Medicare Part A

Medicare Part A is the core coverage in the Medicare program. For most people Part A does not require the payment of a premium. Co-pays and deductibles apply to most Part A care whether it is received through Original Medicare or through an Advantage Medicare Plan. This means you are likely to have some bills related to any hospital stay.

Medicare Part A is focused on providing inpatient care in hospitals and skilled nursing facilities and hospice care for dying patients. Some home health care services are also covered by Part A. Part A does not provide coverage for long-term nursing home care or custodial care services.

Medicare Part A covers inpatient hospital stays. Staying overnight in a hospital does not mean that you automatically have inpatient status. To be an inpatient and receive Part A inpatient Medicare benefits you must be formally admitted to the hospital or facility by a doctor's order. Assuming you are able, check on this as soon as possible by requesting to see a hospital liaison or asking your doctor directly. Your status can significantly impact your out-of-pocket expenses and hospitals are expensive!

Medicare Part A covers a semi-private room and food for hospital inpatients. Coverage also includes critical care, nursing care, rehabilitation services and other essential hospital services. Any drugs, wound dressings or pain medications and blood while you are an inpatient are generally covered. Anything that is deemed "extra" might not be covered by Medicare and you could be charged for these things. A private room, a telephone, a TV, socks, those silly small yellow pans that no one ever uses, may all end up excluded by Medicare and on your bill. Check with the hospital liaison about all these particulars if you are concerned about paying for them later. Provided you are signed up for Medicare Part B, your physician's services will also be covered while you are an inpatient.

Medicare Part A covers skilled nursing facility care but only after you have spent at least 3 days in the hospital. The day you are discharged doesn't count so actually it's 4 days from the date your are formally admitted by the doctor into the hospital. To qualify for skilled nursing home care your doctor must also order Daily Skilled Care. Medicare will not pay for simple custodial care or long-term care. Skilled care includes things like intravenous feeds, complicated monitoring and physical therapy. The coverage is similar to what you received at the hospital. Medicare will pay for a semi-private room, meals, nursing care and medically necessary supplies and medications.