Medicare Part A: Hospital Insurance

Medicare Part A insurance helps pay for “medically necessary” care (care for an illness or medical condition) that involves an inpatient stay in the hospital. Part A also helps pay for a stay in a skilled nursing facility as a follow-up to a hospital stay, hospice care for the terminally ill and some skilled home health care for the homebound. Part A also helps pay for some blood transfusions.

Services Covered

  • A semi-private room
  • Your hospital meals
  • Skilled nursing services
  • Care on special units, such as intensive care
  • Drugs, medical supplies and medical equipment as an inpatient
  • Lab tests, X-rays and radiation treatment as an inpatient
  • Operating room and recovery room services
  • Some blood for transfusions in hospital or skilled nursing facility
  • Rehabilitation services, such as physical therapy received through home health care
  • Skilled health care in your home if you’re homebound and only need part-time care
  • Care to manage symptoms and control pain for the terminally ill (“hospice” care)

Services Not Covered

Part A helps you pay the costs of hospital care when you’re sick. But there are some things it won’t pay. Most doctor services you receive in the hospital are covered by Part B, and you’ll have to pay the Part B deductible and 20% coinsurance. Part A won’t pay personal costs in the hospital, like charges for a television or telephone calls. It also doesn’t help with the cost of “custodial care.” This is care that helps with the activities of daily life, like eating, bathing or dressing. Custodial care doesn’t require the kind of skilled medical care provided in a hospital or skilled nursing facility, so Part A does not cover it.

Limits

If you are hospitalized for a very long time (more than 90 days at one time), there are limits on the number of days of care that Part A will help pay for. In the same way, there are limits on the number of days of care in a skilled nursing facility that Part A will help pay for. Part A pays for an unlimited number of skilled home health care visits, or hospice care visits, but you must meet certain conditions to receive either kind of help.

Providers

You can choose any qualified provider in the United States who has been accepted by Medicare and who is accepting new patients. Because Part A offers the same benefits throughout the United States, you are not limited to a particular state or region for your care.

Information

Guide to Original Medicare (Part A & Part B) What’s the difference between Part A and Part B?