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 also covers skilled nursing facilities when you need rehabilitation after a hospital stay, hospice care for people with terminal illness, and limited home health services.

Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. You do pay a deductible each time you are admitted to a hospital, and you pay daily coinsurance amounts if your stay is longer than a certain number of days. The costs and coverage rules change each year.

Key Takeaways

  • Part A covers the full cost of your hospital room, meals, and basic nursing care during an inpatient hospital stay after you meet your annual deductible.
  • Part A pays for up to 100 days in a skilled nursing facility following a may have access to hospital stay of at least three days, though you pay coinsurance after day 20.
  • Part A covers hospice care for people with a terminal diagnosis, including medications, medical equipment, and counseling, with little to no out-of-pocket cost.
  • Part A covers home health services only when ordered by a doctor and only for people who are homebound, and it does not cover ongoing personal care or housekeeping.

Inpatient Hospital Care: What Part A Pays

When you are admitted to a hospital as an inpatient, Part A covers your room, meals, nursing care, medications given in the hospital, medical equipment and supplies used during your stay, and lab tests and imaging done in the hospital. It also covers blood transfusions and operating room costs. Part A does not cover your doctor's fees — those are covered under Medicare Part B — but it does cover the hospital's facility charges.

You pay a deductible once per benefit period (usually a calendar year) before Part A begins to pay. After you meet the deductible, Part A covers all approved hospital costs for days 1 through 60 of your stay. On days 61 through 90, you pay a daily coinsurance amount. If you stay longer than 90 days, you can use your lifetime reserve days — Medicare gives you 60 of these over your lifetime — and you pay a higher daily coinsurance for those days. Once your reserve days are used, you pay all costs.

A new benefit period begins if you have not been an inpatient in any hospital or skilled nursing facility for 60 days in a row. This means if you are discharged and then readmitted more than 60 days later, you start a new benefit period and pay a new deductible.

Skilled Nursing Facility Care After Hospital Discharge

Part A covers care in a skilled nursing facility (SNF) when you need rehabilitation or skilled care after a hospital stay. You must have been admitted to a hospital as an inpatient for at least three consecutive days (not counting the day you are discharged) to be covered for SNF care. The facility must be Medicare-certified, and your doctor must order the care for a condition related to the reason you were hospitalized.

Part A covers up to 100 days per benefit period. For days 1 through 20, Part A pays all approved costs and you pay nothing. For days 21 through 100, you pay a daily coinsurance amount and Part A pays the rest. After day 100, you pay all costs. Many people leave the facility before day 100, so they never reach the point where they pay coinsurance.

SNF care includes your room, meals, nursing care, physical therapy, occupational therapy, speech therapy, medications, and medical equipment. It does not include custodial care — help with bathing, dressing, or eating — unless that care is part of your skilled rehabilitation plan. If you need only custodial care and no longer need skilled nursing or therapy, Part A stops paying and you must pay out of pocket or use other insurance.

Hospice Care for Terminal Illness

Part A covers hospice care when a 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 and supplies, counseling (including grief counseling for your family), and short-term inpatient care when needed for pain management.

You pay little to nothing for hospice services covered by Part A. You may pay a small copayment for medications and respite care (temporary care that gives your family a break). Hospice can be provided in your home, a hospice facility, a hospital, or a nursing home. You can change your mind about hospice at any time, and if you do, you return to regular Medicare coverage.

Home Health Services Covered by Part A

Part A covers home health services when a doctor orders them, you are homebound (meaning leaving home requires considerable effort or help), and you need skilled nursing care or therapy. Covered services include nursing visits, physical therapy, occupational therapy, speech therapy, and medical social work. Part A also covers medical equipment and supplies such as wheelchairs, walkers, oxygen, and wound care supplies.

Part A does not cover ongoing personal care or housekeeping services. If you need help with bathing, dressing, or meals but do not need skilled nursing or therapy, that care is not covered by Part A. Home health services are covered under the same benefit period as your hospital and SNF care, so they do not require a separate deductible.

What Part A Does Not Cover

Part A does not cover outpatient care — visits to a doctor's office, emergency room, or urgent care center where you are not admitted as an inpatient. It does not cover doctor fees (those are Part B). It does not cover prescription drugs you take at home (those are covered under Medicare Part D). It does not cover dental care, vision care, hearing aids, or routine foot care.

Part A also does not cover custodial care in a nursing home if you do not need skilled nursing or therapy. It does not cover private duty nursing, and it does not cover care in a facility that is not Medicare-certified. If you travel outside the United States, Part A generally does not cover care you receive abroad, with rare exceptions for care in Canada or Mexico under specific circumstances.

Understanding Your Costs and Deductibles

Your Part A costs depend on how long you stay in a hospital or skilled nursing facility and whether you use your lifetime reserve days. The deductible amount changes each year. You can find the current year's deductible, coinsurance amounts, and daily rates on the official Medicare website or by calling Medicare directly.

If you have Medigap (supplemental insurance) or Medicare Advantage, your out-of-pocket costs may be lower because those plans help pay Part A costs. Medigap plans are designed to cover some or all of your deductibles and coinsurance. Medicare Advantage plans have their own deductibles and coinsurance, which may be different from Original Medicare.

Frequently Asked Questions

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

No. Part A covers the hospital's facility charges — your room, meals, nursing care, and equipment. Your doctor's fees are covered under Medicare Part B. You may owe a copayment or coinsurance for the doctor's visit depending on your coverage.

What happens if I stay in a skilled nursing facility longer than 100 days?

Part A stops paying after 100 days in a benefit period. You then pay all costs out of pocket unless you have supplemental insurance like Medigap. If you need ongoing care, you may be able to stay and pay privately, or you may need to move to a different level of care.

Can I use Part A for rehabilitation at home instead of a nursing facility?

Part A covers home health services including physical therapy and occupational therapy, but only if a doctor orders them and you are homebound. Home health is an alternative to facility-based care for some people, but it requires skilled nursing or therapy — not just personal care or housekeeping.

Do I have to pay anything for hospice care?

Part A covers most hospice services with little or no cost to you. You may pay a small copayment for medications and respite care. If you choose treatment that conflicts with your hospice plan, you may pay out of pocket for that treatment.

What if I am admitted to the hospital but discharged the same day?

If you are admitted and discharged on the same day, you are considered an outpatient, not an inpatient. Part A does not cover outpatient hospital visits. Part B covers your doctor's fees and some outpatient services, but you may owe a copayment or coinsurance.