Medicare Part A: Understanding Medicare's Hospital Insurance

Medicare Part A (also known as hospital insurance) helps cover numerous hospital costs, including supplies that are considered medically necessary to treat a disease or condition. It’s also covers other inpatient care, like stays in a skilled nursing facility or hospice care. Below, we examine everything you need to know about Medicare Part A, including eligibility, enrollment and costs.

Medicare Part A: Eligibility

Most people become eligible for Medicare Part A when they turn 65 years old. If you are 65 years old and are receiving Social Security benefits or Railroad Retirement benefits, you will be automatically enrolled in Medicare Part A three months before your 65th birthday.

Some younger people with certain disabilities or medical conditions are also eligible to receive Medicare Part A benefits. In most cases, you will be automatically enrolled in Medicare Part A after your 24th month of receiving Social Security disability benefits.

If you have ALS (also known as Lou Gehrig’s disease), you will be automatically enrolled in Part A the month your disability benefits begin.

Enrollment in Medicare Part A

If you are not automatically enrolled in Medicare Part A, you will have to manually enroll. The best time to enroll in Medicare Part A is during your seven-month initial enrollment period (IEP), which begins three months before your 65th birthday, includes your birthday month, and extends three months after your 65th birthday.

You can manually enroll in Medicare Part A by:

• Applying online at the Social Security website
• Visiting your local Social Security office
• Calling Social Security at 1-800-772-1213
• Calling the RRB at 1-877-772-5772 (if you worked for a railroad)

Medicare Part A Coverage

In addition to covering hospital care, Medicare Part A covers:

• Skilled nursing facility care*
• Nursing home care*
• Hospice
• Home health services**

*Medicare Part A typically does not cover nursing home care if “custodial care” is the only type of care you need. Custodial care includes help with routine daily activities, like getting dressed, bathing, eating and using the bathroom.

**Medicare Part A does not cover round-the-clock care at home or long-term care. It covers limited, eligible home health services.¹

Note: Medicare Part A does not cover prescription drugs. If you would like prescription drug coverage, you must enroll in Medicare Part D. 

Medicare Part A Costs

Most Americans do not have to pay a monthly premium for Medicare Part A because they (or their spouse) paid enough into Social Security taxes.

If you haven’t paid a large enough share of tax dollars into Social Security (10 years, or 25 quarters), you may have to pay a monthly premium for your Part A coverage. For some, this can be as much as $505 in 2024.

Medicare Part A also has several out-of-pocket costs, which include:

• Benefit period deductible. Your Medicare Part A deductible is how much you must pay before Medicare will begin paying its share. In 2024, the Medicare Part A deductible is $1,632 per benefit period.
• Hospice care coinsurance or copayment. Coinsurance and copayments are both forms of cost-sharing that splits the cost of certain health care services between you and Medicare. In 2024, your Medicare Part A coinsurance costs are as follows:
• Days 1-60: $0 coinsurance for each benefit period
• Days 61-90: $408 coinsurance per day of each benefit period
• Days 91 and beyond: $816 coinsurance per each “lifetime reserve day” after day 90 for each benefit period
• Beyond lifetime reserve days: all costs

A Medicare Supplement Insurance (Medigap) Plan can help pay for certain Medicare out-of-pocket costs. To be eligible for Medigap, you must enroll in both Medicare Part A and Medicare Part B.

To learn more about Medicare Part B, including what it covers, how much it costs and how to enroll, refer to this article.

To learn more about Medigap, including which plans are available in your area, speak with a licensed agent at 1-800-995-4219.

Recommended Reading

• Understanding Medicare Part B
• Medicare Terminology Explained
• 20 Medicare Mistakes You Could Be Making
• What Does Original Medicare Cover?

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Sources:

NCPSSM.org: http://www.ncpssm.org/Medicare/MedicareFastFacts

Medicare.gov: https://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html

Medicare.gov: https://www.medicare.gov/coverage/hospital-care-inpatient.html

Medicare.gov: https://www.medicare.gov/coverage/home-health-services.html

SSA.gov: https://www.ssa.gov/pubs/EN-05-10043.pdf

Medicare.gov: https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

¹ https://www.medicare.gov/coverage/home-health-services.html