Medicare Part A - What it is and What it Covers

If you are a senior or are caring for one, you may have some familiarity with Medicare. There are several parts to this federal program: Part A, Part B, Part C (Medicare Advantage), and Part D. 

Medicare Part A is part of what is called "original Medicare." This part of Medicare covers inpatient care in hospitals and skilled nursing facilities, as well as hospice and some home health care. 

In total, 68.4 million American citizens and legal residents are enrolled in Medicare as of January 2025. The vast majority of them — 90.2%, to be exact — are aged 65 and over. There is a roughly 50-50 split between the numbers with Part A coverage from Original Medicare and those receiving Part A care through a Medicare Advantage plan.

What is Medicare Part A? Generally, this coverage, which may also be called Medicare hospital insurance, is one of several sections of the Medicare program. Part A is designed primarily to help pay for hospital costs for older adults, although coverage is also available for younger people with certain conditions, such as end-stage renal disease.

All recipients of Medicare have hospital coverage, either through Part A in original Medicare or via a Medicare Advantage plan, which is an alternative provided by private insurance companies rather than the government. 
Individuals may receive Medicare Part A once they reach 65 and are eligible for Social Security or Railroad Retirement cash benefits. For people who have paid Medicare taxes throughout their working life, there is no premium. A small number of people who don't qualify for premium-free Part A may pay either $285 or $518/month for their coverage as of 2025, depending on how long they or their spouse worked and paid taxes.

Medicare Part A covers a broad range of medical costs. Perhaps the most important is inpatient hospital care. The amount covered varies depending on how many days you're in the hospital. But that's not all. Part A also covers care in a skilled nursing facility if you need treatment and rehabilitation after a qualifying hospital stay.

If you are admitted to a psychiatric hospital, Part A covers certain costs, and it also pays for hospice care, some home health services, and possibly nursing home care, although it does not cover custodial care.

When you ask, what does Medicare Part A cover? "Hospital costs" may be the first thing that comes to mind. Generally, you must be admitted to a hospital that accepts Medicare and have an official doctor's order that says you need inpatient care for your illness or injury. 

Medicare will cover the cost of a semi-private room, your meals, nursing, any medication required for hospital stay, and other hospital services and supplies, such as surgery, lab tests, and more. Emergency room care or the costs of doctors who treat you aren't covered — instead, Medicare Part B pays those costs. The exception: Part A will cover emergency room care if you’re admitted as an inpatient.

Medicare Part A pays for care in a Medicare-certified skilled nursing facility (SNF) if you enter it within 30 days of leaving the hospital after a qualified stay there. There are a few qualifications, and you must need skilled services or therapy to improve or maintain your current condition, or keep it from getting worse. Services and supplies that should be paid for by Medicare include the following:

• Semi-private room
• Speech-language, physical, and occupational therapy
• Skilled nursing care
• Medications
• Social services related to your medical care
• Dietitian services and all meals
• Ambulance transportation to other facilities if you need care that isn’t available at the SNF
• Medical supplies used at the facility

Home health care, as the name suggests, is medical care you receive in your home, either because you can't normally leave, or it is challenging to do so. In some cases, home health care can be a viable alternative to a hospital stay or time in a skilled nursing facility, and it is often less expensive. Home health services may be paid for under Medicare Part A or Part B, depending on the service. Your doctor will need to certify that you need the care for it to be covered. 

Recommended therapies must be considered “specific, safe and effective” for your condition. Your doctor must also certify that you’re homebound, and regularly review your care plan to determine if it needs to be updated. Home health coverage is a great benefit if you need part-time medical care and can’t leave your home due to your health.

Medicare Part A may pay for the following home health services:

• Skilled nursing care for fewer than eight hours per day or 28 hours per week
• Speech-language pathology services
• Physical and occupational therapy
• Medical social services
• Medical supplies used as part of your care
• Medicare Part A and Part B help pay for some injectable drugs that treat osteoporosis, under certain conditions
• Part-time or intermittent home health aide care, if you are also getting skilled nursing care or therapy

Medicare doesn’t pay for meal delivery, 24/7 home-based care, personal care services, or in-home care (homemaker or companionship services).

If you or your loved one is experiencing a terminal illness, and a doctor has certified a life expectancy of six months or less, Medicare Part A will pay for hospice care either in the home or at an inpatient facility. Hospice care focuses on keeping the patient comfortable and pain-free, rather than on aggressive treatment of their illness. 

Once you have been approved for home hospice care, Medicare will cover nursing care, durable medical equipment such as a hospital bed, medications, and spiritual and grief counseling for you and your family members. Services are generally available wherever you call home, whether that’s in a house, in an independent living, assisted living or memory care facility, or elsewhere.

For most people, Medicare Part A costs $0. This is because they or their spouse paid Medicare taxes while working for at least ten years. This is called "premium-free Part A." 

If you do not qualify for premium-free Part A, you may be able to purchase it for either $285 or $518/month as of 2025, depending on how long you or your spouse worked and paid taxes. These are not the only costs associated with Part A, however. The following expenses may also apply:

As of 2025, if you are admitted to a Medicare-certified hospital, you will pay a deductible of $1,676 for each benefit period before Medicare kicks in. A benefit period begins when you are admitted and ends when 60 days have passed in which you have not received any inpatient hospital care (or up to 100 days in a skilled nursing facility). 

There is no limit to the number of benefit periods in each year, which could mean you need to pay the deductible more than once. So, for example, if you come home after a hospital stay, receive no new care for 61 days, and then receive inpatient care again at the hospital, you would need to pay the deductible again.

Copays and coinsurance are two other types of payment you may need to make for medical costs. What's the difference? Copays are a specific cost — like, for example, $30 for a visit to your primary care physician. Coinsurance is when you are required to pay a percentage of the total cost of a service. Here are the copays that may apply with your Medicare Part A coverage:

• Inpatient stay: There is no copay for days 1-60; the copay is $419/ day for days 61-90; $838/day for days 91-150; and after day 150 you pay all costs.
• Skilled nursing facility: no copay for days 1-20; $209.50 for days 21-100; you pay all costs for any days over 100.
• Home hospice care: $5 copay for prescription drugs.

Coinsurance, as we noted above, is always a percentage of a total cost that you or your loved one will pay. Here are the coinsurance costs you may incur for Part A coverage:

• Home Health Care: 20% of the Medicare-approved amount for durable medical equipment, such as wheelchairs or hospital beds
• Inpatient Hospice Care: 5% of the Medicare-approved amount for inpatient respite care, which is temporary care provided in a Medicare-approved nursing home, hospice inpatient facility, or hospital so that a family member or friend who is the patient's caregiver can rest or take some time off. The patient can stay for up to five days each time the caregiver receives respite care

 

Medicare Part A eligibility is based on age, disability status, and citizenship/residency status. If you don’t have a qualifying disability, you must be at least 65 years old to qualify. Since Medicare was first established in 1965, the program has expanded to include younger people with Lou Gehrig’s disease, end-stage renal disease (kidney failure). 

If you’re in your early 60s and don’t qualify for Medicare Part A based on your age, you may be able to qualify based on a disability. In most cases, you must receive disability benefits from the Social Security Administration or U.S. Railroad Retirement Board for 24 months before you qualify for premium-free Part A. Medicare coverage is available to U.S. citizens and lawful permanent residents who’ve lived in the United States for at least five years in a row.

Individuals aged 65 and over sign up for Medicare Parts A and B through the Social Security Administration website. The application can be completed online, and requires that you create an account on the site. There are three potential times when you can sign up:

• During the three months before and after you turn 65.
• If you are older than 65, but you've been covered by an employer group health plan, you must sign up within eight months of the day you stop working.
• Whenever you miss the other two periods, however, this option may come with penalties.

You may want to access the SS website's checklist on what information you will need to sign up. Requirements differ depending on whether you are signing up only for Medicare or you are also applying for Social Security benefits at the same time. According to the site, it should take you between 10 and 30 minutes to complete the application, which can be saved as you go.

Although Medicare Part A and Medicare Part B are both parts of Original Medicare, they cover different things. Medicare Part A covers a variety of inpatient services, such as room and board, nursing care, and medications administered while you’re an inpatient. 

In contrast, Medicare Part B mostly covers the services you receive on an outpatient basis, such as doctor visits and tests performed by an outpatient laboratory. Part B covers emergency room care (when not admitted as an inpatient) and services provided by doctors treating you in the hospital, whether as an inpatient or outpatient.

 Part A and Part B have different cost structures, with separate deductibles and different copays and coinsurance requirements.

Medicare Part A is the portion of the federal Medicare program that helps pay for hospital costs, skilled nursing home costs, some home health care costs, and hospice care. For most people, it has no monthly premium, but there are deductibles, copays, and coinsurance costs that may accrue for some services or supplies. Seniors aged 65 and older, along with some younger people who have qualifying illnesses, are eligible for Medicare Part A. It can be applied for at the Social Security Administration website.

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