What Medicare Part A Covers: Hospital, Skilled Nursing, and Hospice Care

Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and 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 overnight — rather than care you receive as an outpatient (same-day visits). Part A covers four main types of care: inpatient hospital stays, skilled nursing facility stays after a hospital stay, hospice care for terminal illness, and some home health services. You do not pay a monthly premium for Part A if you or your spouse paid Medicare taxes for at least 10 years while working.

Part A does have cost-sharing: you pay a deductible when you enter the hospital, and you pay coinsurance (a daily amount) if your stay is longer than a certain number of days. The exact amounts change each year. Understanding what Part A covers and what it does not will help you know when you need additional coverage and what out-of-pocket costs to expect.

Key Takeaways

• Part A covers inpatient hospital care, including room, meals, tests, and medications given during your stay, but only after you pay the annual deductible.
• Skilled nursing facility care is covered only if you were hospitalized for at least three days first and are admitted within 30 days of leaving the hospital.
• Part A covers hospice care for people with a terminal diagnosis, including medications, equipment, and counseling, with little or no cost-sharing.
• Home health services are covered if ordered by a doctor and provided by a Medicare-certified agency, but only if you are homebound.
• Part A does not cover custodial care, private-duty nursing, or long-term care in a nursing home unless it is skilled nursing care following a hospital stay.

Inpatient Hospital Care: What Part A Pays For

When you are admitted to a hospital as an inpatient, Part A covers your room, meals, nursing care, tests, medications, and medical equipment used during your stay. It also covers blood transfusions, operating room costs, and anesthesia. Part A does not cover the doctor's fee separately — that is covered under Medicare Part B — but the hospital facility itself is Part A's responsibility.

You pay a deductible each time you enter the hospital (the amount resets each calendar year). After you meet the deductible, Part A covers all approved hospital costs for the first 60 days. If you stay longer than 60 days in a single hospital stay, you begin paying coinsurance — a fixed daily amount — for days 61 through 90. If you stay beyond 90 days, you can use lifetime reserve days (a limited pool of extra days available to you once in your lifetime), but you pay a higher coinsurance amount for those days.

A hospital stay ends when you are discharged or transferred to another facility. If you return to the hospital more than 60 days after your previous discharge, it counts as a new hospital stay, and you pay a new deductible.

Skilled Nursing Facility Care After Hospitalization

Part A covers skilled nursing facility (SNF) care — rehabilitation or medical care in a nursing home — but only under specific conditions. You must have been hospitalized for at least three consecutive days (not counting the day you are discharged), and you must be admitted to the SNF within 30 days of leaving the hospital. The care must be for a condition related to the reason you were hospitalized.

Part A covers all costs for the first 20 days of SNF care. For days 21 through 100, you pay a daily coinsurance amount (the amount changes yearly). After 100 days in a single stay, Part A coverage ends and you pay all costs yourself. This is why many people purchase Medigap or Medicare Advantage plans — to cover the coinsurance in a nursing home.

Part A does not cover custodial care — help with bathing, dressing, or eating — unless it is provided alongside skilled nursing or rehabilitation services. If you need only custodial care, Part A will not pay, and you or your family must cover the cost.

Hospice Care for Terminal Illness

Part A covers hospice care if your doctor certifies that you have a terminal illness and have six months or less to live. Hospice focuses on comfort and quality of life rather than cure. Part A covers doctor visits, nursing care, medications related to your terminal condition, medical equipment (such as a hospital bed or oxygen), counseling, and respite care (temporary care to give your family a break).

You pay little to nothing for hospice services covered by Part A — typically only a small copay for medications and respite care. You do not pay the Part A deductible for hospice. If you choose hospice, you are agreeing to stop pursuing curative treatment for your terminal condition, though you can still receive treatment for other health problems.

Hospice can be provided at home, in a hospice facility, a hospital, or a nursing home. Part A covers the full cost of the hospice team's services, including the social worker and chaplain visits, not just the nurse.

Home Health Services Covered by Part A

Part A covers home health services — skilled nursing, physical therapy, occupational therapy, and speech therapy — if a doctor orders them, a Medicare-certified home health agency provides them, and you are homebound (meaning you cannot leave home without considerable difficulty or help). You must be receiving care from a doctor, and the services must be medically necessary.

Part A covers the cost of the visits themselves with no deductible or coinsurance. However, if the home health agency also provides medical equipment (such as a wheelchair or oxygen), you may pay 20 percent coinsurance for the equipment. Home health aides who help with bathing or dressing are covered only if they are part of a skilled nursing or therapy visit.

Part A does not cover ongoing custodial care at home, housekeeping, or meal delivery. It also does not cover home health services if you are not homebound, even if a doctor orders them.

What Part A Does Not Cover

Part A does not cover outpatient care — doctor visits, emergency room visits (unless you are admitted as an inpatient), lab tests, or imaging done outside a hospital. It does not cover prescription drugs you take at home (that is Part D). It does not cover dental care, vision care, hearing aids, or routine physical exams.

Part A does not cover long-term custodial care in a nursing home unless it is skilled nursing care following a hospitalization. It does not cover private-duty nursing, care in a non-Medicare-certified facility, or care ordered by someone other than a doctor. It also does not cover care outside the United States, with rare exceptions for Canada and Mexico in specific border situations.

Cost-Sharing: Deductibles and Coinsurance

Part A requires you to pay upfront costs before coverage begins. The deductible — the amount you pay before Part A starts covering — applies to each hospital stay and resets each calendar year. Once you meet the deductible, you pay nothing for the first 60 days of a hospital stay. The deductible amount changes yearly and is set by Medicare.

After 60 days in the hospital, you pay coinsurance — a daily amount — for days 61 through 90. If you use lifetime reserve days beyond day 90, you pay a higher daily coinsurance. For skilled nursing facilities, you pay coinsurance starting on day 21. These amounts also change yearly. You can find the current year's amounts on Medicare.gov or by calling 1-800-MEDICARE.

If you have a Medigap plan or Medicare Advantage plan, that plan may cover some or all of your Part A cost-sharing, depending on the plan. This is one reason many people buy supplemental coverage.

Frequently Asked Questions

Does Part A cover my doctor's visits while I am in the hospital?

Part A covers the hospital facility and its staff, but your doctor's fee is billed under Medicare Part B. Part B covers the doctor's professional services. You may owe a Part B coinsurance for the doctor visit, depending on your coverage.

What happens if I need a nursing home but was not hospitalized first?

Part A will not cover nursing home care unless you were hospitalized for at least three days and admitted to the facility within 30 days. If you need nursing home care without a hospital stay, you must pay out of pocket or rely on Medicaid if you meet income and asset limits.

Can Part A cover care in my home if I am not homebound?

No. Part A home health coverage requires that you be homebound — unable to leave home without considerable difficulty or help. If you can leave home, home health services are not covered, even if a doctor orders them.

Do I pay anything for hospice care under Part A?

Hospice is nearly free under Part A. You may pay a small copay for medications and respite care, but there is no deductible and no coinsurance for hospice services themselves. This makes hospice one of the most affordable Part A benefits.

What if my hospital stay is longer than 90 days?

After 90 days, you can use lifetime reserve days — a one-time pool of 60 extra days available to you across your entire lifetime. You pay a higher daily coinsurance for reserve days. Once you exhaust reserve days, you pay all costs yourself unless you have supplemental coverage.