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 pays for the first three units of blood for transfusions each calendar year.

Services Covered

  • A semi-private room
  • Your hospital meals as an inpatient
  • Skilled nursing facility
  • Care in 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 as an inpatient
  • The first three units of blood for transfusions in hospital
  • 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 inpatient 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

- You pay a deductible and no coinsurance for day 1-60 of each benefit period.

- You pay coinsurance for days 61-90 of each benefit period.

- You pay coinsurance per "lifetime reserve day" after day 90 of each benefit period (up to 60 day over your lifetime).

- You pay all costs of each day after you use all of your lifetime reserve days.

- Inpatient psychiatric care in a freestanding psychiatric hospital is limited to 190 days in a lifetime.

Providers

You can choose any qualified provider or facility 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