What Medicare Part A covers

Part A of Medicare is hospital insurance that typically covers costs in four areas.

1. Inpatient hospital care

Medicare Part A covers hospital services such as semi-private rooms, meals, general nursing, and drugs for inpatient treatments when you are admitted to a hospital on a doctor's orders. If you require care that is not covered by Part A, such as a private room or a private-duty nurse, you must bear the additional costs.

It's also worth noting that if you require admission to a psychiatric hospital for mental health treatment after enrolling in Medicare, you'll be covered under Part A for fewer days — up to 190 days over your lifetime.

Fortunately, most hospitals accept Medicare, which is a requirement for using Part A; however, Veterans Affairs hospitals and other military hospitals typically accept VA and military insurances rather than Medicare.

Part A of Medicare covers inpatient hospital care in a variety of settings, including:

• Acute care hospitals.
• Hospitals with limited access.
• Rehabilitation facilities for inpatients.
• Inpatient psychiatric care.
• Hospitals that provide long-term care.
• As part of a qualifying clinical research study, inpatient care is provided.

2. Skilled nursing facility care

Part A pays for your short-term care at a certified skilled nursing facility following a three-day qualifying inpatient hospital stay. A semi private room, meals, skilled nursing care, and physical and occupational therapy are all covered services.

Most other wellness-related services are also covered, including:

• Services for speech-language pathology.
• Medical social services.
• Medications.
• The facility's medical supplies and equipment.
• Ambulance transportation to the nearest provider of required services that are not available at your facility (if other transport would endanger your health).
• Dietary counseling.

Your medical team may recommend additional services outside the scope of Part A, for which you will be responsible.

3. Hospice benefits

Hospice is end-of-life care provided to terminally ill patients. Medicare Part A pays for all support care, pain medications, and symptom management to make the patient more comfortable. Grief and loss counseling for you and your family, as well as respite care for your primary caregiver, are also covered.

Medicare Part A covers all hospice care and costs, whether you have Original Medicare or a Medicare Advantage plan. Coordinate your entry into hospice with your specific insurance plan.

4. Home health services

Homebound Medicare recipients may be able to receive certain health care services right in their own homes. In most cases, a doctor must approve the situation, and you must work with a Medicare-certified agency. Part-time skilled nursing and home health aide care, occupational therapy, physical therapy, speech-language pathology services, medical social services, and injectable osteoporosis drugs for women are among the services that are covered.

When considering home health care, proceed with caution. Medicare does not cover 24-hour home care, meal delivery, homemaker services (if that's all you need), or personal care such as bathing or dressing (if that's all you need). And you'll need to do a lot of research to figure out which services are covered by Part A and which are your responsibility.

How much Medicare Part A costs

If you or your spouse have worked and paid Medicare taxes for at least 10 years, or 40 quarters, you are eligible for premium-free Medicare Part A. Use Medicare's eligibility calculator to determine your eligibility.

If you are not eligible for premium-free coverage, you may be able to purchase Part A coverage. If you must pay for Part A, the premium in 2023 could be as high as $506 per month, depending on your and your spouse's work history and Medicare tax history.

"If you're over 65 and can afford it, it makes sense to pay for Part A," admits Joseph Schneier, CEO and co-founder of Trusty.care, a Medicare quoting and enrollment tool for brokers, despite the fact that premiums aren't cheap. "Original Medicare plus a supplement is likely to be the best insurance you have," he says of Medigap plans.

Aside from Part A premiums, there are other costs associated with your health-care utilization. The table below summarizes your share of the costs incurred while in the hospital or receiving skilled nursing care. These costs may be covered by your Medigap plan or Medicare Advantage policy, depending on the specifics of your policy.

*If you don't have supplemental insurance that covers these deductibles and coinsurance charges, this is your share of Part A costs.

Medicare Part A eligibility

According to Medicare, you are generally eligible for Medicare Part A if you meet one of the following requirements:

• You are at least 65 years old.
• You've been receiving Social Security or Railroad Retirement Board disability benefits for 24 months.
• You are receiving disability benefits due to Amyotrophic Lateral Sclerosis, also known as ALS or Lou Gehrig's disease.
• You have end-stage renal disease and meet specific criteria.