Medicare Resource Center
  • Print

Medicare Part A (Hospital Insurance)

Medicare Part A helps cover inpatient care in hospitals. This includes critical access hospitals and inpatient rehabilitation facilities. It also helps cover hospice care and home health care, and skilled nursing facilities (not custodial or long-term care). You must meet certain conditions to get these benefits.

Medicare Part A - Covered Services

Source: Information from the official government handbook published by the Centers for Medicare and Medicaid Services: Medicare & You 2010
Blood In most cases, the hospital gets blood from a blood bank at no charge, and you won't have to pay for it or replace it. If the hospital has to buy blood for you, you must either pay the hospital costs for the first 3 units of blood you get in a calendar year or have the blood donated by you or someone else.
Home Health Services Limited to medically-necessary part-time or intermittent skilled nursing care, or physical therapy, speech-language pathology, or a continuing need for occupational therapy. A doctor must order your care, and a Medicare-certified home health agency must provide it. Home health services may also include medical social services, part-time or intermittent home health aide services, durable medical equipment, and medical supplies for use at home. You must be homebound, which means that leaving home is a major effort.
Hospice Care For people with a terminal illness. Your doctor must certify that you are expected to live 6 months or less. Coverage includes drugs for pain relief and symptom management; medical, nursing, social services; and other covered services as well as services Medicare usually doesn't cover, such as grief counseling. A Medicare-approved hospice usually gives hospice care in your home (or other facility like a nursing home). Medicare covers some short-term inpatient stays for pain and symptom management that can't be addressed in the home. These stays must be in a Medicare-approved facility, such as a hospice facility, hospital, or skilled nursing facility. Medicare also covers inpatient respite care which is care you get in a Medicare-approved facility so that your usual caregiver can rest. You can stay up to 5 days each time you get respite care. Medicare will pay for covered services for health problems that aren't related to your terminal illness. You can continue to get hospice care as long as the hospice medical director or hospice doctor recertifies that you are terminally ill.
Hospital Stays (Inpatient) Includes semi-private room, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies. Examples include inpatient care you get in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals, inpatient care as part of a qualifying clinical research study, and mental health care. This doesn't include private-duty nursing, a television or telephone in your room (if there is a separate charge for these items), or personal care items like razors or slipper socks. It also doesn't include a private room, unless medically necessary. If you have Part B, it covers the doctor and emergency room services you get while you are in a hospital.
Skilled Nursing Facility Care Includes semi-private room, meals, skilled nursing and rehabilitative services, and other services and supplies (only after a 3-day minimum inpatient hospital stay for a related illness or injury). To qualify for care in a skilled nursing facility, your doctor must certify that you need daily skilled care like intravenous injections or physical therapy. Medicare doesn't cover long-term care or custodial care in this setting.

Who Can Enroll in Medicare Part A?

Most people age 65 or older who are citizens or permanent residents of the United States are eligible for free Medicare hospital insurance (Part A).

You are eligible at age 65 if:

  • You receive or are eligible to receive Social Security benefits; or
  • You receive or are eligible to receive railroad retirement benefits; or
  • You are the dependent parent of someone who worked long enough in a government job where Medicare taxes were paid; or
  • If you do not meet these requirements, you may be able to get Medicare hospital insurance by paying a monthly premium. Usually, you can sign up for this hospital insurance only during designated enrollment periods.

NOTE: Even though the full retirement age is no longer 65, you should sign up for Medicare three months before your 65th birthday

Before age 65, you are eligible for Medicare Part A if:

  • You have been entitled to Social Security disability benefits for 24 months; or
  • You receive a disability pension from the railroad retirement board and meet certain conditions; or
  • You have Lou Gehrig's disease (amyotrophic lateral sclerosis); or
  • You worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program; or
  • You are the child or widow(er) age 50 or older, including a divorced widow(er), of someone who has worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program; or
  • You have permanent kidney failure and you receive maintenance dialysis or a kidney transplant and:
    • You are eligible for or receive monthly benefits under Social Security or the railroad retirement system; or
    • You have worked long enough in a Medicare-covered government job; or
    • You are the child or spouse (including a divorced spouse) of a worker (living or deceased) who has worked long enough under Social Security or in a Medicare-covered government job.

Most of the information on this Resource Center was obtained from government agency websites and publications, including the Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (DHHS), National Institutes of Health (NIH) and Social Security Administration (SSA). All content is provided for informational purposes only and is subject to change without notice. Although we believe that the source of this information is reliable, we do not warrant or guarantee its accuracy, completeness or timeliness.

eHealth Medicare contains information about and access to insurance plans for people who are eligible for Medicare and seniors in general. It is operated by eHealthInsurance Services, Inc., a licensed health insurance agency. eHealthInsurance and this website are not associated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS) or any other government agency.