Medicare Part A covers hospital stays, skilled nursing, hospice, and some home health care

Medicare Part A is hospital insurance. It pays for inpatient hospital stays, time in a skilled nursing facility after you leave the hospital, hospice care for terminal illness, and limited home health services. It does not pay for outpatient doctor visits, prescription drugs, dental work, vision care, or long-term custodial care in a nursing home.

Part A is automatic — you get it at 65 if you have worked and paid Medicare taxes for at least 10 years. You pay a monthly premium only if you or your spouse did not work long enough; otherwise, Part A is free. You do pay a deductible and copayments when you use hospital services.

Key Takeaways

  • Medicare Part A covers the full cost of the first three days in a hospital, then you pay a daily copayment for days 4 through 60, and a higher copayment for days 61 through 90.
  • Skilled nursing facility care is covered only if you spent at least three consecutive days in a hospital first, and only for up to 100 days per benefit period.
  • Home health care is covered only if a doctor orders it, you are homebound, and the care is skilled (nursing or therapy), not just help with daily tasks.
  • Hospice care is covered in full for people with a terminal diagnosis expected to live six months or less, but you must choose hospice instead of curative treatment.
  • Part A does not cover prescription drugs, dental, vision, hearing aids, or ongoing help with bathing and dressing unless it is part of skilled nursing care.

Hospital stays and the daily copayment structure

When you are admitted to a hospital as an inpatient, Medicare Part A covers all approved charges after you pay the deductible. For 2024, the Part A deductible is $1,632 per benefit period. A benefit period starts the day you enter the hospital and ends 60 days after you leave without being readmitted.

After you pay the deductible, Part A covers your entire hospital bill for days 1 through 3. Starting on day 4, you pay a copayment for each day you stay. For 2024, that copayment is $408 per day for days 4 through 60. If you stay longer than 60 days, the copayment rises to $816 per day for days 61 through 90. Medicare Part A covers up to 90 days in the hospital per benefit period, plus 60 additional "lifetime reserve days" that you can use only once.

The deductible and copayments reset if you go home for 60 days without being readmitted. If you are readmitted within 60 days, you are still in the same benefit period and do not pay a new deductible.

Skilled nursing facility care after hospitalization

Medicare Part A covers care in a skilled nursing facility (SNF) — a nursing home that provides medical care, not just room and board — but only under specific conditions. You must have spent at least three consecutive days in a hospital first. The hospital stay must be for the same condition you are being treated for in the nursing home, or a related one. Part A will not pay for a nursing home stay if you were admitted directly from home or from an outpatient clinic.

Part A covers the full cost of the first 20 days in a skilled nursing facility per benefit period. For days 21 through 100, you pay a copayment of $204 per day (for 2024). After 100 days, Part A stops paying and you pay the full cost yourself. Many people buy Medigap or Medicare Advantage plans partly to cover these copayments.

The facility must be Medicare-certified, and the care must be skilled — meaning a nurse or therapist must provide it, not just a nursing aide. Physical therapy, occupational therapy, and speech therapy all count as skilled care. Help with bathing, dressing, and meals alone does not count as skilled care and is not covered by Part A.

Home health care when you are homebound

Medicare Part A covers home health care if a doctor orders it, you are homebound (meaning you cannot leave home without help), and the care is skilled. Skilled care means a nurse, physical therapist, occupational therapist, or speech-language pathologist provides it. Part A covers the full cost of home health visits with no copayment, as long as the services are medically necessary.

Home health care does not include help with housekeeping, meal preparation, or personal care like bathing unless a nurse or therapist is also providing skilled services in the home. If you need only help with daily tasks, that is called custodial care and Part A does not cover it. You would need to pay out of pocket or have a private long-term care plan.

The home health agency must be Medicare-certified. Your doctor must order the services and recertify the need every 60 days. If you are admitted to a hospital or nursing home, home health services stop while you are there.

Hospice care for terminal illness

Medicare Part A covers hospice care in full — with no copayment — for people with a terminal diagnosis. A doctor must certify that you are expected to live six months or less. Hospice covers pain management, symptom relief, emotional support, and spiritual care. It includes drugs, medical equipment, and nursing visits.

Hospice can be provided at home, in a hospice facility, in a hospital, or in a nursing home. Part A covers up to five days of inpatient respite care per benefit period, which allows a family caregiver to take a break.

Choosing hospice means you are choosing comfort care instead of curative treatment. You can stop hospice at any time and go back to regular Medicare coverage if your condition improves or you change your mind. If you choose hospice, Part A will not pay for hospital stays or other treatments aimed at curing your illness, though it will still pay for care unrelated to your terminal condition.

What Part A does not cover

Medicare Part A does not cover outpatient services — doctor visits, lab tests, imaging, or procedures done in a clinic or hospital outpatient department. That is covered by Medicare Part B. Part A does not cover prescription drugs; you need Medicare Part D for that. Part A does not cover dental work, vision care, hearing aids, or routine foot care.

Part A does not cover custodial care — help with bathing, dressing, eating, and toileting when no skilled nursing or therapy is involved. It does not cover long-term care in a nursing home unless the care is skilled and follows a hospital stay. It does not cover private-duty nursing, adult day care, or meals delivered to your home.

Part A does not cover experimental treatments or procedures that Medicare determines are not medically necessary. It does not cover care received outside the United States, except in limited cases in Canada and Mexico near the U.S. border.

Benefit periods and how they reset

A benefit period is the way Medicare measures your use of Part A services. It starts the day you are admitted to a hospital as an inpatient and ends 60 days after you are discharged and not readmitted. When a benefit period ends, your deductible resets and your copayment counters reset.

If you are readmitted to a hospital within 60 days of discharge, you are still in the same benefit period. You do not pay a new deductible, but your copayments continue where they left off. If you are discharged and then readmitted after 60 days have passed, a new benefit period begins and you pay a new deductible.

Skilled nursing facility care and home health care do not start a new benefit period — they are part of the same benefit period that began with your hospital stay. Once a benefit period ends, you start fresh with a new deductible and new day counters.

Questions to ask your doctor or Medicare

Before you are admitted to the hospital or nursing home, ask your doctor whether the stay will be covered by Part A and whether you will meet the three-day hospital requirement for nursing home coverage. Ask whether the care you will receive is considered skilled or custodial. Ask how many days you are expected to stay and what your out-of-pocket costs will be.

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 nursing home billing department to explain what Part A will and will not pay for your specific situation.

Frequently Asked Questions

Does Medicare Part A cover a hospital stay for surgery?

Yes. If you are admitted to the hospital as an inpatient for surgery, Part A covers the hospital charges after you pay the deductible. It does not cover the surgeon's fee — that is billed to Medicare Part B. Part A covers the bed, meals, nursing care, and use of the operating room.

What happens if I stay in the hospital longer than 90 days?

After 90 days in one benefit period, you can use your lifetime reserve days — 60 additional days that Medicare will pay for, but only once in your lifetime. After those are used, you pay the full cost of the hospital stay yourself. This is why many people buy Medigap coverage.

If I go to a nursing home, does Part A pay for everything?

Part A pays for skilled nursing and therapy care for up to 100 days per benefit period, but you pay copayments starting on day 21. Part A does not pay for custodial care — help with bathing and dressing — or for stays longer than 100 days. Many people run out of Part A coverage before they leave the nursing home.

Can I use Part A for home care instead of a nursing home?

Yes, if a doctor orders it and you are homebound. Part A covers skilled nursing and therapy visits at home with no copayment. However, it does not cover help with housekeeping or personal care unless a nurse or therapist is also providing skilled services.

Does Part A cover prescription drugs?

No. Part A covers hospital and nursing facility care, not drugs. You need Medicare Part D to cover prescription medications. If you are in hospice, Part A covers drugs related to your terminal condition as part of hospice care.