What Does Medicare Part A Cover?
Medicare Part A, also known as hospital insurance, is part of Original Medicare, which is federal Medicare health insurance for qualified Americans aged 65 and older or to those of any age who enter their 25th month of receiving disability benefits through Social Security or the Railroad Retirement Board. You may also qualify at any age if you have certain health conditions, such as end-stage renal disease or amyotrophic lateral sclerosis (or Lou Gehrig’s disease). To be eligible for Medicare, you must be a U.S. citizen or a legal permanent resident of at least five continuous years.
Medicare Part A generally covers medically necessary services and supplies needed to treat a certain disease or condition and care when you’re a hospital inpatient in a Medicare-enrolled hospital. The following list describes some of the main services and supplies Part A specifically covers (this is not necessarily a complete list).
- Hospital care: If you’re admitted as an inpatient, Medicare covers semi-private rooms, prescription drugs given as part of your inpatient treatment, meals, general nursing, and more.
- Long-term care hospitals: Medicare covers long-term care hospital services if you were transferred from an acute-care hospital or admitted to the long-term care hospital within 60 days of being discharged from an inpatient hospital stay.
- Skilled nursing facility care: If your doctor determines that you need care in a Medicare-certified skilled nursing facility, Medicare Part A covers certain services and supplies, generally for a limited time.
Medicare may cover services and supplies including, but not limited to: semi-private rooms, meals, skilled nursing care, medications, medical supplies and equipment, and ambulance transportation. There are several qualifying factors that determine whether Medicare will cover your stay in such a facility.
- Nursing home care: Medicare might cover care in a skilled nursing facility (described above) as long as you need skilled nursing care and not just custodial care (help with eating, dressing, bathing, etc.).
- Hospice: Medicare covers doctor services, nursing care, medical equipment, medical supplies, and more. To qualify, your doctor must certify that you’re terminally ill and expected live six months or less; you must agree to accept palliative care (aimed at easing your pain instead of delivering a cure); and you must sign an agreement stating that you’re accepting hospice care instead of other Medicare-covered treatments for your health condition.
- Home health services: Medicare may cover certain home health services, generally for a limited time while you recover from a hospital stay. Medicare may cover intermittent at-home skilled nursing care, physical therapy, occupational services, and more for beneficiaries whose doctors certify that they need this care at home. The home health agency caring for the beneficiary must be Medicare-certified.
Now that you have an idea of what Medicare Part A covers, click here to learn about Medicare Part B.