Medicare Part A

Resources > Medicare Part A

Medicare’s Hospital Insurance Plan

The original Medicare program was designed to provide health benefits for America’s senior citizens and contained two parts, Medicare Part A and Medicare Part B. Medicare Part A was specifically designed to cover hospital expenses.

Medicare Part A coverage includes:

  • Inpatient hospital procedures that include at least an overnight stay
  • Semi-private rooms
  • Meals
  • Required tests
  • Doctor’s fees

Part A will also cover brief stays in a skilled nursing home for convalescence, provided that the following criteria are met:

  • A hospital stay beforehand of at least three days and three nights, not including the discharge date.
  • A stay in a nursing home must be the result of a problem diagnosed at the hospital or the cause of the hospital visit.
  • A patient has another ailment that requires skilled nursing attention. Custodial, non-skilled, and long-term care facilities and programs are not covered.

Medicare Part A’s coverage of nursing homes is not all-inclusive; there are guidelines to the coverage that are important to understand to avoid costly charges. Part A will cover up to 100 days in a skilled nursing facility, but there are out-of-pocket costs for patients. 2017 coverage amounts are listed below:

  • Day 1-20: Medicare covers 100%
  • Day 21-100: You pay $164.50 coinsurance per day*. Medicare covers the rest.
  • Beyond 100 days: You are responsible for all charges.

Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition.

If you’re in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions.

In general, Part A covers:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care (as long as custodial care isn’t the only care you need)
  • Hospice
  • Home health services