What Medicare Part A Covers
Medicare Part A is the hospital insurance part of Original Medicare. It pays for necessary hospital care and some home-based services. Here's what Part A covers:
Inpatient Hospital Care
When you stay in a hospital overnight or longer, Part A covers your room, meals, nursing care, medications, and medical procedures. This includes semi-private rooms and standard nursing care. It does not cover private rooms or private nurses unless medically necessary.
Skilled Nursing Facility (SNF) Care
After staying in a hospital for at least three days, Part A covers up to 100 days in a Medicare-approved skilled nursing facility (SNF). These facilities provide nursing care and rehabilitation, like physical therapy or wound care, for people recovering from surgery, illness, or injury. Coverage ends when you no longer need daily skilled care or when you use all 100 days in a benefit period.
Hospice Care
Part A covers hospice services for people with a terminal illness (expected to live six months or less) who want comfort care instead of treatment to cure the illness. This includes doctor and nursing visits, pain management, medications, counseling, and respite care (temporary help for caregivers). You can stay in hospice as long as your doctor says you need it. You may leave and come back during the same illness if your situation changes.
Home Health Services
Part A covers skilled home health care from a Medicare-approved agency, such as nursing visits or therapy. A doctor must order the care, and you must be homebound (unable to leave home without a lot of difficulty). Home health care is not the same as helping with daily living or household work.
Benefit Periods and How They Reset
Part A uses a "benefit period" to count your covered days. A benefit period starts when you enter a hospital or nursing facility and ends 60 days after you leave and don't return for more care. When one benefit period ends, a new one begins automatically, and you get a fresh set of covered days.
If you have multiple hospital or nursing stays in one year, you'll have multiple benefit periods. Each period gives you new covered days. This benefit period idea is unique to Part A—it's different from the calendar year that many health plans use.
Who Gets Part A for Free, and Who Pays a Premium
Most people age 65 and older get Part A with no premium. You qualify if you or your spouse worked at least 10 years and paid Medicare taxes.
If you don't have 10 years of work history but are 65 or older, or if you qualify for Medicare because of disability or kidney disease, you can still enroll in Part A. But you'll pay a monthly premium. If you have low income and few resources, you may get help paying your premium through government programs.
Deductibles, Coinsurance, and Out-of-Pocket Costs
Part A has significant cost-sharing. Instead of one deductible per year, Part A costs depend on your benefit period and how many days you stay:
Inpatient Hospital Costs
You pay a deductible at the start of each benefit period. After you pay it, Medicare covers all costs for days 1–60. From day 61 to day 90, you pay a set amount per day. For days 91 and beyond, you can use lifetime reserve days (a one-time pool). These cost more per day. Once you use all your reserve days, you pay all costs.
For the current deductible and daily amounts, visit Medicare.gov, since these change each year.
Skilled Nursing Facility Costs
You pay nothing for days 1–20 of SNF care per benefit period (if you meet the requirements, like a three-day hospital stay). From days 21–100, you pay a set amount per day. After day 100, you pay all costs. The daily amount changes each year, so check Medicare.gov for current costs.
Hospice and Home Health
Part A covers hospice with very low costs. You may pay a small copayment for medications and respite care, but hospice has no deductible or coinsurance. Home health services are also covered at no cost when needed.
What Part A Does Not Cover
Part A has clear limits. It does not cover:
- Long-term custodial care: If you need ongoing help with daily living (bathing, dressing, eating) but not skilled nursing or therapy, Part A does not cover it. Medicaid or long-term care insurance may help. Learn more at Medicaid Eligibility.
- Outpatient prescription drugs: Covered under Medicare Part D, not Part A.
- Outpatient doctor visits and services: Covered under Medicare Part B.
- Preventive care and wellness exams: Also Part B.
- Dental, vision, and hearing: Not covered by any part of Original Medicare (may be included in Medicare Advantage plans).
The Custodial Care Distinction
This is one of the most important limits. Part A only covers "skilled" care—care that a nurse, therapist, or licensed professional needs to provide. If you need help with daily living but not skilled care, that's custodial care, and Part A doesn't pay. Many people are surprised that a nursing home stay for custodial reasons (not skilled rehab) is not covered by Medicare. Some people qualify for Medicaid to help pay for this kind of care, depending on their state and income.
What Part A Covers and Doesn't Cover at a Glance
| Service | Part A Covers | Part A Doesn't Cover |
|---|---|---|
| Inpatient hospital stay | Room, meals, nursing, medications, procedures (days 1–60 fully covered after deductible; days 61–90 with coinsurance) | Private rooms or private duty nurses (unless medically necessary); non-covered services |
| Skilled nursing facility | Days 1–20 covered (after 3-day hospital stay); days 21–100 with coinsurance; nursing and therapy services | Days beyond 100 per benefit period; custodial or non-skilled care; self-care assistance only |
| Hospice | Doctor and nursing visits, medications, pain management, counseling, respite care | Non-hospice care (curative treatment); some medications or services outside hospice plan |
| Home health | Skilled nursing or therapy visits (must be homebound; doctor-ordered) | Custodial care, non-medical assistance, housekeeping, routine check-ins |
| Outpatient drugs | Medications during hospital or SNF stays | Outpatient prescriptions (Part D covers these) |
| Long-term custodial care | Only if skilled nursing/therapy is also needed | Pure custodial stays; may be covered by Medicaid |
How to Enroll in Part A
Enrollment timing depends on your situation:
Automatic Enrollment
If you get Social Security benefits, Medicare Part A (and Part B) enrolls you automatically. This starts three months before you turn 65. You'll get your Medicare card in the mail. You don't need to do anything, but check the card to make sure it's correct.
Manual Enrollment
If you're not getting Social Security yet, you must sign up for Part A yourself. You can enroll online at Social Security Administration, by phone at 1-800-MEDICARE, or in person at your local Social Security office. Your Initial Enrollment Period is three months before you turn 65 to three months after. Enroll during this time to avoid late penalties on Part B. Part A penalties are waived if you qualify for free coverage.
For a full timeline and details on enrollment deadlines, see Enrollment and Deadlines.
Part A and Other Coverage
Part A is one part of Medicare. Most people add Part B (Medical Insurance) for doctor visits and outpatient care. Many also add Part D (Prescription Drug Coverage) or Medigap (also called Medicare supplement insurance) to lower their out-of-pocket costs. Some people choose Medicare Advantage instead, which includes Parts A, B, and D all together.
To understand how costs add up across all parts of Medicare, see Understanding Your Costs.
Key Takeaways
- Part A covers inpatient hospital care, skilled nursing facility stays, hospice, and home health services.
- Most people age 65 and older don't pay for Part A. Some people may get help or pay a monthly fee.
- Costs depend on your benefit period and how many days you stay. Deductibles and daily costs change each year.
- Part A does not cover long-term custodial care or outpatient services (covered by Part B and Part D instead).
- Benefit periods reset 60 days after you leave the hospital or nursing facility. You get a fresh set of covered days.
- Enroll during your Initial Enrollment Period to avoid penalties (age 65, starting 3 months before).