Medicare Plan Part A (Hospital Insurance)

Medicare Plan Part A is the hospital insurance that is provided by Medicare. A majority of people do not have to pay a premium for this coverage.

Medicare Part A covers inpatient care in approved skilled nursing facilities, critical access hospitals, and hospitals. If you meet specific Medicare requirements, then you may also be eligible for hospice or home health care.

Medicare Part A does not include long-term or custodial care. Private insurance companies are the intermediaries that process and pay Medicare claims for the federal government.

No matter which health care insurance coverage you choose, make sure that you have a clear understanding of all of your options, coverage and premiums. Do not be afraid to ask questions and seek a Medicare representative that can help you to fully understand and tell you what you will need to do to sign up.

What does Medicare Part A Help Pay For?

Medicare Part A will help pay for your care in hospitals as an inpatient, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care.

Information about your coverage under Medicare Part A can be found in the Medical Coverage database.  If you aren't sure if you have Part A, look on your red, white, and blue Medicare card. If you have Part A, "HOSPITAL (PART A)" is printed on your card.

With regards to hospital stays, Medicare Part A will cover a semi-private room, your general nursing care, your meals and regular hospital supplies and services. Also covered by Medicare Part A is inpatient critical access hospital and mental health care. Stays in the hospitals must be at least 3 days (72 hours).

Any of your nursing home or skilled nursing facility care must be related to your diagonsis during your stay at the hospital. For example, If your hospital stay was for a stroke, then your nursing facility stay for rehabilitation would be covered. Your stay at the nursing facility is similar to the hospital with a semi-private room, meals and nursing care being covered.

Your coverage for Medicare Part A is limited to 100 days maximum during a benefit period. The first 20 days of your stay are paid in full and the remaining 80 days are a co-payment. Remember that Medicare Part A does not cover daily living, long-term care, or non-skilled nursing care.

Medicare Part A does help cover Hospice care, which is for a person that is terminally ill and only has six months to live. The Medicare coverage for Hospice includes medical services, grief counseling, pain relief and associated drugs. Care is given by a Medicare-approved caregiver that visits you at your home. Medicare will also cover any additional care for a Hospice patient so that the main caregiver can take some time off. Medicare does not cover all the services that may be provided by Hospice.

Medicare Part A only covers limited home health care services and part-time care. Some of the services that are covered by Medicare are skilled nursing care, therapy, speech language pathology, home health aid service and medical social services. Medicare Part A will also cover some specific equipment for use at home. The list of equipment includes hospital beds, wheelchairs, walkers and oxygen.

What is the cost of Medicare Part A?

In most cases you will get Medicare Part A automatically when you turn age 65. You don't have to pay a monthly payment called a premium for Medicare Part A because you or your spouse paid Medicare taxes while you were working throughout your career. 

If you don't automatically get premium-free Medicare Part A, you may be able to buy it. If you (or your spouse) aren't entitled to Social Security because you didn't work or didn't pay enough Medicare taxes while you worked and you are age 65 or older, or you are disabled but no longer get premium-free Part A because you returned to work.  If you have limited income and resources, your state of residence may help you pay for Medicare Part A and/or Medicare Part B.