Medicare Part A is also known as hospital insurance. This part of Original Medicare typically helps cover inpatient services, such as hospital stays and care at a Skilled Nursing Facility (SNF).
Medicare Part A generally helps cover many services that you receive in a hospital or long-term care setting. Here are a few examples of inpatient care covered by Medicare Part A.
Inpatient hospital care
If a doctor formally admits you to a hospital, Part A will cover you for up to 90 days in your benefit period. This period begins the day you are admitted and ends when you have been out of the hospital for 60 days in a row.
Once you meet your deductible, Part A will pay for days 1–60 that you are in the hospital. For days 61–90, you will pay a coinsurance for each day. If you need to stay in the hospital for longer than 90 days, you can use up to 60 lifetime reserve days. These are extra days of Medicare coverage for long hospital stays. However, lifetime reserve days are nonrenewable, and require a daily coinsurance payment.
Skilled Nursing Facility care
Part A will help cover many services in a Skilled Nursing Facility (SNF). This includes room and board, as well as administering medicine or changing sterile dressings. Medicare will cover you for up to 100 days in each benefit period. To qualify for this coverage, you must spend at least 3 days as an inpatient in a hospital within 30 days of being admitted to an SNF.
Hospice care can provide comfort when a patient is terminally ill. Fortunately, there are relatively fewer restrictions on Medicare eligibility for hospice care coverage. As long as your provider certifies the care, Medicare will cover the cost.
If you need skilled care and are homebound, you could qualify for Medicare coverage for home healthcare. Skilled care generally refers to services that require a license or medical supervision to carry out. Medicare Part A can cover up to 100 days of home healthcare if you spent 3 days or more as a hospital inpatient within 14 days of getting home healthcare.
Original Medicare part A helps you cover many expenses for hospital or nursing care. But there are a few costs associated with Part A.
Premium-free Medicare Part A
Generally, if you’re 65 or older, and you or your spouse worked and paid Medicare taxes for at least 10 years, you’ll pay no premium for Medicare Part A.
Medicare Part A premium
If you don’t qualify for premium-free Part A, you can still get Original Medicare Part A, but you will have a monthly premium. Your premium will be no more than $506 each month in 2023. This amount depends on how long you or your spouse worked and paid Medicare taxes.1
Medicare Part A benefit periods, deductibles and copays
There are other costs for Medicare outside of premiums. Your deductible is the amount you must pay for healthcare before Medicare begins coverage. For Part A inpatient hospital coverage in 2023, this deductible amount is $1,600 for each benefit period.
The Medicare Part A benefit period for a stay in the hospital or an SNF begins the day you are admitted and ends when you have been out of the hospital or SNF for 60 days in a row. You will pay a new deductible with each new benefit period.
Medicare Part A copays change based on the benefit period. Coinsurance payments for Part A during a hospital or SNF stay are:
- 1–60 days: $0 copay for each benefit period
- 61–90 days: $400 copay per day in each benefit period
- 91 days and after: $800 copay per each lifetime reserve day
Most people become eligible for Medicare Part A and Part B (also called Original Medicare) when they turn 65. However, you may be eligible for Medicare before you turn 65 under certain conditions:
- If you have been getting Social Security disability benefits for 24 months in a row
- If you have amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease)
- If you have end-stage kidney disease (ESKD) and need regular dialysis or a transplant
If you are eligible to enroll in Medicare, you can sign up for Part A and Part B through the Social Security website. You can sign up for Medicare in the following enrollment periods:
- Initial Enrollment Period (IEP): This period starts 3 months before you turn 65 and ends 3 months after your 65th birthday.
- General Enrollment Period (GEP): This runs from Jan. 1 to March 31 each year. If you miss your IEP, you may have to pay a monthly late enrollment penalty.
- Special Enrollment Period (SEP): In some cases, you can sign up for Medicare outside of your IEP without paying a late enrollment penalty. For example, if you are still working past 65 and get health insurance through your job, you might qualify for an SEP.
Medicare may not cover everything you need. But there are other ways you can help pay for some medical costs. One option is Medicare Supplement Insurance, also called Medigap. Although Medigap can’t cover long-term care, it can help cover costs such as copayments, deductibles or coinsurance. Medigap is not the same as Medicare Advantage and can only be combined with Original Medicare.
Medicare Advantage is another option. Medicare Advantage plans are offered through private companies, and offer coverage for everything included in Original Medicare Part A and Part B. Many Medicare Advantage plans may also include coverage for services outside of Original Medicare, including vision, dental or Part D prescription drug coverage.