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 and stay overnight — rather than care you get as an outpatient visiting a doctor's office. Part A covers four main types of care: hospital stays, skilled nursing facilities, hospice care, 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 works differently from Part B (doctor visits and outpatient care). With Part A, you pay a deductible — a set amount you pay out of pocket before Medicare starts to pay — rather than a copay each time you use a service. The deductible amount changes each year. After you meet the deductible, Medicare covers most of the cost, though you may still pay coinsurance (a percentage of the bill) for longer stays.

Key Takeaways

  • Part A covers inpatient hospital care, including semi-private rooms, meals, and standard hospital services, after you pay an annual deductible.
  • Skilled nursing facility care is covered for up to 100 days per benefit period if you were hospitalized first and meet specific medical requirements.
  • Hospice care is covered when a doctor confirms you have six months or less to live, and includes pain management, counseling, and medications related to your terminal condition.
  • Home health services are covered when ordered by a doctor and provided by a Medicare-approved agency, but only if you are homebound or have severe mobility limits.
  • Part A does not cover custodial care (help with daily living), private duty nursing, or long-term residential care in assisted living or nursing homes.

Hospital Inpatient Care: What Part A Pays For

When you are admitted to a hospital as an inpatient, Part A covers a semi-private room (two beds, shared with one other patient), all meals, nursing care, medications given in the hospital, lab tests, imaging like X-rays and CT scans, and operating room costs. It also covers blood transfusions, medical equipment used in the hospital such as oxygen or wheelchairs, and rehabilitation services if you need them before discharge.

You pay the Part A deductible once per benefit period (a benefit period starts when you enter the hospital and ends 60 days after you leave). After you pay the deductible, Medicare covers all approved hospital costs for the first 60 days. Days 61 through 90 require a daily coinsurance payment from you. If you stay longer than 90 days, you have access to lifetime reserve days — 60 additional days Medicare will cover during your lifetime, but with a higher daily coinsurance amount. Once you use your lifetime reserve days, you pay all costs.

Part A does not cover a private room unless it is medically necessary, a private nurse, or a television and telephone in your room (though many hospitals provide these). It also does not cover the cost of getting to the hospital by ambulance unless the ambulance is medically necessary — for example, if you cannot safely travel by car.

Skilled Nursing Facility Care: The Three-Day Rule and Beyond

Part A covers care in a skilled nursing facility (SNF) — a nursing home or facility that provides skilled medical care — but only under specific conditions. You must have been hospitalized as an inpatient for at least three consecutive days before entering the SNF, and you must enter the SNF within 30 days of leaving the hospital. The hospital stay and SNF stay must be for the same or a related condition.

Once you meet these requirements, Part A covers up to 100 days per benefit period. You pay nothing for days 1 through 20. Days 21 through 100 require a daily coinsurance payment. After day 100, you pay all costs. The facility must be Medicare-approved; ask the hospital social worker or call ahead to confirm.

Part A covers a semi-private room, meals, skilled nursing care, physical therapy, occupational therapy, speech therapy, medications, medical equipment, and lab work. It does not cover custodial care — help with bathing, dressing, or toileting when that is the only service you need. If you improve and no longer need skilled care, your coverage ends even if you have days remaining.

Hospice Care: Coverage for End-of-Life Comfort

Part A covers hospice care when a doctor has determined you have six months or less to live and you choose to focus on comfort rather than curative treatment. Hospice is usually provided in your home, though it can also be in a hospice facility, hospital, or nursing home. You must be enrolled in a Medicare-approved hospice program.

Hospice coverage includes doctor visits, nursing care, pain management medications, counseling (for you and your family), spiritual care if you want it, and respite care — temporary care in a facility so your family caregiver can take a break. Part A also covers medical equipment and supplies related to your terminal condition, such as a hospital bed or oxygen.

You pay nothing for hospice care except for medications and inpatient respite care, which have small copays. If you choose to stop hospice and pursue curative treatment instead, you can do so, though you will no longer be covered under the hospice benefit. You can return to hospice later if your condition changes.

Home Health Services: When You Are Homebound

Part A covers home health services when a doctor orders them, you are homebound or have severe difficulty leaving home, and a Medicare-approved agency provides the care. Homebound means leaving home requires considerable effort and help, or leaving would be medically inadvisable.

Covered services include skilled nursing visits, physical therapy, occupational therapy, speech therapy, and medical social work. Part A also covers medical equipment and supplies such as wheelchairs, walkers, hospital beds, and wound care supplies. You pay nothing for these services if they are ordered by a doctor and provided by a Medicare-approved agency.

Home health does not cover custodial care (bathing, dressing, meal preparation) unless it is provided alongside a skilled service. It also does not cover homemaker services, yard work, or home repairs. If you improve and no longer need skilled care, your home health coverage ends.

What Part A Does Not Cover

Part A does not cover custodial care — the help with daily living that many people need as they age. This includes information with bathing, dressing, grooming, toileting, and meal preparation when that is the only service provided. Long-term residential care in an assisted living facility or nursing home (when you do not need skilled medical care) is not covered by Part A.

Part A also does not cover private duty nursing, private rooms (unless medically necessary), or care outside the United States except in limited circumstances (such as a hospital stay that begins in the U.S. and continues while you are traveling). Experimental treatments and procedures not approved by Medicare are not covered. Dental care, hearing aids, eyeglasses, and routine foot care are not Part A benefits.

How the Deductible and Coinsurance Work

Each year, Part A has a deductible amount that you pay once per benefit period before Medicare starts to pay. A benefit period is not the same as a calendar year — it begins when you enter a hospital and ends 60 days after you are discharged. If you are hospitalized again more than 60 days after your last discharge, a new benefit period begins and you pay the deductible again.

After you pay the deductible, your costs depend on how long you stay. For a hospital stay, days 1 through 60 are fully covered (except for the deductible). Days 61 through 90 require a daily coinsurance payment. For a skilled nursing facility, days 1 through 20 are fully covered, and days 21 through 100 require daily coinsurance. The exact dollar amounts change each year; you can find the current amounts on Medicare.gov or by calling 1-800-MEDICARE.

Frequently Asked Questions

Does Part A cover a hospital stay for outpatient surgery?

No. If you have surgery and go home the same day, that is outpatient care covered by Part B, not Part A. You pay a copay for the surgeon and facility. Part A only covers care when you are admitted to the hospital as an inpatient and stay overnight.

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

Part A will not cover it. You must have a three-day hospital stay first. If you need long-term residential care without a hospital stay, you would pay out of pocket or use Medicaid if you meet income and asset limits. Talk to a social worker about your options.

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

No. Home health services require that you be homebound or have severe difficulty leaving home. If you can leave home safely, you would need to visit a doctor's office or clinic, which is covered by Part B instead.

Do I have to pay anything for hospice care?

Hospice care itself is covered with no cost to you. You may have small copays for medications and inpatient respite care, but the hospice services — nursing, counseling, spiritual care — are covered in full once you are enrolled in a Medicare-approved program.

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

After 100 days in a benefit period, Part A coverage ends and you pay all costs out of pocket. Some people have supplemental insurance (Medigap) that covers some of these costs, but you should check your policy. Medicaid may cover long-term care if you meet income and asset limits.