Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services
Medicare Part A is hospital insurance. It pays for care you receive as an inpatient — meaning you are admitted to a facility and stay overnight — rather than care you receive as an outpatient in a doctor's office or emergency room. Part A covers the facility itself, the room, meals, nursing care, and most of the medical supplies and equipment you use while you are there. It does not cover the doctor's fees separately; those are billed under Part B.
Part A is automatic for most people at age 65 if they or their spouse paid Medicare taxes while working. You do not have to pay a monthly premium for Part A if you have 40 quarters of work history (roughly 10 years). If you do not have that work history, you can still buy Part A, but the premium varies by how many quarters you have.
Part A has a deductible — a set amount you pay out of pocket before Medicare starts paying. For 2024, the Part A deductible is $1,632 per benefit period for hospital stays. A benefit period starts when you enter the hospital and ends 60 days after you leave. If you go back into the hospital after those 60 days, a new benefit period begins and you owe a new deductible.
Key Takeaways
- Part A pays for inpatient hospital care, skilled nursing facility stays after a hospital stay, hospice care, and some home health services, but not outpatient doctor visits or emergency room visits unless you are admitted.
- You owe a deductible of $1,632 per benefit period for hospital stays, plus copayments for days 4 through 90 in a hospital and days 21 through 100 in a skilled nursing facility.
- Part A does not cover the full cost of a skilled nursing facility — it covers only the first 100 days, and only if you were hospitalized for at least three days first.
- Home health services covered by Part A must be ordered by a doctor, provided by a Medicare-certified agency, and limited to skilled care like nursing or physical therapy, not custodial help with daily living.
Hospital stays and what Part A pays
When you are admitted to a hospital as an inpatient, Part A covers the room, meals, standard nursing care, lab tests, X-rays, surgery, anesthesia, and medical equipment and supplies used in the hospital. It does not cover a private room unless medically necessary, and it does not cover a television, telephone, or personal comfort items.
For days 1 through 3 of a hospital stay, you pay the deductible ($1,632 in 2024) and nothing else. Starting on day 4, you owe a copayment — a fixed daily amount — for each day you stay. For 2024, that copayment is $408 per day for days 4 through 90. If you stay longer than 90 days in a single benefit period, the copayment increases to $816 per day for days 91 through 100. After 100 days, Part A stops paying and you pay the full cost.
Part A does not pay for the doctor who treats you in the hospital. Your doctor's services are covered under Medicare Part B, which has its own deductible and copayments. You may receive bills from the hospital and from the doctor separately.
Skilled nursing facility care after hospitalization
Part A covers a stay in a skilled nursing facility (SNF) — a nursing home or facility that provides skilled care like wound care, physical therapy, or medication management — but only if specific conditions are met. You must have been hospitalized for at least three consecutive days (not counting the day you leave), and you must enter the SNF within 30 days of leaving the hospital. The SNF must be Medicare-certified, and a doctor must order the care.
Part A covers the first 20 days of SNF care with no copayment from you. For days 21 through 100, you owe a copayment of $204 per day in 2024. After 100 days in a benefit period, Part A stops paying and you pay the full cost. Many people do not realize that Part A does not cover the full cost of a long nursing home stay — it covers only the first 100 days, and only under these conditions.
Part A does not cover custodial care — help with bathing, dressing, eating, or toileting — unless it is part of a skilled service. If you need only custodial care and no skilled nursing or therapy, Part A will not pay, and you will need to pay out of pocket or use Medicaid if you meet income and asset limits.
Home health services covered by Part A
Part A covers home health services if a doctor orders them, a Medicare-certified home health agency provides them, and they are skilled services — not custodial care. Covered services include nursing care, physical therapy, occupational therapy, speech-language pathology, and medical social services. Part A pays the full cost of home health services with no deductible or copayment, as long as the conditions are met.
You must be homebound — meaning leaving home is difficult and requires supportive information — for Part A to cover home health. The services must be intermittent or part-time, not full-time live-in care. If you need full-time custodial care at home, Part A does not cover it.
Home health is different from home care agencies that provide housekeeping, meal preparation, or personal care. Those services are not covered by Medicare Part A or Part B. You pay for them privately or through other programs.
Hospice care for terminal illness
Part A covers hospice care if a doctor certifies that you have a terminal illness and are expected to live six months or less. Hospice focuses on comfort and quality of life rather than cure. Part A covers doctor visits, nursing care, medications related to the terminal illness, medical equipment and supplies, counseling, and respite care (short-term inpatient care to give family caregivers a break).
You pay nothing for hospice services covered by Part A, except for a copayment of up to $5 per prescription for drugs and a copayment of up to 5 percent of the cost for respite care. If your condition improves and you are no longer expected to live six months or less, you can leave hospice and return to regular Medicare coverage.
What Part A does not cover
Part A does not cover outpatient care — visits to a doctor's office, urgent care center, or emergency room (unless you are admitted to the hospital). Those services are covered under Part B. Part A also does not cover routine physical exams, dental care, vision care, hearing aids, or most prescription drugs taken at home. It does not cover custodial care in any setting, whether at home, in a nursing facility, or in an assisted living facility.
Part A does not cover care in a facility that is not Medicare-certified, and it does not cover care ordered by someone other than a doctor. If you travel outside the United States, Part A generally does not cover care received abroad, with limited exceptions for emergencies in Canada or Mexico.
Deductibles and copayments for 2024
| Service | What You Pay |
|---|---|
| Hospital stay, days 1–3 | $1,632 deductible |
| Hospital stay, days 4–90 | $408 per day |
| Hospital stay, days 91–100 | $816 per day |
| Skilled nursing facility, days 1–20 | No copayment |
| Skilled nursing facility, days 21–100 | $204 per day |
| Home health services | No copayment |
| Hospice care | Up to $5 per prescription; up to 5% of respite care cost |
Questions to ask your doctor or Medicare
Before a hospital stay or admission to a skilled nursing facility, ask your doctor whether the care will be covered by Part A and whether you will meet the requirements (such as the three-day hospital stay before SNF care). Ask whether you will receive separate bills from doctors or other providers, and whether those will be covered by Part B.
If you are unsure whether a service is covered, call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov. You can also ask the hospital or facility billing department before you receive care. If you receive a bill you think should have been covered, you have the right to appeal.
Frequently Asked Questions
Does Part A cover the doctor's bill when I am in the hospital?
No. Part A covers the hospital facility and services, but the doctor's fees are billed separately under Part B. You will likely receive two bills — one from the hospital and one from the doctor or doctors who treated you. Part B has its own deductible and copayments.
What happens if I stay in the hospital longer than 100 days?
Part A stops paying after 100 days in a benefit period. You become responsible for the full cost of the hospital stay. A benefit period ends 60 days after you leave the hospital, so if you are readmitted after that time, a new benefit period begins and you owe a new deductible.
Can Part A cover a stay in an assisted living facility?
No. Part A covers skilled nursing facilities only, not assisted living. Assisted living provides custodial care and help with daily living, which Part A does not cover. You pay for assisted living privately or through Medicaid if you meet income and asset limits.
Do I have to pay for home health services if Part A covers them?
No copayment or deductible applies to home health services covered by Part A. However, the service must be ordered by a doctor, provided by a Medicare-certified agency, and be skilled care — not custodial help. If those conditions are not met, you pay the full cost.
What should I do if I receive a bill I think Part A should have covered?
Contact the provider or facility first to ask why the bill was not submitted to Medicare. If you believe the service should have been covered, you can file an appeal with Medicare. Call 1-800-MEDICARE or ask the provider for the appeal process and forms.