Medicare Part A Coverage and Costs Explained
When you first enroll in Medicare, you’ll enroll in Parts A and B, which make up Original Medicare. Medicare Part A, commonly referred to as hospital insurance, is free for Americans who have worked and paid taxes for at least ten years (and their spouses). For this reason, most Americans enroll in Part A as soon as they become eligible for Medicare.
Keep reading to learn more about Part A covers, how much it costs (when it’s not free), and when and how to enroll.
Medicare Part A Coverage
Part A generally covers:
Inpatient care in a hospital
Skilled nursing facility care
Inpatient nursing home care
Hospice care
Some home health care
Depending on your specific situation, Medicare doesn’t always cover these services—or it may not cover the full cost. It’s always best to talk to your doctor and ask if certain services and supplies will be covered by Medicare.
Medicare Part A Costs
Most people can sign up for premium-free Part A, meaning there is no monthly payment.
You can get premium-free Part A benefits at 65 if you meet any of the following conditions:
You or your spouse worked and paid taxes for 10 years
You already receive or are eligible to receive retirement benefits from Social Security or the Railroad Retirement Board
You or your spouse had Medicare-covered government employment
If you’re under 65, you can receive premium-free Part A if you meet one of the following conditions:
You received Social Security or Railroad Retirement Board disability benefits for 24 months
You have End-Stage Renal Disease and meet specific requirements
While most Americans pay no premium for Part A, you are responsible for out-of-pocket costs (your Part A deductible and coinsurance).
Deductible
The Part A deductible is $1,600 in 2023 and covers your share of costs for the first 60 days of each inpatient hospital benefit period. Benefit periods start the day you’re admitted as an inpatient and end when you haven’t received inpatient care for 60 days in a row. This means that the Part A deductible, unlike traditional deductibles, is not an annual amount, and you may pay the deductible multiple times in a year for different hospital stays.
Copayments for inpatient stays
After you meet your Part A deductible, which covers the first 60 days of your stay, you’ll pay daily copayments:
$400 each day for days 61-90
$800 each day for days 91-150 (while using your 60 lifetime reserve days)
100% of costs after day 150
Visit Medicare.gov to learn more about additional copayments and coinsurance for Medicare Part A.
Medicare Part A Enrollment
If you’re already receiving Social Security benefits, then you should be automatically enrolled in Medicare when you turn 65. You can confirm that you are enrolled in Medicare Part A by either receiving your Medicare red, white, and blue card, viewing your status via your Medicare account or Social Security account online, or calling the Social Security Administration. If you are not enrolled, contact social security to sign up to avoid late enrollment fees.
If you are not already receiving Social Security benefits, you will have a 7-month period (your Initial Enrollment Period) to notify Social Security that you intend to enroll in Medicare. The window begins three months before the month in which you turn 65, includes your birth month, and continues for three months after your birth month.
How to notify Social Security you want to enroll in Medicare
Call Social Security at 1-800-772-1213
If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772
Have questions about Medicare? Speak with one of our licensed Advisors to get all your questions answered. Get started by scheduling a free consultation or calling us at (855) 900-2427!