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 covers four main types of care: hospital stays, skilled nursing facilities, hospice services, and home health visits ordered by a doctor.
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 — a set amount you pay out of pocket before Part A begins to pay — and you may pay coinsurance (a percentage of costs) depending on how long you stay. The longer your stay, the more you may owe.
Key Takeaways
- Part A covers inpatient hospital care, including semi-private rooms, meals, and medically necessary procedures, for up to 90 days per benefit period.
- Skilled nursing facility care is covered for up to 100 days per benefit period if you were hospitalized for at least three consecutive days first.
- Hospice care is covered when a doctor certifies you have six months or less to live, and includes pain management and comfort care at home or in a facility.
- Home health services are covered when ordered by your doctor and include nursing visits, physical therapy, and medical equipment, with no deductible or coinsurance.
- You pay a deductible for hospital stays and skilled nursing care, but home health and hospice have no deductible or coinsurance.
Hospital Inpatient Care Covered by Part A
Part A covers a semi-private room (two beds), all meals, nursing care, and medically necessary procedures and tests while you are admitted to a hospital. This includes surgery, X-rays, lab work, and medications given to you in the hospital. It also covers blood transfusions, operating room costs, and intensive care if you need it.
Part A covers up to 90 days per benefit period. A benefit period begins the day you enter the hospital and ends 60 days after you leave. If you return to the hospital after those 60 days have passed, a new benefit period starts. You pay a deductible for the first day of each hospital stay (the amount changes yearly). After that, Part A pays the full cost for days 1 through 60. On days 61 through 90, you pay coinsurance — a daily amount that also changes yearly.
Part A does not cover a private room unless it is medically necessary, a television or telephone in your room, or a doctor's services (those are covered under Part B). It also does not cover experimental treatments or care that is not medically necessary.
Skilled Nursing Facility Care After Hospital Discharge
If you need ongoing medical care after leaving the hospital — such as wound care, physical therapy, or help regaining strength — you may go to a skilled nursing facility (SNF). Part A covers up to 100 days per benefit period, but only if you were hospitalized for at least three consecutive days first and you enter the SNF within 30 days of leaving the hospital.
Part A covers a semi-private room, meals, nursing care, therapy (physical, occupational, or speech), medications, and medical equipment like wheelchairs or walkers. You pay nothing for the first 20 days. On days 21 through 100, you pay a daily coinsurance amount. After 100 days in a benefit period, Part A stops paying and you pay all costs.
The three-day hospital stay requirement is strict. Observation stays — where you are in the hospital but not formally admitted as an inpatient — do not count. If you are unsure whether you were admitted as an inpatient or held for observation, ask the hospital before you leave.
Hospice Care for End-of-Life Comfort
Part A covers hospice care when a doctor certifies that you have six months or less to live and you choose comfort care instead of treatment aimed at curing your illness. Hospice focuses on managing pain and symptoms, not extending life. It can be provided at home, in a hospice facility, a hospital, or a nursing home.
Part A covers doctor visits, nursing care, medications related to your condition, medical equipment, counseling (spiritual, grief, and family), and short-term inpatient care if pain or symptoms cannot be managed at home. You pay nothing for hospice services covered by Part A. You may pay a small coinsurance for medications and inpatient respite care (a short hospital stay to give your caregiver a break).
Choosing hospice does not mean you cannot change your mind. You can stop hospice care at any time and return to curative treatment, though you would then use your hospital and skilled nursing benefits again.
Home Health Services With No Deductible
Part A covers home health services when a doctor orders them and you are homebound or have difficulty leaving home. Services include skilled nursing visits, physical therapy, occupational therapy, speech therapy, and medical social work. Part A also covers medical equipment such as oxygen, walkers, hospital beds, and wound care supplies.
Home health has no deductible and no coinsurance — Part A pays the full cost. The services must be ordered by your doctor and provided by a Medicare-certified home health agency. You do not choose the agency; your doctor or hospital discharge planner usually refers you to one in your area.
Part A does not cover homemaker or personal care services (help with bathing, dressing, or meals) unless they are part of a skilled nursing or therapy visit. It also does not cover 24-hour care at home or care that is not medically necessary.
What Part A Does Not Cover
Part A does not cover outpatient care — visits to a doctor's office, emergency room, or urgent care clinic where you are not admitted to stay overnight. Those services are covered under Medicare Part B. Part A also does not cover dental care, vision care, hearing aids, or routine foot care.
Part A does not cover custodial care — help with daily activities like bathing, dressing, or eating — unless it is provided alongside skilled nursing or therapy. It does not cover care in a facility that is not Medicare-certified, and it does not cover care outside the United States (with rare exceptions for certain border areas and cruise ships).
If you need long-term custodial care in a nursing home, that is usually paid by Medicaid (if you meet income and asset limits), private pay, or long-term care insurance — not by Medicare Part A.
How Much You Pay: Deductibles and Coinsurance
Part A costs vary depending on the type of care and how long you stay. For hospital stays, you pay a deductible for each benefit period (the amount is set yearly by Medicare). For skilled nursing facilities, you pay coinsurance starting on day 21. Home health and hospice have no deductible or coinsurance.
The exact dollar amounts change each year. You can find the current amounts on Medicare.gov or by calling 1-800-MEDICARE. If you have limited income, you may be able to get help paying Part A costs through a program called Medicaid or a Medicare Savings Program run by your state.
Frequently Asked Questions
Does Part A cover my doctor's visits while I am in the hospital?
No. Part A covers the hospital facility, room, and nursing care. Your doctor's services are covered under Part B. You may owe a copay or coinsurance for the doctor visit depending on your Part B coverage.
What is the difference between observation and inpatient admission?
Inpatient means you are formally admitted to the hospital and stay overnight. Observation means you are in the hospital but not admitted — you may stay one night or several, but it is not counted as an inpatient stay. This matters because skilled nursing care after discharge requires a three-day inpatient hospital stay. Ask the hospital to clarify your status before you leave.
Can Part A cover me if I go to the hospital in another state?
Yes. Part A covers inpatient care at any Medicare-certified hospital in the United States, regardless of which state you live in. If you travel or split time between states, your Part A coverage goes with you.
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. After day 100, you pay all costs out of pocket unless you have supplemental insurance (Medigap) or Medicaid coverage. Some people use long-term care insurance or private pay for extended stays.
Do I need Part B if I have Part A?
Part A and Part B work together but cover different services. Part A covers inpatient care; Part B covers outpatient care like doctor visits and tests. Most people have both. You can have Part A without Part B, but if you delay signing up for Part B when you are first may be able to access, you may pay a penalty later.