Medicare Part A covers inpatient hospital stays, skilled nursing care, hospice, and home health services
Part A is hospital insurance. It pays for care you receive as an inpatient — meaning you are admitted to a hospital or facility and stay overnight. It does not cover outpatient visits, where you go in for treatment and leave the same day. Part A also covers some follow-up care after you leave the hospital, like a stay in a skilled nursing facility or home health visits from nurses and therapists.
Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. You may still have costs when you use it: a deductible when you enter the hospital, and daily copayments if your stay is long. These amounts change each year.
Key Takeaways
- Part A covers inpatient hospital stays, including semi-private rooms, meals, and basic nursing care, but not private rooms or private-duty nurses unless medically necessary.
- Skilled nursing facility care is covered for up to 100 days after a hospital stay of at least three days, but only if you need skilled care like wound care or physical therapy — not custodial care or help with daily living alone.
- Home health services covered by Part A include nursing visits, physical therapy, and occupational therapy, but only if a doctor orders them and you are homebound.
- Hospice care is covered for people with a terminal illness, including pain management, counseling, and respite care, though you may pay small copayments for drugs and supplies.
- Part A does not cover outpatient doctor visits, emergency room visits that do not result in admission, or routine preventive care — those are covered by Part B.
Inpatient Hospital Care: What Part A Pays For
When you are admitted to a hospital as an inpatient, Part A covers the cost of your room (semi-private), meals, nursing care, medications given in the hospital, lab tests, X-rays, and medical equipment like wheelchairs or oxygen. It also covers surgery, anesthesia, and operating room costs. You pay a deductible for each benefit period — a benefit period starts when you enter the hospital and ends after you have been out of the hospital or skilled nursing facility for 60 days in a row.
Part A does not cover a private room unless it is medically necessary, private-duty nurses, or personal comfort items like a television or phone. If you need blood transfusions, you pay for the first three pints; Part A covers the rest. The length of your stay matters: Part A covers all approved costs for days 1 through 60 of a hospital stay in a benefit period. From day 61 to day 90, you pay a daily copayment. If you stay longer than 90 days, you can use "lifetime reserve days" — 60 additional days you can use once in your lifetime, though you pay a higher daily copayment for those days.
Skilled Nursing Facility Care After Hospital Discharge
If you spend at least three consecutive days in a hospital and then need skilled care, Part A covers up to 100 days in a skilled nursing facility per benefit period. Skilled care means you need services that only a nurse or therapist can provide — wound dressing, physical therapy, occupational therapy, or speech therapy. You do not pay anything for days 1 through 20. From day 21 to day 100, you pay a daily copayment.
Part A does not cover custodial care, which is help with bathing, dressing, eating, or toileting when that is the only care you need. Many people assume a nursing home stay is automatically covered; it is not. The facility must be a Medicare-certified skilled nursing facility, not just any nursing home, and a doctor must order the skilled care. If you are admitted to a facility for custodial care only, Part A will not pay, and you will be responsible for the full cost.
Home Health Services Covered by Part A
Part A covers home health visits from nurses, physical therapists, occupational therapists, and speech therapists, but only if three conditions are met: a doctor must order the care, you must be homebound (meaning leaving home is difficult or impossible without help), and the care must be skilled — not just help with daily tasks. Home health aides can come to help with bathing or dressing, but only if a nurse or therapist is also visiting for skilled care.
Part A covers the cost of medical supplies used in home health care, such as wound dressings, catheters, and diabetic supplies. It does not cover housekeeping, meal preparation, or ongoing personal care if no skilled service is being provided. Home health visits are covered for as long as your doctor orders them and you remain homebound; there is no time limit, and you pay nothing out of pocket for Part A–covered home health services.
Hospice Care and End-of-Life Services
Part A covers hospice care for people with a terminal illness when a doctor certifies that you have six months or less to live. Hospice covers pain management, symptom relief, counseling, spiritual care, and respite care (a short inpatient stay to give your caregiver a break). You can receive hospice at home, in a hospice facility, a hospital, or a nursing home. You pay nothing for hospice services themselves, though you may pay small copayments — up to $5 per prescription for drugs and $5 per day for respite care.
Choosing hospice means you are focusing on comfort rather than curative treatment. Part A will still cover other services you need that are not related to your terminal illness, such as treatment for a broken arm. If your condition improves and you no longer meet the hospice criteria, you can leave the hospice program 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 where you are not admitted to the hospital. It does not cover routine preventive care like annual checkups, screenings, or vaccinations. Dental care, vision care, hearing aids, and most prescription drugs are not covered by Part A. If you need these services, you would need Part B, Part D (for prescriptions), or a separate dental or vision plan.
Part A also does not cover care in a hospital or facility outside the United States, except in limited situations near the U.S. border or if you are traveling from the U.S. to a foreign country and need emergency care. Experimental treatments and procedures not approved by Medicare are not covered. If you receive care that Part A does not cover, you are responsible for the full cost unless you have a supplemental insurance plan (Medigap) or a Medicare Advantage plan that covers it.
How Part A Costs Work: Deductibles and Copayments
Part A has a deductible you pay once per benefit period when you are admitted to a hospital. The deductible amount changes each year; it is higher than most people expect. After you meet the deductible, you pay nothing for days 1 through 60 of a hospital stay. From day 61 to day 90, you pay a daily copayment. If you use lifetime reserve days (days 91 and beyond), you pay a higher daily copayment for each of those days.
For skilled nursing facility care, you pay nothing for days 1 through 20, then a daily copayment for days 21 through 100. Home health and hospice have no copayments or deductibles. If you have a Medigap plan or Medicare Advantage plan, it may cover some or all of these costs, depending on the plan. You can contact Medicare directly or visit Medicare.gov to see the current year's deductible and copayment amounts.
Frequently Asked Questions
Does Part A cover an emergency room visit?
Part A covers emergency room care only if you are admitted to the hospital as an inpatient. If you go to the emergency room, are treated, and sent home, Part B (medical insurance) covers the visit, not Part A. You should know which coverage applies before you receive the bill.
If I have a three-day hospital stay and then go to a nursing home, is the nursing home stay automatically covered?
The three-day hospital stay qualifies you for Part A coverage of skilled nursing care, but only if the nursing home is Medicare-certified and a doctor orders skilled care. If you are admitted for custodial care only, Part A will not pay. Ask the facility and your doctor to confirm that skilled care is ordered before you are discharged from the hospital.
Can Part A cover care at home if I am not homebound?
No. Home health services must be ordered by a doctor and you must be homebound — meaning leaving home requires considerable and taxing effort, or is medically contraindicated. If you can leave home, you do not meet the homebound requirement, and Part A will not cover home health visits.
What happens if I stay in the hospital longer than 90 days?
You can use lifetime reserve days — 60 additional days available once in your lifetime. You pay a higher daily copayment for reserve days. Once you use all 60 lifetime reserve days, you pay the full cost of any additional hospital days. These days do not renew each year.
Does Part A cover a private room in the hospital?
Part A covers a semi-private room. A private room is covered only if it is medically necessary — for example, if you have a contagious infection or need isolation for medical reasons. Your doctor must document the medical need, or you will be charged the difference between the semi-private and private room rates.