What Does Medicare Part A Cover?

Original Medicare Part A costs and coverage

by Ray Wilson+ on Jan 31, 2015 | 8 Comments

What is Medicare Part A and what does it cover? This is an important question to ask, but many people new to Medicare get confused at the different parts of Medicare. For starters, Original Medicare is made up of two parts: Medicare Part A (which mainly covers hospitalization) and Medicare Part B ( which covers your day-to-day medical coverage). This article will explain Part A but you can read more about Medicare B here

What is Medicare Part A and What Does it Cover?

Medicare Part A is hospitalization coverage. Basically it covers anytime you’re in the hospital, Skilled Nursing Facilities, Hospice or Home Health Services. One thing many people don’t realize is that Medicare Part A, while for most people is premium-free ($0 monthly cost), it still has out of pocket costs and limitations on coverage.

What Will You Pay with Part A?

  • Part A Premium for most people: $0
  • Part A Premium if you do not meet the premium-free qualifications: $422
  • Hospital/Mental Inpatient Benefit Period Deductible* From Day 1-60: $1,340
  • Hospital/Mental Inpatient Coinsurance Days 61-90: $335 per day
  • Hospital/Mental Inpatient Coinsurance Days 91-150 (Lifetime Reserve Days): $670 per day
  • Hospital/Mental Inpatient Costs after Lifetime Reserved Days: 100%
  • Skilled Nursing Facility (SNF) Coinsurance Days 1-20: $0
  • SNF Coinsurance Days 21-100: $167.50
  • SNF Coinsurance Beyond Day 100: 100%
  • Hospice Costs**: $0
  • Health Home Services**: $0

*Deductible can be charged multiple times per year, since it is a “benefit period” deductible. For instance, if you enter the hospital on January 5th for one week, you’d be charged the deductible. Then if 60 days pass since your exit from the hospital and you enter the hospital again, say May 15th, you would be charged the Part A deductible again.

**You can still be charged 20% for durable medical equipment through Part B, and in addition, if you are in Hospice care, if you seek respite care you can be charged up to 5%.

What Does Part A Not Cover?

Here are a few things Medicare Part A does not cover: day to day care (that is covered by Part B), hearing aids, dental, vision, acupuncture, non-donated blood, and prescription drugs.

Important Things to Note About What Part A Does Not Cover:
As you can see with Medicare Part A you are partially covered for services, but can still have significant and varying out of pocket costs, and it does not put a cap on your out of pocket spending. One way to limit these costs is to enroll in additional Medicare insurance.

Learn about Medicare Part B

Return to the Senior Medicare FAQ page

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Reader Comments and Questions

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By clara gonsalves on October 26, 2018

hey i turned 66 this september. i was not aware of medicare .when i enroll should i enroll for both medicare part A and B.How much do i pay?..i work as a cashier in subway restuarant...at present i am good in health i have just become a citizen now pl advise.

By Michael on June 28, 2018

I will be 65 in Sept. I currently only have medical coverage through my Veterans benefits. What do I need to carry for medical coverage in the future ?

Michael,
Check out our VA article located here. I think it will address your question.
-Eric at Senior65.com


By b on May 01, 2018

Currently I have Part A and w/ill not qualify for Part B until 7 I have a pain in my hip down to my ankle and big toe on my right side. I cannot stand for very long at all. It has been better if I'm walking but now the pain in the leg sometimes limits myability to walk. If I go to Urgent Care or Emergency, will Medicare pay for it? It's so confusing

B-
Medicare Part B (Medical Insurance) covers urgent care and emergency department services so if you have Medicare part A only, you would have to pay for those services.
Once you have Medicare Part B, your emergency and urgent care coverage kicks in but comes with deductibles and other out of pocket expenses. You can purchase a Medigap or MA plan to help cover some or all of those costs. We can help you enroll in a supplemental plan once you have part B.
-Michelle from Senior65.com


By Erika on January 27, 2017

Your website says: "Medicare Advantage (MA) requires private companies to REPLACE Original Medicare with, at minimum, the equivalent benefits. While these plans usually have a smaller network of doctors, some MA plans may cover prescriptions, dental or even Medicare deductibles. Medicare Advantage (MA) plans are plans offered by private companies that cover the same benefits offered in Medicare Part A and Part B (as well as some additional benefits not found in traditional Medicare). By selecting a MA plan, you are choosing to have a private company to manage your Medicare Part A and Part B benefits. " My question is: If Medicare Advantage Plans simply replace Medicare A and B benefits, what is the advantage of a Medicare Advantage plan over Original Medicare? E.g., why would be "choosing to have a private company manage your Medicare Part A and Part B benefits"?

Erika,
That advantage of choosing a Medicare Advantage plan over only having Original Medicare is that with MA plans you have max out of pocket, whereas Original Medicare does not put a limit on what you can spend, and with MA plans you can extra coverage like drugs, dental, vision, and hearing. For more info, check out our article that discusses Medicare Advantage's Pros and Cons.
-Chris from https://www.senior65.com/


By Karen Logan on March 15, 2016

Question: I having bunion surgery, which is an out patient procedure. Does Medicare Part A cover this? I am still employed and have Coventry as my secondary insurance. Does it make a difference if the procedure is done in the hospital as an out patient, or at an out patient clinic?

Karen,
Out-patient surgery is covered by Part B, hospitalization/surgery in a hospital is covered by Part A. You will want to contact your current insurer to find out how they will cover your out-patient procedure. If you need help finding a Medigap plan to cover your costs, please call us at 800-930-7956.
-Amy from https://www.senior65.com/


By stephaniel201561@gmail.com on November 22, 2015

Does original Medicare cover doctor visits

Stephanie,
Medicare Part B covers doctor's office visits with you paying 20% of the cost, after you meet your Part B deductible. Hope this helps!
-Amy from https://www.senior65.com/


By Penny S. on August 05, 2015

This is really informative. I didn't realize that Medicare Part a could cost me so much money out of pocket. How can I avoid these costs (save for staying healthy, obviously)?

Penny,
You're right Medicare Part A can cost you a lot. There are two options if you don't have job-based or other qualifying coverage: Medicare Advantage (puts a cap on your out of pocket spending to $6700) and Medigap (plans like Medigap F can cover your deductibles, copays, and coinsurance). Hope this helps.
-Chris from https://www.senior65.com/


By Francise Rice on August 02, 2015

Does medicare part a or a or d cover hearing aides? If I lost one hering aid will medicare cover a new one?

Francise,
Unfortunately, Medicare Part A, B, or D does not cover hearing aids. However, if you enroll in a Medicare Advantage plan it may include hearing coverage. Contact us at 800-930-7956 if you want help finding a plan that includes hearing coverage.
-Amy from https://www.senior65.com/



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