Medicare Part A Explained: What it is, what it covers, and more

What is Medicare Part A?

Medicare Part A is sometimes called “hospital insurance.” Part A covers inpatient hospital stays, skilled nursing facility care, nursing home care, some home health care, and hospice care. You will automatically be enrolled in Part A when you apply for Medicare. Most people do not pay a monthly premium for Part A coverage. 

What does Medicare Part A cover?

  • Inpatient hospital care: This includes semi-private rooms, meals, general nursing, drugs, and other hospital services and supplies. Inpatient psychiatric hospital stays are also included for up to 190 days during your lifetime. It does not cover private duty nursing, a television or phone in your room (if there is a separate charge for these items), or personal care items like toothpaste or razors.
  • Skilled nursing facility care: Part A covers short-term care at a skilled nursing facility if it's medically necessary following a qualifying inpatient hospital stay. Coverage includes semi-private rooms, meals, skilled nursing care, required physical and/or occupational therapy, required speech-language pathology services, medical social services, drugs, medical supplies and equipment, ambulance transportation, and dietary counseling. It does not cover long-term or custodial care.
  • Home health care: If you are homebound or unable to leave your home without help, Medicare Part A covers part-time skilled nursing care, physical therapy, occupational therapy, speech therapy, injectable osteoporosis drugs for women, certain durable medical equipment (like walkers and wheelchairs), and at-home medical supplies.
  • Hospice care: Medicare Part A will cover palliative or comfort care for terminally ill patients. This includes doctor, nursing, and medical services, durable medical equipment, medical supplies, pain management drugs, spiritual and grief counseling, physical and occupational therapy, and other services to manage pain and symptoms.

What is the difference between Medicare Parts A and B?

Medicare Part A covers inpatient hospital and skilled nursing care, while Medicare Part B covers outpatient medical services and supplies. Part A does not have a premium for most people, but Part B requires a monthly premium. Part A has deductibles and coinsurance for inpatient care, while Part B has separate deductibles and coinsurance for outpatient services. Most people are automatically enrolled in Part A when they become eligible for Medicare. Still, they will need to actively enroll in Part B during their Initial Enrollment Period unless they have other coverage (like employer insurance).
 

What is not covered under Medicare Part A?

Some of the services not covered under Medicare Part A include hearing, dental, or vision services, long-term care in a nursing home, personal care items during a hospital stay, private duty nursing, private rooms in a hospital or nursing facility (unless medically necessary), meals outside of a hospital stay, nonemergency ambulance transportation, and prescription drugs.
 
While Part A may not cover certain items or services, other parts of Medicare, including Medicare Advantage plans (Part C), may cover these exclusions. Medicare Advantage plans can also offer significant extra benefits like emergency coverage when traveling outside of the US, gym memberships, and an allowance to buy health care products.

How much does Medicare Part A cost?

 Most people don’t pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working. However, these costs may apply: 

  • Premiums: The amount you are required to pay each month for your health care coverage. Most people do not pay a monthly premium for Part A. If you or your spouse worked for 10 years and paid Medicare taxes, you will not have to pay a premium. 
  • Deductible: This is a set amount you pay for covered services before your plan begins to pay. Not all plans have a deductible, and not all services apply. In 2024, the Medicare Part A deductible is $1,632 per benefit period. A benefit period begins the day you’re admitted to a hospital or skilled nursing facility. It ends when you haven’t had any inpatient care for 60 days in a row. 
  • Coinsurance: This is percentage of the cost you pay when you receive covered services (for example, 20 percent). After you’ve paid the deductible, you typically pay coinsurance for each benefit period. For example, for days 61–90 of a hospital stay in a benefit period, you pay a daily coinsurance amount.

For more information, visit Medicare.gov's costs page.

 

Medicare Part A eligibility requirements

You can enroll in Medicare Part A if:

  • You are age 65 or older, or
  • You are under age 65 with certain disabilities, or 
  • You have permanent kidney failure requiring dialysis.

What happens if you don’t enroll in Medicare Part A at 65?

There is a seven-month period to enroll in Medicare when you turn 65. This is called the Initial Enrollment Period. If you don’t enroll in Medicare Part A during the Initial Enrollment Period, you could have a delay in coverage or face late enrollment penalties later. Your monthly premium could go up 10 percent, and you will have to pay this penalty for twice the number of years you didn’t sign up.

How to get Medicare Part A

If you already get benefits from Social Security, you'll get Medicare Parts A and B automatically when you're first eligible and don't need to sign up. Medicare will send you a "Welcome to Medicare" packet three months before you turn 65. You can also contact the Social Security Administration to sign up for Original Medicare. Go to SSA.gov or call toll-free 1-800-772-1213 Monday through Friday from 8 a.m. to 7 p.m. TTY users should call 1-800-325-0778.

Next steps

Explore additional Medicare options offered by UPMC for Life to find the right fit for you.

Contact us

UPMC for Life Members
Call us toll-free: 1-877-539-3080 (TTY: 711)

Oct. 1 – March 31: 
Seven days a week from 8 a.m. to 8 p.m. 
 
April 1 – Sept. 30: 
Monday through Friday from 8 a.m. to 8 p.m. 

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077 (TTY: 711)
Oct. 1 – March 31: 
Seven days a week from 8 a.m. to 8 p.m. 
 
April 1 – Sept. 30: 
Monday through Friday from 8 a.m. to 8 p.m. Saturday from 9 a.m. to 3 p.m.

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO D-SNP, and PPO plans. The HMO D-SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., UPMC for You Inc., and UPMC Health Coverage Inc.

SilverSneakers is a registered trademark of Tivity Health Inc. SilverSneakers GO is a trademark of Tivity Health Inc. © 2024 Tivity Health Inc. All rights reserved.

UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m. Saturday from 9 a.m. to 3 p.m.

Y0069_251030

Last Updated: 10/01/2024