Medicare Part A, along with Medicare Part B, is part of Original Medicare. Enrollment in Medicare automatically includes enrollment in Part A, which provides hospital insurance coverage.
Table of Contents
- 1 Medicare Part A Eligibility
- 2 Medicare Part A Enrollment
- 3 Medicare Part A Coverage
- 3.1 Covered Treatments
- 3.2 Care and Items Not Covered by Medicare Part A
- 3.3 Prescription Drug Coverage
- 3.4 Premium-Free Eligibility
- 3.5 Premium Structure for Beneficiaries Not Eligible for Premium-Free Coverage
- 4 Other Medicare Coverages
Medicare Part A Eligibility
Automatic Eligibility at Age 65
You are eligible for Medicare Part A coverage If you:
- are at least 65 years old,
- are a U.S. citizen or have been a permanent legal U.S. resident for five years, and
- are eligible to collect retirement benefits from Social Security or the Railroad Retirement Board.
Learn more about what age you can get Medicare.
Limited Eligibility Before Age 65
If you are under 65 years old, you may be eligible for Medicare Part A coverage if you are a U.S. citizen or have been a permanent legal U.S. resident for five years, and:
- you receive disability benefits from the Social Security Administration,
- you have end-stage renal disease (ESRD), or
- you have amyotrophic lateral sclerosis (ALS).
Learn how to apply for Medicare.
Medicare Part A Enrollment
Automatic Enrollment at Age 65 For Retirement Beneficiaries
Enrollment in Medicare Part A is usually automatic for persons 65 or older who are already receiving retirement benefits from Social Security or the Railroad Retirement Board. Persons who are automatically eligible receive their permanent Medicare card about three months before turning 65.
Learn how to get a replacement Medicare card.
Manual Enrollment For Persons Ineligible for Automatic Enrollment
Persons who are eligible for Medicare Part A coverage but do not qualify for retirement benefits from Social Security or the Railroad Retirement Board must take steps to enroll manually for Medicare Part A coverage. Application for coverage can be made at the Social Security website, visiting a Social Security office, or by telephone (1-800-772-1213 / TTY users 1-800-325-0778).
Original applications should be made during a person’s Initial Enrollment Period (IEP). The IEP begins three months before an applicant turns 65 and ends three months after the applicant’s 65th birthday.
Medicare Part A Coverage
Inpatient Hospital Care
Medicare Part A provides coverage if you are admitted to a hospital that accepts Medicare for inpatient care. The hospital admission must be ordered by a doctor. In some cases, a hospital is required to approve inpatient treatment during the hospital stay.
Home Health Care Services
Medicare Part A provides coverage for part-time skilled nursing care, physical therapy, occupational therapy, medical social services, and part-time health aide services for personal care.
Nursing Home and Skilled Nursing Facility Care
Nursing home care must include necessary medical treatment for coverage. Skilled nursing facility care is covered as temporary inpatient treatment.
Medicare Part A covers hospice care when a hospice doctor and a primary care doctor certify that a patient is terminally ill with a life expectancy of six months or less. Covered patients must also accept palliative care rather than care intended to cure an illness.
Care and Items Not Covered by Medicare Part A
Unless related to medical treatment, Medicare Part A does not cover meals, private rooms, homemaker or personal care services. Medicare Part A does not cover the cost of personal care items or hospital charges not related to necessary medical treatment.
Prescription Drug Coverage
Medicare Part A covers the drugs needed during covered inpatient hospital or skilled nursing facility stays. Prescribed drugs may be covered by Medicare Part D during stays at skilled nursing facilities not covered by Medicare Part A.
Medicare Part A Premiums
Enrollees in Medicare Part A usually are not charged a monthly premium for coverage. If you are already receiving retirement benefits from Social Security or the Railroad Board (or are eligible for them) when you are eligible for Medicare Part A coverage you will not be charged a premium. If you or your spouse is retired from Medicare-covered government employment, there is no premium for Medicare Part A coverage.
Premium Structure for Beneficiaries Not Eligible for Premium-Free Coverage
Persons eligible for Medicare Part A coverage who do not qualify for premium-free coverage may still obtain coverage for a monthly premium. Currently, the maximum premium for Medicare Part A coverage is $437 per month. Persons paying a premium for Medicare Part A coverage must also obtain and pay a premium for Medicare Part B coverage.
Other Medicare Coverages
Medicare Part A is part of Original Medicare, which includes Medicare Part B. Medicare Part C involves Medicare Advantage plans that combine parts of coverages under Parts A and B. Medicare Part D involves prescription drug coverage. Click the links below for more information on the other parts of Medicare coverage.