Medicare Part A covers inpatient hospital stays, skilled nursing care after hospitalization, hospice care, 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 the facility itself, the room, meals, nursing care, and basic medical supplies while you are there. It does not cover the doctor's fees for seeing you (those fall under Part B), and it does not cover outpatient services like lab work or imaging done in a hospital's outpatient department.

Most people age 65 and older receive Part A automatically when they turn 65, with no monthly premium, because they or their spouse paid Medicare taxes while working. If you did not work long enough to may have access to for premium-free Part A, you can still purchase it, though the cost varies based on how many years of Medicare taxes you paid.

Key Takeaways

  • Part A covers overnight hospital stays, including the room, meals, nursing care, and hospital-provided medical supplies, but not the doctor's professional fees.
  • Part A pays for up to 100 days in a skilled nursing facility after a hospital stay of at least three days, though you pay a daily copay after day 20.
  • Part A covers hospice care for people with a terminal illness and some home health services, including nursing visits and physical therapy, when ordered by a doctor.
  • Part A has a deductible you pay once per benefit period (not per year), and costs vary depending on how long you or your spouse worked and paid Medicare taxes.
  • Part A does not cover outpatient services, doctor visits, prescription drugs, or long-term custodial care in a nursing home.

Hospital Inpatient Care: What Part A Pays

When you are admitted to a hospital as an inpatient, Part A covers your hospital room, meals, nursing care, medications given to you in the hospital, medical equipment and supplies used during your stay, and lab tests and imaging done while you are hospitalized. It also covers anesthesia, operating room costs, and blood transfusions. The hospital bills Medicare directly for these services.

You pay a single deductible per benefit period — not per calendar year. A benefit period begins the day you enter the hospital and ends 60 days after you leave without receiving any hospital or skilled nursing care. If you are readmitted within those 60 days, you do not pay a new deductible; if you stay out longer than 60 days, a new benefit period starts and you owe a new deductible when you are admitted again. The deductible amount changes each year.

After you meet the deductible, Part A covers all approved hospital costs for days 1 through 60 of your stay. For days 61 through 90, you pay a daily copay. If you need to stay longer than 90 days, you can use your lifetime reserve days — 60 additional days that Medicare provides over your entire lifetime — and you pay a higher daily copay for those days. Once your reserve days are used, they do not renew.

Skilled Nursing Facility Care After Hospital Discharge

Part A covers care in a skilled nursing facility (SNF) — a nursing home that provides skilled care like wound care, physical therapy, or intravenous medication — but only if you meet specific conditions. You must have been admitted to a hospital as an inpatient for at least three consecutive days (not counting the day you leave), and you must enter the nursing facility within 30 days of leaving the hospital. The nursing facility must also be Medicare-approved and the care must be for the same condition you were hospitalized for or a related condition.

Part A covers all costs for the first 20 days in a skilled nursing facility. From day 21 through day 100, you pay a daily copay, and Part A covers the rest. After day 100 in a benefit period, the nursing facility is your responsibility. This is different from custodial care — help with bathing, dressing, and eating — which Part A does not cover at any point, even in a nursing home. If you need a nursing home only for custodial care and not for skilled nursing services, Part A will not pay.

Home Health Services Covered by Part A

Part A covers home health services when a doctor orders them and you are homebound or have difficulty leaving home. Covered services include skilled nursing visits, physical therapy, occupational therapy, speech-language pathology, and medical social services. Part A also covers medical equipment and supplies — such as oxygen, wheelchairs, or wound care supplies — that your doctor prescribes. You pay nothing for these services; Part A covers them in full when they are ordered by a doctor and provided by a Medicare-approved home health agency.

Home health coverage does not require a hospital stay first, unlike skilled nursing facility care. However, the services must be skilled — meaning they require a nurse or therapist — rather than custodial or personal care. If you need someone to help you bathe or take medications but do not need nursing or therapy, home health will not cover it.

Hospice Care and End-of-Life Services

Part A covers hospice care for people with a terminal illness — a condition expected to end in six months or less — when a doctor certifies the diagnosis. Hospice focuses on comfort and quality of life rather than cure. Part A covers nursing care, doctor visits, medications related to the terminal illness, counseling, and respite care (temporary care that gives family caregivers a break). You typically pay nothing for hospice services, though you may pay a small copay for medications and respite care.

Choosing hospice means you are agreeing that you will not pursue curative treatment for the terminal illness, though you can still receive treatment for other conditions. If your condition improves and you no longer meet the six-month prognosis, you can leave hospice and return to regular Medicare coverage.

What Part A Does Not Cover

Part A does not cover outpatient services — care you receive without being admitted to the hospital overnight. This includes emergency room visits that do not result in admission, doctor office visits, lab work or imaging done in an outpatient setting, and preventive care like screenings and vaccinations. Those services fall under Medicare Part B.

Part A also does not cover prescription drugs you take at home (covered under Part D), dental care, vision care, hearing aids, or long-term custodial care in a nursing home. If you need a nursing home only for help with daily living and not for skilled medical care, you pay out of pocket; Medicare does not cover it.

Understanding Your Costs Under Part A

Most people age 65 and older pay no monthly premium for Part A because they or their spouse paid Medicare payroll taxes for at least 10 years. If you did not work long enough, you can purchase Part A, and the monthly cost depends on how many years of Medicare taxes you paid — typically ranging from a lower amount if you paid for 30 or more years to a higher amount if you paid for fewer years.

Your out-of-pocket costs under Part A are the deductible per benefit period, daily copays for hospital days 61 through 90 and beyond, daily copays for skilled nursing days 21 through 100, and small copays for some hospice medications and respite care. If you have a Medigap or Medicare Advantage plan, that plan may cover some or all of these costs, depending on the plan you chose.

Frequently Asked Questions

Does Part A cover my doctor's bill when I am in the hospital?

No. Part A covers the hospital facility and services, but the doctor who treats you sends a separate bill covered by Medicare Part B. You are responsible for Part B's deductible and copay for the doctor's services.

What happens if I stay in the hospital longer than 90 days?

You can use your lifetime reserve days — 60 additional days provided over your entire lifetime — and you pay a higher daily copay for each reserve day used. Once those 60 days are exhausted, you pay all costs yourself. Reserve days do not renew each year.

Do I need a hospital stay before I can use Part A for home health?

No. Home health services can be covered by Part A without a prior hospital stay, as long as a doctor orders them and you are homebound or have difficulty leaving home. Skilled nursing facility care, however, does require a three-day hospital stay first.

Does Part A cover a nursing home if I only need help with bathing and dressing?

No. Part A covers skilled nursing facility care only — services like wound care, physical therapy, or medication management. Help with bathing, dressing, and eating is custodial care, which Part A does not cover in any setting.

Can I use Part A if I am still working at age 65?

Yes. You can enroll in Part A at 65 even if you are still working. Part A is hospital insurance and does not depend on your employment status. You may delay Part B if you have employer coverage, but Part A enrollment at 65 is generally recommended.