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Medicare Part A

IN-PATIENT HOSPITAL CARE

Medicare Part A  coverage includes inpatient care in hospitals, skilled nursing facility care, home health care, and hospice care.

Updated January 2025

- PART A DETAILS ON MEDICARE.GOV -

* BENEFIT PERIOD EXPLAINED

A Benefit Period begins the day that you enter a hospital or skilled nursing facility and ends when you have not received in-patient hospital or Medicare-covered skilled care for 60 days in a row.


The benefit period is not tied to the calendar year.  If you go into the hospital after one benefit period has ended (more than 60 days after you were discharged from the hospital), a new benefit period begins.


There is no limit to the number of benefit periods you can have, and it is possible to have several Benefit Periods in a given year.   

IN-PATIENT HOSPITAL CARE INCLUDES

Hospital Care

Medicare Part A  covers inpatient hospital care when: 

  • The hospital accepts Medicare.
  • You have an official doctor’s order which says you need inpatient hospital care to treat your illness or injury.
  • In certain cases, the Utilization Review Committee of the hospital approves your stay while you’re in the hospital.

click here for more details on medicare.gov

Skilled Nursing Facility

Medicare Part A covers skilled nursing care on a short-term basis if you have days left in your benefit period and if you have qualifying hospital stay.

click here for more details on medicare.gov

Home Health Services

To be eligible for home health services, you must be under the care of a doctor, and the doctor must certify that you are homebound.

click here for more details on medicare.gov

Hospice Care

If you qualify, you and your family will work with the hospice team to set up a plan that meets your needs.

click here for more details on medicare.gov

Nursing Home Care

Medicare Part A may cover care in a certified Skilled Nursing Facilty (SNF) if it is "medically necessary".

click here for more details on medicare.gov

All services and supplies must be considered medically necessary to treat a disease or condition. 

NOTE:

Your doctor or other health care provider may recommend you get services more often than Medicare covers.  Or, they may recommend services that Medicare doesn’t cover.  If this happens, you may have to pay some or all of the costs. 


It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them. 

NOTE:

You are responsible for private-duty nursing, television, or phone charges in your room.  You are also responsible for private room charges unless it's medically necessary.

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