Medicare Part A Plans

Medicare is a federal health insurance program designed to cover Americans 65 and older and some younger Americans with disabilities. Medicare comes in four Parts: A, B, C and D. Here’s what you need to know about Medicare Part A.

• What is Medicare Part A?
• What does Medicare Part A cover?
• What doesn’t Medicare Part A cover?
• Who is eligible for Medicare Part A?
• What does Medicare Part A cost?
• How do I apply for Medicare Part A?

What is Medicare Part A?

Medicare Part A is in-patient or hospital insurance. It broadly covers care at hospitals, skilled nursing facilities, nursing homes and hospices. It also covers certain home health services. Medicare Part A, when combined with Medicare Part B (outpatient or physician insurance) is known as Original Medicare.

• Learn more about what Medicare Part B covers.

Medicare Part C is a private alternative to Original Medicare. Medicare Part D is prescription drug coverage.

• Learn more about what Medicare Part Ccovers.
• Learn more about what Medicare Part Dcovers.

You can shop for Medicare Part C or Medicare Part D after you enroll in Original Medicare. (Our partner Via Benefits can help you compare Medicare plans in your area.)

What does Medicare Part A cover?

Medicare Part A covers the following at acute care, critical access or long-term care hospitals and inpatient rehabilitation centers:

• semi-private rooms
• meals
• drugs administered as part of your in-patient treatment
• most necessary surgical procedures

In addition to the items above, Medicare Part A covers the following at nursing homes:

• ambulance to the nearest hospital, if medically necessary
• physical and occupational therapy, if medically necessary
• speech-language pathology services, if medically necessary
• dietary counseling
• medical social services

Inpatient treatment at psychiatric hospitals and as part of clinical research studies is also covered by Medicare Part A.

What doesn’t Medicare Part A cover?

Medicare Part A does not cover the following at acute care, critical access or long-term care hospitals and inpatient rehabilitation centers:

• a private room, unless medically necessary
• in-room television and phone services
• personal items, like slipper socks
• private-duty nursing services

What is the difference between Medicare Part A & Medicare Part B?

Medicare Part A also doesn’t cover outpatient services. That falls to Medicare Part B, which covers outpatient and preventative screenings and services. Think of it as doctor insurance. The following chart illustrates what type of services each Part covers.

Medicare Part A vs. Medicare Part B

Medicare Part A and Medicare Part B work in tandem. You enroll in both and can elect to sub in with Medicare Part C (a private alternative for outpatient coverage) or Medicare Part D (prescription drug coverage).

All enrollees pay a monthly premium for Medicare Part B. It is usually $134, but climbs higher, depending on income. There’s also a separate annual deductible of $183 and 20% coinsurance for services covered by Medicare Part B.

Who is eligible for Medicare Part A?

You are eligible for Medicare Part A once you turn 65 years old if you are a U.S. citizen or permanent resident. You can also qualify for Medicare Part A if you are under 65, but receiving federal disability benefits for a period of time, usually 24 months.

For Medicare to cover specific bills, the following must happen:

• A doctor makes an official order saying you need 2 or more midnights of medical treatment and the hospital admits you.
• You need care only given in a hospital.
• Your hospital accepts Medicare.
• The hospital’s Utilization Review Committee approves your stay while you’re there.

You can see what hospitals accept Medicare and what specific services are covered on Medicare.gov. You can also talk to your doctor or health care provider about whether a service or treatment they are recommending is traditionally covered by Medicare.

How much does Medicare Part A cost?

If you’re getting retirement benefits or are eligible for retirement benefits, Medicare Part A has a $0 monthly premium payment. The same rule applies if you’re under 65 and on federal disability for 24 months or diagnosed with end-stage kidney disease. Americans who are eligible for Medicare, but not other federal benefits, can still get coverage for a premium up to $422 each month.

Medicare Part A comes with a $1,340 deductible (the amount you must pay out-of-pocket before coverage kicks in) for each benefit period. A benefit period begins the day you’re admitted to a hospital and ends once you haven’t received in-hospital care for 60 days. Medicare recipients also pay coinsurance, but the amount varies, depending on how long you’re in the hospital. Here’s the basic breakdown:

Days 1-60: $0 per day each benefit period Days 61-90: $335 per day each benefit period Days 91 or longer: $670 for each "lifetime reserve day" after day 90 each benefit period. You get 60 lifetime reserve days while on Medicare. After lifetime reserve days: all costs

Learn more about the total cost of Medicare here.

How do I apply for Medicare Part A?

If you’re on federal retirement benefits, you get automatically enrolled in Medicare Part A and Medicare Part B on the first day of the month you turn 65. If you are on federal disability benefits, you get automatically enrolled at 24 months.

Otherwise, you will need to enroll yourself. You can apply by visiting your local Social Security office, calling Medicare at 1-800-772-1213 or simply filling out an application online at the Social Security Administration website. Here is step-by-step guide to applying for Medicare.