Medicare Part A Explained
Medicare Part A Explained — Medicare Part A is the foundation of Original Medicare, covering inpatient hospital care, skilled nursing facility stays, hospice care, and limited home health services. It’s often called “hospital insurance” and, for most people, comes at no cost if you or your spouse paid Medicare taxes for at least 10 years.
At Diversified Insurance Brokers, we help clients understand how Part A fits into their complete Medicare strategy, including how it works with Part B, Medigap, and Medicare Advantage plans. Our team ensures that your coverage protects both your health and your retirement savings.
What Does Medicare Part A Cover?
Part A primarily covers costs related to inpatient and facility-based care. Understanding what’s included—and what isn’t—helps you avoid unexpected expenses and plan for the right supplemental coverage.
- Inpatient hospital care – room, meals, nursing, and drugs as part of inpatient treatment
- Skilled nursing facility care – after a qualifying 3-day hospital stay
- Hospice care – for those with terminal illness and comfort care needs
- Limited home health services – intermittent skilled nursing and therapy when medically necessary
Who Is Eligible for Medicare Part A?
Most individuals become eligible for Medicare at age 65. You may qualify for premium-free Part A if you or your spouse worked and paid Medicare taxes for at least 10 years. If not, you can still purchase Part A by paying a monthly premium.
If you’re under 65 and have been receiving Social Security Disability benefits for 24 months or have specific conditions such as End-Stage Renal Disease (ESRD) or ALS, you may also qualify for Medicare early.
How Much Does Medicare Part A Cost?
Most people pay $0 in monthly premiums for Part A. However, you’re responsible for a deductible and daily copayments depending on the length of your hospital or skilled nursing stay.
- Hospital deductible: Set annually by Medicare
- Daily coinsurance: Applies after day 60 in the hospital or day 20 in a skilled nursing facility
These costs can add up quickly, which is why many retirees choose to pair Part A with a Medigap plan or a Medicare Advantage plan to limit out-of-pocket exposure.
When and How to Enroll in Part A
If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Part A when you turn 65. If you’re still working or delaying retirement, you can apply online through the Social Security Administration.
For guidance on timing and coordination with employer coverage, see How to Get Medicare While Working.
Estimate Your Medicare Costs
See how Part A and Part B costs impact your total Medicare budget.
How Part A Works with Other Coverage
Medicare Part A can coordinate with group health coverage, retiree plans, or Medicare Advantage. Understanding how benefits are paid in coordination ensures you aren’t paying twice for the same coverage or missing out on hospital benefits.
If you’re nearing retirement, consider how Part A interacts with Social Security timing—our Social Security Filing Checklist can help you align both start dates.
Model Lifetime Income Alongside Medicare Costs
See how your retirement income can support healthcare expenses and coverage decisions.
Common Misconceptions About Part A
- Part A doesn’t cover outpatient care or routine doctor visits—that’s under Part B.
- You can have both Medicare Part A and employer insurance while still working.
- Enrolling in Part A doesn’t affect HSA eligibility until you activate Part B.
Why Work with Diversified Insurance Brokers
Our Medicare specialists simplify the process of comparing coverage, understanding costs, and planning long-term healthcare expenses. With access to dozens of A-rated carriers, we ensure your Medicare strategy is comprehensive, affordable, and aligned with your retirement goals.
Get Help with Medicare Part A
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FAQs: Medicare Part A
What does Medicare Part A cover?
Part A helps pay for inpatient hospital care, skilled nursing facility care after a qualifying stay, hospice, and limited home health services when medically necessary.
Who qualifies for premium-free Part A?
Most people age 65+ qualify for $0 Part A premiums if they or a spouse paid Medicare taxes for at least 10 years (40 quarters). Others can enroll by paying a monthly premium.
How much are the Part A deductibles and copays?
You pay a Part A deductible per benefit period for inpatient hospital care, then daily coinsurance amounts after certain day limits. Skilled nursing facility care is fully covered for the first 20 days, then daily coinsurance applies for days 21–100.
What is a “benefit period” under Part A?
A benefit period starts the day you’re admitted as an inpatient and ends after you’ve been out of inpatient or skilled nursing facility care for 60 days in a row. A new period can start later with a new deductible.
Does Part A cover observation or outpatient services?
No. Observation stays and outpatient services are generally covered by Part B—even if you stayed overnight at the hospital.
How does Part A work if I’m still working and have employer coverage?
You can enroll in Part A at 65 and keep employer coverage. Which plan pays first depends on employer size and plan rules. Coordinating benefits helps avoid gaps or duplicate costs.
Will enrolling in Part A affect my HSA contributions?
Yes. Once Part A is active, you can’t contribute to an HSA. If you want to keep contributing, consider delaying Part A and confirm timing with your employer and tax advisor.
Is Part A automatic when I turn 65?
If you’re already receiving Social Security, you’re typically auto-enrolled in Part A. Otherwise, apply during your Initial Enrollment Period or a Special Enrollment Period if eligible.
How does Part A coordinate with Medicare Advantage or Medigap?
With Medicare Advantage (Part C), your benefits are provided by the plan you join. With Original Medicare plus Medigap, Medicare pays first and Medigap helps cover deductibles and coinsurance based on your plan letter.
Does Part A cover long-term custodial care?
No. Part A doesn’t cover long-term custodial care. Consider long-term care insurance or hybrid policies if you need coverage for extended personal care.
