Part A is the hospital side of Medicare. It's the part most people never pay a monthly premium for, and the part whose rules people usually learn only when someone they love ends up in the hospital.
What Part A pays for
- Inpatient hospital care — a semi-private room, meals, nursing, and the drugs and services you receive as an admitted inpatient.
- Skilled nursing facility care — short-term care in a skilled nursing facility after a qualifying inpatient hospital stay, when you need daily skilled care such as rehabilitation.
- Hospice care — comfort care for people with a terminal illness.
- Some home health care — certain part-time skilled care at home.
Why most people pay no premium
If you or your spouse worked and paid Medicare taxes for long enough — generally about ten years in total — you get Part A without a monthly premium. People who didn't work that long can usually buy it.
"No premium" doesn't mean free care. Part A has a deductible for each benefit period, and longer stays in a hospital or skilled nursing facility come with daily coinsurance.
The detail that surprises people: staying overnight in a hospital doesn't automatically make you an inpatient. Hospitals sometimes keep patients under observation status, which counts as outpatient care under Part B, not Part A. That affects what you pay, and it can affect whether a later skilled nursing stay is covered. If you or a family member is in the hospital, it's fair to ask: "Is this an inpatient admission or observation?"
What Part A doesn't cover
- Long-term custodial care — help with daily activities like bathing and dressing, in a nursing home or at home, when that's the only care you need.
- Doctor services — even while you're in the hospital, your doctors' services generally fall under Part B.
- Private rooms and personal items, unless medically necessary.
How Part A fits with the rest
Part A and Part B together are called Original Medicare. If you join a Medicare Advantage plan instead, the plan covers everything Part A covers (hospice stays with Original Medicare), but with its own costs and rules. Our comparison of the two routes explains the trade-offs.
For your own situation, see Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048).
The Medicare cheat sheet
Parts A, B, C and D on a single page, plus the dates that matter this fall. The email version is coming soon.