Medicare quoting and enrollment tool for brokers, acknowledging that the premiums aren’t cheap. He says that Original Medicare plus a Supplement is likely to be the best type of insurance you have, and he refers to Medigap plans.

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