Medicare
What is Medicare Part A?
Medicare Part A is one of the four components of the federal government’s health insurance program, specifically designed for older adults and other eligible individuals. It is often referred to as Medicare hospital coverage because it helps pay for bills related to inpatient hospital stays and procedures, inpatient care in a skilled nursing facility, hospice care, and home health care.
Coverage Under Medicare Part A
Medicare Part A covers a wide range of services, including inpatient care at hospitals, skilled nursing facilities, and nursing homes. It also covers home health care services, such as physical and occupational therapy, if the patient is homebound. For terminally ill patients, Medicare Part A includes doctor’s services, medication, and grief-and-loss counseling for the families.
Specifically, it covers expenses like semi-private rooms at skilled nursing facilities, inpatient care, supplies, and drugs during a hospital stay. However, it does not cover simple custodial care in a nursing home if the patient does not need other types of care.
Eligibility for Medicare Part A
To be eligible for Medicare Part A, you must meet certain criteria. Generally, you must be a U.S. citizen or permanent resident. The primary eligibility groups include individuals who are 65 or older, people with disabilities who are younger than 65, and those diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
Individuals receiving Social Security Disability Insurance (SSDI) benefits for 24 months are automatically enrolled in Medicare Parts A and B in the 25th month. Additionally, individuals with permanent kidney failure requiring dialysis or a transplant, and those diagnosed with ALS, are automatically enrolled in Medicare Parts A and B the month their disability benefits begin.
Enrollment and Premiums for Medicare Part A
Most people receive Medicare Part A for free because they or their spouses have paid the Medicare payroll tax during their working years. This tax, which is 1.45% of all wages, is split equally between the employee and the employer. If you haven’t started collecting Social Security at age 65, you need to enroll in Medicare online, by phone, or at a Social Security office.
If you didn’t pay this tax during your working years, you will have to pay premiums for Medicare Part A. As of 2025, these premiums can be as much as $518 per month. Even when Medicare Part A is premium-free, most people will still have out-of-pocket expenses for copayments and coinsurance.
Inpatient vs. Outpatient Care
It is crucial to understand the difference between inpatient and outpatient care, as this affects how long your stay will be covered and how much you may pay in deductibles and coinsurance costs. To receive coverage under Part A, you must be formally admitted as an inpatient at the hospital or other treatment center. If you are not formally admitted as an inpatient, the services received will be considered outpatient care, which is covered under Medicare Part B.
Additional Considerations
While Medicare Part A provides comprehensive coverage for inpatient and related care, it does not cover all health care services. For example, it does not cover outpatient care, services from doctors and other health care providers, durable medical equipment, or many preventive services, which are instead covered under Medicare Part B.
For prescription drugs, you would need to enroll in a Medicare drug plan (Part D) or join a Medicare Advantage Plan with drug coverage. Additionally, you can purchase Medicare Supplemental Insurance (Medigap) to help pay your share of costs in Original Medicare.