Medicare Part A – Hospital Coverage

medicare card with part a and part b

What Does Medicare Part A Cover?

Medicare Part A Covers - Infographic

Medicare Part A covers inpatient hospital and skilled nursing care.

Medicare Part A generally covers the following:

  • Inpatient care in a hospital
    • You’re admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
    • The hospital accepts Medicare.
    • In certain cases, the Utilization Review Committee of the hospital approves your stay while you’re in the hospital.
  • Skilled nursing facility care
    • You have Part A and have days left in your benefit period to use.
    • You have a qualifying hospital stay .
    • Your doctor has decided that you need daily skilled care. It must be given by, or under the supervision of, skilled nursing or therapy staff.
    • You get these skilled services in a SNF that’s certified by Medicare.
    • You need these skilled services for a medical condition that’s either:
      • A hospital-related medical condition treated during your qualifying 3-day inpatient hospital stay, even if it wasn’t the reason you were admitted to the hospital. 
      • A condition that started while you were getting care in the SNF for a hospital-related medical condition (for example, if you develop an infection that requires IV antibiotics while you’re getting SNF care)
  • Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
  • Hospice care
    • Your hospice doctor and your regular doctor (if you have one) certify that you’re terminally ill (with a life expectancy of 6 months or less).
    • You accept palliative care (for comfort) instead of care to cure your illness.
    • You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness and related conditions.
  • Home health care

Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these:

Usually, a home health care agency coordinates the services your doctor orders for you.

Medicare doesn’t pay for:

  • 24-hour-a-day care at home
  • Meals delivered to your home
  • Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
  • Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need

How Much Does It Cost?

medicare part a - how much does it cost

You usually don’t pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called “premium-free Part A.” So most Americans will not pay a monthly premium for Medicare Part A but there are some exceptions where you may have to pay for Part A Premium since you don’t qualify. 

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 got Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

If you don’t qualify for premium-free Part A, you can buy Part A.

If you buy Part A, you’ll pay up to $458 each month. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $458. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252.

In most cases, if you choose to buy Part A, you must also:

Contact Social Security for more information about the Part A premium in your circumstances. A Coverage2Care agent can assist you after you receive Part A and Part B or Part A and Part D.  

Is there a deductible for Medicare Part A?

medicare part a deductible

If you stay with original Medicare as your primary insurance there is a deductible of $1,408 for the year 2020 that must be met BEFORE the government pays their 80% for Part A.

If you have a Medicare Supplement/Medigap or Medicare Advantage (Part C) plan the deductible may not apply to you.

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