Medicare Part A is a federal health insurance program. It was mainly designed and introduced to help people 65 and older. The program also covers younger people with disabilities or specific health conditions. Medicare Part A, also known as "Hospital Insurance" is One of the essential components of Medicare. It helps you cover essential hospital services like hospital stays, skilled nursing care, and hospice care.
Medicare Part A pays for a range of inpatient services!
Medicare Part A is a health insurance program that promises peace of mind when you need it most. Yes, it is absolutely true but how? Because it enables you to pay for a range of inpatient services. Here’s what Part A typically covers:
Inpatient Hospital Care
Medicare Part A covers the costs of being admitted to a hospital including:
- Semi-private rooms
- Meals during your stay
- Nursing care
- Drugs you need as part of your treatment
- Medical supplies and equipment used during your hospital stay
- Certain hospital services like lab tests and X-rays
Skilled Nursing Facility (SNF) Care
Medicare Part A is a really good program because it also covers skilled nursing care (if you need it after a hospital stay), in a skilled nursing facility. This care includes:
- Medication
- Certain medical supplies and equipment
- Room and board
- Nursing care
- Physical, occupational, and speech therapy
However, it is very important to note that Medicare Part A only covers short-term stays that follow a qualifying hospital stay. It doesn’t cover long-term care in a nursing home.
Hospice Care
Thirdly, Medicare Part A covers hospice care. That means, the program enables you to manage symptoms and improve the quality of life during the final stages if you or a loved one is facing a terminal illness. This includes:
- Care at home or in a hospice facility
- Counseling for the patient and family members
- Medical equipment like wheelchairs and hospital beds
- Pain relief and symptom management
Home Health Care
Fourthly, limited home health services are also covered by Medicare Part A, such as:
- Skilled nursing visits
- Physical or occupational therapy
- Certain medical supplies
These services are typically provided after a hospital stay and must be provided under a doctor’s care.
Who is Eligible for Medicare Part A?
Most people become automatically eligible for Medicare Part A after turning 65. They may also be eligible earlier in case of certain disabilities or health conditions. There are a few key points regarding eligibility:
- People 65 or older: All U.S. citizens or legal residents who have lived in the U.S. for at least five years are eligible to sign up for Medicare after turning 65.
- People under 65 with disabilities: All U.S. citizens or legal residents who have lived in the U.S. for at least five years have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months, and qualify for Medicare at any age.
- People with specific conditions: Certain conditions like End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis also make patients eligible for Medicare, regardless of age.
How Much Does Medicare Part A Cost?
There are costs associated with Medicare Part A, such as:
Deductibles and Coinsurance:
- Inpatient Hospital Deductible: You have to pay a deductible that is $1,600 in 2025 for each benefit period. Thus, Medicare Part A covers most of your hospital costs for up to 60 days.
- Coinsurance for Days 61-90: However, if you’re in the hospital for more than 60 days, you’ll have to pay a coinsurance fee of $400 per day in 2025 for days 61 through 90.
- Coinsurance for Days 91 and beyond: After day 90, you can use your “lifetime reserve days” (up to 60 additional days), but you’ll pay $800 per day (in 2025) for these extra days.
Skilled Nursing Facility Coinsurance:
Medicare Part A also covers skilled nursing facility care after a 3-day minimum hospital stay. However, you need to pay:
- $200 per day for days 21 through 100 in 2025.
Note: Premium-free Part A refers to a program wherein most people don’t pay a premium for Medicare Part A because they (or their spouse) have paid Medicare taxes while working for at least 10 years (40 quarters).
How to Enroll in Medicare Part A?
As mentioned earlier, people are automatically enrolled in Medicare Part A after turning 65 if they are already receiving Social Security or Railroad Retirement Board benefits. However, if they are not automatically enrolled, they can sign up through:
- Online: You can apply through the Social Security website.
- By phone: Call the Social Security Administration at 1-800-772-1213.
- In-person: Visit your local Social Security office.
However, it is important to enroll in Medicare Part A to avoid any potential penalties if you are still working and covered by employer health insurance.
What Happens If You Don’t Enroll in Medicare Part A?
Enrolling in Medicare Part A in a timely manner when eligible, when you don't have other coverage (like employer insurance), is important to avoid a late enrollment penalty. This penalty can increase your monthly premiums for the rest of your life. Additionally, you could also incur high medical costs after having a gap in coverage.