Medicare Health Center

Font Size

Medicare Part A: Hospital Care and Services

Medicare Part A generally covers inpatient services. This includes stays in a hospital or nursing facility. It also pays for some home care and hospice.

Medicare Parts A and B are sometimes called "Original Medicare". Original Medicare is very different from private insurance plans like Health Maintenance Organizations. HMOs often restrict you to doctors or hospitals in their network. Traditional Medicare allows you to go to any doctor or hospital that accepts Medicare. Original Medicare is also called "fee-for-service," which has to do with how the doctor or hospital gets paid.

Medicare Benefits: How Do I Get Medicare Part A?

The Social Security Administration handles Medicare enrollment. You are automatically enrolled in Medicare Part A if you're 65 and receive Social Security checks. Typically, you'll get your Medicare card three months before your 65th birthday.

If you have a disability, Lou Gehrig's disease, or kidney failure, you may get Medicare even when you're younger than 65. And if you are 65 or older but don't get Social Security payments, you can still enroll in Medicare. Call Social Security at 1-800-772-1213, visit the web site at http://www.socialsecurity.gov/ or apply at your local Social Security office.

How Much Does Medicare Part A Cost?

The vast majority of people over 65 get Medicare Part A for free. But if you or your spouse worked and paid Medicare taxes for less than 10 years total, you will have to pay a monthly fee of $233 or $423 per month in 2008. How much you will have to pay depends on how long you or your spouse worked and paid into Medicare.

Medicare Coverage: What Does Medicare Part A Cover?

Medicare Part A pays some of the charges for:

Hospital stays. The amount covered depends on how long you're in the hospital. For instance, for the first 60 days, you pay a maximum of $1,024 and Medicare pays the rest. After that, the longer you stay, the more you pay. You pay $256 per day for days 61-90. After that, you pay $512 per day until the 60 days of “lifetime benefits” run out. After that, you pay all the costs.
Skilled nursing facility care. This is to allow you to recover after a stay in the hospital; Medicare does not pay for long stays in a nursing facility. Medicare pays for the first 20 days. For the next 80 days, you pay a co-pay of $128 per day. After that, you pay all the costs of your stay in a skilled nursing facility.
Home health care. If you are recovering from an illness or injury -- and your doctor says you need short-term skilled care -- Medicare Part A pays for nurses and some therapists to provide services in your home. As long as the provider is certified by Medicare, you pay nothing -- except for 20% of the charges for some medical equipment, such as wheelchairs and walkers.
Hospice care. This covers some care for people who are terminally ill. Medicare Part A covers most drug costs, as well as medical and support services. Hospice care is usually given at home or in the facility where you live. But Medicare also covers most of the charges for short stretches in a hospice facility to manage pain and other symptoms -- and to give the regular caregiver a break.
Blood transfusions. After you pay for the first 3 pints, Medicare Part A pays 80% of any additional blood you need in the hospital.