Medicare Part A is one part of Original Medicare. It typically covers inpatient treatment and services in a hospital or skilled nursing facility. Many people receive Part A with no monthly premium.
Original Medicare consists of Part A and Part B. Part A is also known as hospital insurance, as it covers inpatient care and services. Part B is also known as medical insurance. It covers outpatient and preventive services and treatments.
Glossary of Medicare terms
- Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money someone pays each month for Medicare coverage.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare Part A provides coverage for inpatient care and services received in:
- critical access hospitals
- hospitals
- skilled nursing facilities
It also helps pay for hospice care and some home healthcare.
Inpatient care coverage
Inpatient care is treatment and services a person receives in one of the following facilities:
- acute care hospitals
- critical access hospitals
- inpatient rehabilitation facilities
- inpatient psychiatric facilities
- long-term care hospitals
Part A covers the following during a person’s stay:
- semiprivate rooms
- general nursing
- medications received
- meals
- other hospital services and supplies as part of the inpatient treatment
What Part A does not cover
Part A does not cover the following during an inpatient stay:
- private room, unless medically necessary
- television or phone in the room, if there are separate charges for them
- personal care items, such as slippers or razors
- private-duty nursing
Most people pay $0 for a monthly premium with Part A. This is known as premium-free Part A.
To qualify for premium-free Part A, a person or their spouse must have worked and paid Medicare taxes for at least 10 years (40 quarters).
If a person does not qualify for premium-free, they will either pay $285 or $518 per month, depending on how long they or their spouse has worked.
Other costs
Each person with Part A must pay a deductible of $1,676 for each inpatient benefit period before Medicare begins paying.
During an inpatient hospital stay, an individual is also responsible for the following copayments:
- Days 1 to 60: $0 after deductible is met
- Days 61 to 90: $419 per day
- Days 91 to 150: $838 per day while using lifetime reserve days
- After day 150: all costs
Medicare Part A is available to individuals who meet one of the following requirements:
- 65 years old or older
- have a disability and receive Social Security Disability Insurance (SSDI) for at least 24 months
- have end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)
A person must also either be a U.S. citizen or a legal resident living in the United States for at least 5 years.
Learn more
- What is Original Medicare?
- Medicare Advantage (Medicare Part C) coverage and plans
- How do Original Medicare and Medicare Advantage differ?
- What are the different parts of Medicare?
- When are the Medicare enrollment periods?
- What to know about navigating Medicare
- Medicare information: Plans and coverage explained
Medicare Part B is the other part of Original Medicare. While Part A covers inpatient care and services, Part B covers outpatient care.
Part B covers:
- services from doctors and other healthcare professionals
- durable medical equipment (DME), such as walkers, wheelchairs, hospital beds, and other equipment
- preventive care, such as vaccines and screenings
- some at-home healthcare
Medicare Part C is often referred to as Medicare Advantage. Medicare Advantage plans are an alternative to Original Medicare (parts A and B).
These plans are provided by Medicare-approved private insurance companies. They offer the same coverage as Original Medicare. However, most Medicare Advantage plans also offer additional services not covered by Original Medicare, such as:
- vision
- dental
- hearing
- fitness programs
Medicare Supplement Insurance (Medigap) is additional insurance you can purchase from Medicare-approved private insurance companies. It helps cover some of the costs associated with Original Medicare, including:
- deductibles
- copayments
- coinsurance
Medigap policies may also help cover certain services that Original Medicare does not cover, such as emergency care when traveling outside the United States.
Only people with Original Medicare can have Medigap plans. They are not compatible with Medicare Advantage plans.
Medicare Part A is one part of Original Medicare. It covers services and care that a person receives when they are in the hospital or a skilled nursing facility.
Part A typically covers the majority of services an individual receives as an inpatient. However, out-of-pocket costs apply, such as a deductible and daily copayment amounts, depending on the length of the stay.