What Is Covered Under Medicare Part A?

April 30, 2025

Introduction

Medicare is a federal health insurance program designed primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities or specific health conditions. One of its key components is Medicare Part A, which is often referred to as hospital insurance. Medicare Part A plays a crucial role in covering the costs of inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.

In this blog, we’ll break down what is covered under it, who qualifies for it, and how it works to help you understand how it fits into your overall healthcare coverage.

What Is Medicare Part A?

Medicare Part A is one of the four parts of Medicare (Parts A, B, C, and D) and primarily focuses on covering hospital-related services. It is considered “hospital insurance” and helps pay for inpatient care and other healthcare services provided in institutional settings. Most people are automatically enrolled in Part A when they turn 65 and qualify for Medicare.

For many beneficiaries, Medicare Part A is premium-free, provided they or their spouse have paid Medicare taxes for at least 10 years (40 quarters). However, if you don’t meet this work requirement, you can still purchase Part A by paying a monthly premium.

What Does Medicare Part A Cover?

Medicare Part A provides coverage for several essential healthcare services, most of which are related to inpatient or facility-based care. Below is a breakdown of the key services covered:

1. Inpatient Hospital Care

Medicare Part A covers the costs of medically necessary inpatient hospital stays, which can include treatment for serious illnesses or surgeries. Coverage applies to semi-private rooms, meals, nursing care, and other hospital services.

Covered Services Include:

General nursing care.
Medications administered during your hospital stay.
Lab tests and imaging (e.g., X-rays) required for treatment.
Operating room and recovery room costs.
Meals and dietary counseling.
Supplies and medical equipment used during the stay (e.g., IVs, catheters).

Important Notes:

You must be formally admitted to the hospital as an inpatient for Part A to apply. Observation stays do not qualify as inpatient care and may be covered under Medicare Part B instead.
There is a deductible for each benefit period ($1,600 in 2023).

2. Skilled Nursing Facility (SNF) Care

After a qualifying inpatient hospital stay of at least three days, Medicare Part A covers skilled nursing facility care if you need additional time to recover or rehabilitate. This is not the same as custodial care (e.g., long-term care or assistance with daily activities).

Covered Services Include:

Semi-private room.
Skilled nursing care (e.g., wound care, IV therapy, injections).
Physical, occupational, and speech therapy.
Meals and dietary counseling.
Medical social services.
Medications, medical supplies, and equipment used in the facility.

Important Notes:

Medicare Part A covers up to 100 days of skilled nursing care per benefit period:
- The first 20 days are fully covered.
- Days 21–100 require a daily coinsurance payment ($200 per day in 2023).
- After 100 days, you’re responsible for the full cost.

3. Hospice Care

If you’re diagnosed with a terminal illness and choose hospice care, it provides comprehensive coverage for services focused on comfort, pain relief, and emotional support.
Covered Services Include:

Hospice nursing care.
Medications for symptom control and pain relief.
Medical equipment (e.g., wheelchairs, hospital beds).
Physical and occupational therapy.
Counseling and grief support for you and your family.
Short-term inpatient care for symptom management.
Respite care (temporary relief for caregivers).

Important Notes:

To qualify for hospice care under Part A, a doctor must certify that you have a life expectancy of six months or less.
Most hospice services are covered in full, but you may have a small copayment (no more than $5) for prescription drugs or a portion of respite care costs.

4. Home Health Care

Medicare Part A covers limited home health care services if you’re homebound and need skilled care on a part-time or intermittent basis.
Covered Services Include:

Skilled nursing care.
Physical, occupational, and speech therapy.
Medical social services.
Medical supplies and durable medical equipment (e.g., walkers, wheelchairs).

Important Notes:

Home health care is only covered if it’s ordered by a doctor and provided by a Medicare-approved home health agency.
Personal care services (e.g., bathing, dressing) are not covered unless they are part of the overall skilled care plan.

What Medicare Does NOT Cover

While it provides essential hospital-related coverage, it does not cover everything. Here are some examples of services that Part A does not cover:

Custodial Care: Long-term care or personal assistance with daily activities (e.g., bathing, dressing, eating) if that’s the only care you need.
Private Room: Unless medically necessary.
Doctor Services: These are typically covered under Medicare Part B.
Outpatient Care: Such as emergency room visits, unless you are formally admitted as an inpatient.

If you need coverage for these services, you may need to rely on Medicare Part B, a Medicare Advantage Plan (Part C), or supplemental insurance (Medigap).

How Does Medicare Part A Work?

It gives benefits that operate on a benefit period system, which determines how much you’ll pay for inpatient hospital stays and skilled nursing care. A benefit period begins the day you’re admitted as an inpatient and ends after you’ve been out of the hospital or skilled nursing facility for 60 consecutive days.

Deductible: You must pay the Part A deductible ($1,600 in 2023) for each benefit period before Medicare covers costs.
Coinsurance: After the deductible is met, Medicare covers most costs for a limited time. You may owe coinsurance if your hospital stay exceeds 60 days or skilled nursing care exceeds 20 days.

Who Qualifies for Medicare Part A?

You’re eligible for Medicare Part A if you meet one of the following criteria:

You’re 65 or older and either you or your spouse worked and paid Medicare taxes for at least 10 years.
You’re under 65 and have a qualifying disability (e.g., you’ve been receiving Social Security Disability Insurance for 24 months).
You have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).

Most people qualify for premium-free Part A. If you don’t, you can purchase Part A by paying a monthly premium (up to $506 in 2023), depending on how many quarters you’ve paid Medicare taxes.

Conclusion

Medicare Part A is a critical component of the Medicare program, covering essential hospital-related services such as inpatient care, skilled nursing facilities, hospice care, and some home health services. While it provides a strong foundation for healthcare coverage, it’s important to understand what Part A does and does not cover, as well as any associated costs like deductibles and coinsurance.

To ensure you have comprehensive coverage, consider how Medicare works alongside other parts of Medicare, like Part B, Part D, or a Medigap plan. By staying informed about your benefits, you can make the most of your Medicare coverage and protect yourself from unexpected healthcare expenses.

Pro Tip: Review your coverage annually and explore options during the Medicare Open Enrollment Period to ensure your plan meets your healthcare needs.