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What is Medicare Part A?

Original Medicare is made up of two parts: Part A and Part B. Medicare Part A is the hospital insurance portion. It helps cover the cost of hospital stays as well as some outpatient services following a hospital say. In other words, it provides you with “room and board” in the hospital including a semiprivate room with a bed, regular meals and nursing care. It also pays for some home health services and hospice care if you meet the conditions for coverage.

In this article:

Am I eligible for Part A?Jump to
What does Medicare Part A cover? Jump to
Medicare Part A costs  Jump to
How do I enroll in Part A?  Jump to

Am I Eligible for Medicare Part A?

Generally, you’re eligible for Part A if you meet one of the following criteriai:

  • You’re 65 or older and meet the citizenship and residency requirements
  • You’re receiving disability benefits
  • You have ESRD (End-Stage Renal Disease)

What Does Medicare Part A Cover?

Generally, Part A covers hospitalization, hospice care, and some skilled nursing facility and home health care.

Hospitalization

Hospital stays deemed necessary by a doctor, including the cost of a semiprivate room, regular meals, medications provided while you’re there, lab services and medical supplies.

Your costs (per benefit period):ii

  • $1,556 deductible
  • Days 1-60 $0 coinsurance
  • Days 61-90: $389 coinsurance per day
  • Days 91 and beyond: $778 coinsurance per each “lifetime reserve day” (up to 60 days for over your lifetime)
  • Beyond your 60 lifetime reserve days: 100% of costs

Skilled nursing facility care

Post-hospitalization stays in a skilled nursing facility or nursing home which are short-term and medically necessary.

Your costs (per benefit period):ii

  • Days 1-20: $0 coinsurance
  • Days 21-100: $194.50 coinsurance per day
  • Days 100 and beyond: 100% of costs

Home health care

Post-hospitalization home health care services like physical, occupational and speech therapies that are deemed medically necessary.

Your costs: ii

  • $0 for covered home health care services
  • 20% of the Medicare-approved amount for durable medical equipment

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Hospice care

Palliative care provided after a doctor certifies that you’re terminally ill, meaning you have a life expectancy of 6 months or less including all items and services needed for pain relief and symptom management.

Your costs: ii

  • $0 for hospice care
  • Up to $5 copay for outpatient prescriptions
  • 5% of Medicare-approved amount for inpatient respite care

Medicare Part A Premiums

For most people, Medicare Part A is “free” – as in you don’t have to pay monthly premiums. This is because you’ve already pre-paid it in the form of employment taxes. So, as long as you’ve worked for at least 10 years in the US, you’ll generally pay nothing for Part A. If you don’t qualify for premium-free benefits, you can get still get Part A coverage by paying monthly for it. In this case, you may pay between $274 – $499 a month. ii

How Do I Enroll in Medicare Part A?

You’ll be automatically enrolled in Medicare Part A when you turn 65 if you’re already taking Social Security income benefits. In this case, your Medicare card will be mailed to you 2-3 months before you turn 65.

If you’re not already receiving Social Security income benefits or Railroad Retirement income benefits, then you’ll need to enroll in Part A yourself using the Social Security Website. You can do this any time during your 7-month Medicare Initial Enrollment Period (IEP), starting 3 months before the month you turn 65. If you miss your IEP, you can enroll annually during the General Enrollment Period between January – March or during one of the Medicare-approved Special Enrollment Periods.

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Education is crucial in finding the right Medicare solution for you. With so many Medicare resources out there, it can be difficult finding a source you can trust. That’s why Ensurem has a Compliance Program dedicated to ensuring our Medicare content meets Centers for Medicare & Medicaid Services (CMS) regulations. So, you can rest assured you’re getting the information you need to make the right coverage decisions.

Learn More Here

i Medicare.gov. “Enrolling in Medicare Parts A & B.” Accessed Jan. 28, 2022.

ii Medicare.gov. “Medicare Costs at a Glance.” Accessed Jan. 28, 2022.

Denise Austin, 65, Ensurem Ambassador

Best-Selling Author, Creator of Fit Over 50 Magazine

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