As noted in my previous Sixty and Me blog, Original Medicare consists of Part A and Part B. This blog focuses on Part A which applies to inpatient hospital stays plus some other services.

Part A (Hospital Insurance) covers:

• Inpatient stays in a hospital
• Inpatient stays in a skilled nursing facility (not custodial or long-term care)
• Hospice care
• Home health care

Costs for Medicare Part A

Most of us won’t have premiums for Medicare Part A. Therefore, the only costs are deductibles, coinsurance or copayments.

Deductible

The amount paid for healthcare services or prescriptions before Medicare or other insurance plan pays.

Coinsurance

A percentage of the total cost for healthcare services after any deductibles.

Copayment

An amount paid before deductibles or coinsurance.

Inpatient Care in a Hospital

If you are in the hospital as an inpatient, Medicare covers the following:

• Semi-private room
• Meals
• General nursing
• Medications while in the hospital
• Other services and supplies

Costs not paid by Medicare are:

• Private room
• Private nursing
• Phone, television or internet access
• Personal care items like deodorant or slipper socks

Knowing if you’re an inpatient or an outpatient is essential when in the hospital. Sometimes you might be considered an outpatient because you’re in for observation or tests. Since Medicare pays inpatient and outpatient costs differently, make sure you ask about your inpatient/outpatient status.

Inpatient Care in a Skilled Nursing Facility

After a hospital stay of three days or longer, Medicare pays for 100 days or less of skilled nursing care in most cases. The covered services are:

• Semi-private room
• Meals
• Skilled nursing
• Therapy (e.g., physical)
• Medications while in the facility
• Other medically necessary services and supplies

Medicare generally does not cover the costs of assistance with daily activities like dressing or bathing unless received during a medically necessary stay in a skilled nursing facility.

Hospice Care

Hospice care for the terminally ill may be covered under Medicare Part A if a doctor confirms the patient has six months or less to live. Patients in Medicare-covered hospice receive comfort care only instead of services intended to extend life.

Covered services include:

• Pain and symptom management
• Medical, nursing and therapy services
• Aide and homemaker services
• Spiritual and grief counseling

Some additional details about hospice care:

Home Health Care

Medicare Part A may cover services at home if deemed medically necessary by a doctor or other sanctioned healthcare professional. Home healthcare services must be provided by a Medicare-approved agency.

Covered services include:

• Nursing care
• Therapy (e.g., physical)
• Part-time aides
• Durable medical equipment (e.g., hospital bed)
• Medical supplies

Medicare home care coverage usually does not include:

• Full-time (24-hour) care
• Meal delivery
• Household services not related to the care plan like shopping, laundry or cleaning
• Help with daily activities like dressing or bathing if that is the only care needed

You can learn more about Medicare Part A by checking out the Medicare website or downloading the latest Medicare and Me handbook. Also, look for my future blog posts on Sixty and Me for more valuable Medicare information. For an even deeper dive, check out my Medicare eBook at Living50+.

Let’s Have a Conversation:

What services have been covered for you under Medicare Part A? What haven’t been covered? Have you found Medicare Part A sufficient for your needs so far?