Medicare Part A Covers Inpatient Hospital Care and More

Medicare is federal health insurance for people 65 and older and individuals with qualifying disabilities.

Generally applying to care in institutions, Medicare Part A covers inpatient hospitals, skilled nursing facilities, hospice, inpatient rehabilitation, and select home health care services.

When Am I Eligible for Medicare Part A Coverage?

You become eligible for Medicare at age 65. If you are currently receiving Social Security, you will automatically receive Medicare Part A and Medicare Part B benefits. (Medicare Parts A and B comprise Traditional, or Original, Medicare.)

Learn more about by reading our articles on Medicare enrollment and what you need to know to sign up.

What Does Medicare Part A Cover?

Hospitalizations

Medicare Part A covers expenses for 60 days of hospitalization. Then, coinsurance kicks in, and enrollees contribute to some of the cost.

Those enrolled in Part A also get 60 lifetime reserve days with a coinsurance. They can use them all at once or through individual episodes of illness. Coverage includes semi-private rooms and private rooms when medically necessary, meals, general nursing, medications, and psychiatric treatment.

If the hospital gets blood from a free blood bank, individuals do not have to pay for it. Otherwise, they must make up for the first three units of blood they receive by paying for the blood, donating blood within the calendar year, or having someone donate on their behalf.

Skilled Nursing

In addition to paying for inpatient hospital care, Medicare Part A covers your first 20 days in a skilled nursing facility, where trained nurses provide medical care before coinsurance payments start.

Unlike nursing homes and assisted living facilities, skilled nursing facilities are for short-term medical assistance. Although Part A covers skilled nursing care, it does not cover long-term care in a nursing home or assisted living.

Stays in skilled nursing facilities typically follow hospitalizations. To be eligible for skilled nursing coverage, enrollees must have stayed in a hospital for at least three days and demonstrate that they need skilled nursing to improve or maintain a current condition. The program includes semi-private rooms, meals, skilled nursing, and therapy services.

Home Hospice Care

Although Medicare Part A mainly encompasses care in institutions, it does pay for in-home hospice care when a doctor certifies that an individual is terminally ill. Health care must not prolong the beneficiary’s life but rather help them be comfortable when approaching death.

Per Medicare.gov, this coverage includes:

• Pain relief and symptom management
• Medical, nursing, and social services
• Pain-relieving drugs with a $5 copay
• Medical equipment for pain relief and symptom management
• Home aid services
• Grief counseling

Respite Care

Although Medicare does not cover hospice care in a facility, it does allow beneficiaries five days of respite care. Respite care focuses on providing primary caregivers with a reprieve.

Religious, Nonmedical Health Care Institutions

Some recipients qualify for inpatient care in religious, nonmedical health care institutions. In those cases, the insurance only covers nonreligious items that do not need a doctor’s prescription. This may include things like room and board, wound dressings, and the use of a simple walker.

2024 Premiums, Hospital Deductible, and Coinsurance Amounts

Any person who has reached age 65 and who is entitled to Social Security benefits (e.g., has 40 quarters of Medicare-covered employment) is eligible for Medicare Part A without charge.

According to the Centers for Medicare and Medicaid Services (CMS), 99 percent of all Part A enrollees do not pay a premium for Part A. Others must pay a premium. Medicare also counts a spouse’s work for qualifying purposes.

• Individuals with at least 30 quarters of Medicare-qualifying work can purchase Part A at a reduced monthly premium rate of $278 in 2024.
• Uninsured older adults and qualifying individuals with disabilities can buy into the program at $505 a month in 2024.

For 2024, Part A enrollees are responsible for the following amounts:

• The inpatient hospital deductible is $1,632. Medicare Part A recipients must pay this amount before the insurance kicks in and covers hospital expenses.
• Medicare Part A covers the first 60 days in a hospital or skilled nursing facility. Enrollees must then pay a daily coinsurance. The daily cost is $408 for days 61 to 90, and then $816 per day when it taps into the 90 lifetime reserve days.
• Medicare Part A pays for the first 20 days when a patient resides in a skilled nursing facility. Then, the individual must pay $204 until the 100th day, after which the individual must bear the entire cost.
• Individuals may be responsible for 5 percent of the Medicare-approved amount for respite care.

Work With an Elder Law Expert

Medicare is a complex topic. Consult with an elder law attorney to receive expert guidance. They can help you understand the different parts of Medicare. They also can assist in identifying any Medicare Savings Programs for which you may be eligible.

Find a qualified elder law attorney near you today.