Medicare Part A

Medicare Part A

Medicare Part A (Hospital Insurance) covers inpatient hospital care when all of these are true:

  • You’re admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
  • The hospital accepts Medicare.
  • In certain cases, the Utilization Review Committee of the hospital approves your stay while you’re in the hospital.

The Cost to you? You pay this:

  • $1,408 deductible for each benefit period .
  • Days 1–60: $0 coinsurance for each benefit period.
  • Days 61–90: $352 coinsurance per day of each benefit period.
  • Days 91 and beyond: $704 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days : all costs.

Medicare-covered hospital services include:

  • Semi-private rooms
  • Meals
  • General nursing
  • Drugs as part of your inpatient treatment
  • Other hospital services and supplies

Skilled Nursing Facilities:

Medicare Part A (Hospital Insurance) covers skilled nursing care provided in a SNF in certain conditions for a limited time (on a short-term basis). Subject to certain restrictions.

  • You have Part A and have days left in your benefit period to use.
  • You have a qualifying hospital stay.
  • Your doctor has decided that you need daily skilled care. It must be given by, or under the supervision of, skilled nursing or therapy staff.
  • You get these skilled services in a SNF that’s certified by Medicare. You need these skilled services for a medical condition that’s either:
  • A hospital-related medical condition treated during your qualifying 3-day inpatient hospital stay, even if it wasn’t the reason you were admitted to the hospital.
  • A condition that started while you were getting care in the SNF for a hospital-related medical condition (for example, if you develop an infection that requires IV antibiotics while you’re getting SNF care)

Your Costs? You pay: 

  • Days 1–20: $0 for each benefit period .  
  • Days 21–100: $176 coinsurance per day of each benefit period.
  • Days 101 and beyond: all costs.

Hospice Care:

If you qualify for hospice care, you and your family will work with the hospice team. Together, you’ll set up a plan of care that meets your needs.

Home Health Care:

Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these:

  • Part-time or “intermittent” skilled nursing care
  • Physical therapy
  • Occupational therapy
  • Speech-language pathology services
  • Medical social services
  • Part-time or intermittent home health aide services (personal hands-on care)
  • Injectable osteoporosis drugs for women

Usually, a home health care agency coordinates the services your doctor orders for you.

Medicare doesn’t pay for:

  • 24-hour-a-day care at home
  • Meals delivered to your home
  • Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
  • Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need.

For more information contact a Medicare Specialist at (610) 420-6064

For Information on Part B click here