Medicare Part A

What Is Medicare Part A?

Medicare Part A is one of four components of the federal government’s health insurance program for older adults and other eligible people. Medicare Part A helps pay for bills related to inpatient hospital stays, skilled nursing facility care, inpatient care in a skilled nursing facility, hospice care, and home health care.

It covers expenses such as semi-private rooms at skilled nursing facilities, inpatient care, supplies, and drugs during a hospital stay, as well as physical and occupational therapy in your home if you are homebound. Doctor’s services, medication, and grief-and-loss counseling for terminally ill patients are also covered. 

Understanding Medicare Part A

Medicare Part A, or Medicare hospital coverage, pays for care at a hospital, skilled nursing facility, or nursing home, and for home health services. Enrollees who paid Medicare taxes during their working years or people whose spouse paid these taxes don’t pay premiums for Medicare Part A once they’re 65 years old. This means you've already paid your premiums through the 1.45% Medicare payroll tax that you and your employer each paid on all of your wages.

If you didn’t pay this tax during your working years, the premiums are several hundred dollars per month. This can be as high as $471 in 2021. Younger people who receive long-term Social Security disability benefits also qualify for premium-free Part A. However, even when Medicare Part A is premium-free, most people will still have out-of-pocket expenses for copayments and coinsurance.

People insured under Medicare still have to pay deductibles, too. For 2021, deductibles for inpatient hospital stays are $1,484. This payment covers the first 60 days of a patient's stay in the hospital. Copays kick in after the 61st day. Patients are responsible for a $371 copay for the 61st to 90th day in the hospital.

Medicare Part A Eligibility

In general, you're eligible for Medicare Part A if you meet the citizenship and residency requirements and you:

How to Sign Up for Medicare Part A

Many people are automatically enrolled when they qualify, while others have to sign up for it. In general, it depends on whether you're receiving Social Security benefits. You may, for example, be enrolled automatically in Medicare Part A and Medicare Part B if you:

If you have end-stage renal disease (ESRD), you're eligible for Medicare and can enroll in Parts A and B or in a Medicare Advantage Plan. If you choose Original Medicare (Parts A and B), you will need both parts to get the full benefits available with Medicare to cover certain dialysis and kidney transplant services. If you're interested in a Medicare Advantage Plan, be sure to check that the healthcare providers you currently see or want to see in the future, are in the plan's network.

If you aren't automatically enrolled in Medicare and you'll be eligible when you turn 65, you should sign up through Social Security during your initial enrollment period. This is a seven-month period that:

Enrollment can be done online, by phone, or at a Social Security office.

In most cases, if you don't enroll in Part B when you first become eligible, you'll owe a late enrollment penalty each month for as long as you have Part B and could have a gap in your health insurance.

Special Considerations for Medicare Part A

Although Medicare Part A covers many hospital-related services, it doesn’t cover everything. Providers must ask patients to sign a notice before receiving treatment when a service may not be covered. This procedure allows the patient to choose whether to accept the service and pay for it out of pocket or to refuse the service.

To be proactive about keeping your medical bills down, it’s a good idea to find out before using a Part A service if Medicare will cover all, part, or none of the cost. If Medicare won’t cover enough of the expense, find out why. There may be an alternative that is covered that would still help you, or you can file an appeal to try to get the coverage decision changed in your favor.

The three reasons why Medicare Part A might not cover something are:

One example of a service Medicare does not usually cover is custodial care in a skilled nursing facility — help with basic activities of daily living, such as getting dressed, bathing, and eating — if it’s the only care you need. You must have more serious medical needs for Medicare to cover your stay at a nursing home.

The CARES Act of 2020