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 the facility itself, the room, meals, nursing care, and most of the medical supplies and equipment you use while you are there.
Part A does not cover doctor fees separately; those fall under Part B. Part A also does not cover outpatient services, prescription drugs, dental care, vision care, or hearing aids. If you have Original Medicare (Part A and Part B together), you pay a deductible and coinsurance for Part A services, and those costs can add up quickly during a long hospital stay.
Key Takeaways
- Part A covers inpatient hospital stays after you meet your annual deductible, which is the same whether you stay one night or many.
- Part A pays for up to 100 days in a skilled nursing facility if you were hospitalized first and meet specific conditions, but you pay coinsurance starting on day 21.
- Part A covers hospice care for people with a terminal illness, including medications and equipment related to that illness.
- Part A covers some home health services if a doctor orders them, you are homebound, and a home health agency is involved — but not custodial care like bathing or housekeeping alone.
- You do not pay a premium for Part A if you or your spouse paid Medicare taxes for at least 10 years, but you do pay a deductible and coinsurance.
Hospital Stays: What Part A Pays and What You Pay
When you are admitted to a hospital as an inpatient, Part A covers your room, meals, nursing care, lab tests, imaging, blood transfusions, and most medical supplies and equipment used during your stay. It does not cover television, phone calls, or a private room unless medically necessary.
You pay a single deductible per benefit period — not per day — regardless of how long you stay. A benefit period begins the day you enter the hospital and ends 60 days after you leave without returning. If you go back into the hospital within 60 days, you are still in the same benefit period and do not owe another deductible. If you return after 60 days, a new benefit period starts and you owe a new deductible.
After you meet the deductible, Part A covers all costs for days 1 through 60. For days 61 through 90, you pay coinsurance (a fixed daily amount). If you stay longer than 90 days, you can use your lifetime reserve days — 60 additional days that Medicare provides once in your lifetime. You pay coinsurance for those days too. After your reserve days run out, you pay all costs.
Skilled Nursing Facility Care: The Three-Day Rule and Beyond
Part A covers care in a skilled nursing facility (a nursing home or rehabilitation center) only if you meet strict conditions. You must have been an inpatient in a hospital 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 care you receive in the nursing facility must be for the same condition you were hospitalized for, or a condition that developed during your hospital stay.
Part A covers all costs for the first 20 days. For days 21 through 100, you pay coinsurance per day. After day 100 in a benefit period, you pay all costs. Many people assume they need a three-day hospital stay to may have access to, but Medicare counts three consecutive days of inpatient care — observation stays do not count, even if they last three calendar days.
Part A does not cover custodial care — help with bathing, dressing, eating, or toileting — unless it is part of skilled care you are receiving. If you need only custodial care, Part A will not pay, and you will need to cover those costs yourself or through Medicaid if you may have access to.
Hospice Care: End-of-Life Services and Medications
Part A covers hospice care if your doctor certifies that you have a terminal illness and are expected to live six months or less. Hospice covers pain management, symptom management, nursing care, counseling, and medications related to your terminal illness. It also covers some medical equipment and supplies, and respite care — temporary care that gives your family caregiver a break.
You pay little to nothing for hospice services covered by Part A. You may pay a small copayment for medications and respite care, but costs are minimal compared to hospital or nursing facility care. Hospice is designed to focus on comfort rather than cure, and it can be provided at home, in a hospice facility, a hospital, or a nursing home.
Home Health Services: When Part A Pays
Part A covers home health services if a doctor orders them, you are homebound (meaning you cannot leave home without help), and a Medicare-approved home health agency provides the care. Covered services include skilled nursing, physical therapy, occupational therapy, speech therapy, and medical social work. Part A also covers medical equipment like oxygen, wheelchairs, and hospital beds if ordered by your doctor.
Part A does not cover custodial care — bathing, dressing, or housekeeping — unless it is part of a skilled service. For example, if a nurse visits to change a wound dressing and also helps you bathe because you cannot do it safely, the bathing is covered as part of the skilled nursing visit. If you need only help with bathing and housekeeping, Part A will not pay.
You do not pay a deductible or coinsurance for home health services covered by Part A, as long as the agency is Medicare-approved and the services are medically necessary. However, you do pay 20 percent coinsurance for durable medical equipment.
Blood and Blood Products
Part A covers blood and blood products you receive as an inpatient in a hospital or skilled nursing facility. You do not pay for the blood itself after you meet your deductible, but you may pay for the first three pints of blood you receive unless they are donated to replace blood you donated before your hospital stay.
What Part A Does Not Cover
Part A does not cover outpatient services — care you receive without being admitted as an inpatient. This includes emergency room visits, urgent care, doctor office visits, lab work ordered by your doctor that you have done at a lab rather than in a hospital, and imaging like X-rays or MRI scans done outside a hospital setting. Those services fall under Part B.
Part A does not cover prescription drugs you take at home, dental care, vision care, hearing aids, or routine physical exams. It does not cover custodial care unless it is bundled with skilled care. It does not cover care in a nursing home if you do not meet the three-day hospital stay requirement first. It does not cover private duty nursing, and it does not cover care in a facility that is not Medicare-approved.
Frequently Asked Questions
Do I have to pay a premium for Part A?
No, if you or your spouse paid Medicare taxes for at least 10 years. If you did not, you can still enroll in Part A but you will pay a monthly premium. The amount depends on how many years you or your spouse paid Medicare taxes. You do pay a deductible and coinsurance even if you do not pay a premium.
What is the difference between Part A and Part B?
Part A is hospital insurance and covers inpatient care. Part B is medical insurance and covers outpatient services like doctor visits, lab work, imaging, and some equipment. Most people have both Part A and Part B, called Original Medicare. Doctor fees during a hospital stay are covered under Part B, not Part A.
If I have a Medigap or Medicare Advantage plan, does Part A still explore?
Yes. Part A is the foundation of all Medicare coverage. Medigap plans help pay your Part A deductible and coinsurance. Medicare Advantage plans (Part C) include Part A coverage but may have different rules about which hospitals and facilities you can use. Check your plan documents to understand your costs.
Does Part A cover a hospital stay for observation?
No. Observation status means you are in the hospital but not admitted as an inpatient. Part B covers observation, not Part A. This matters because if you later move to a skilled nursing facility, observation days do not count toward the three-day inpatient requirement. Ask the hospital to clarify your status when you arrive.
What happens if I stay in the hospital longer than 90 days?
After 90 days, you can use your lifetime reserve days — 60 additional days that Medicare provides once in your lifetime. You pay coinsurance for those days. After your reserve days are used, you pay all hospital costs. Once you use your lifetime reserve days, they are gone permanently, so use them carefully.