Medicare Part A is the hospital coverage portion of Medicare. For many people who worked and paid Medicare taxes, Medicare Part A is free of charge, starting when you reach age 65.
This article covers everything you want to know about Medicare Part A, including how to use this coverage in 2021.
The government designed Medicare to serve as an “a la carte” menu of healthcare options, or “parts.” Medicare Part A is the first part; you can also choose from among parts B, C, and D.
Services covered under Medicare Part A include:
- inpatient hospital care
- inpatient mental health services
- inpatient rehabilitation services
- hospice care
- limited home healthcare
- limited stays in a skilled nursing facility
There are specific rules about the services and supplies Medicare Part A covers, as well as how long they’re covered.
Other parts of Medicare that cover hospitalization costs
Although Part A is generally known as hospital insurance, other parts of Medicare may also cover some of the costs of a hospital stay.
These may include:
- Part B. Generally, Medicare Part B doesn’t cover costs for inpatient care, but it may cover services that occur before or after inpatient care. Part B covers doctor’s appointments, emergency room visits, urgent care visits, lab work, X-rays, and many other outpatient services.
- Part C (Medicare Advantage). Medicare Advantage plans are sold by private insurance companies and include the services covered under parts A and B. They may also cover prescription drugs, dental care, or vision care.
- Medicare supplement insurance (Medigap). These plans help you pay for out-of-pocket healthcare costs and fees from Part A and Part B, such as copays, coinsurance, and deductibles. Medigap plans are sold by private insurance companies, so coverage and costs vary by plan, provider, and location.
From year to year, there may be slight variations in coverage and costs for Medicare Part A. For 2021, the main changes are related to costs, including the deductible and coinsurance amounts.
The monthly premium costs for Medicare Part A depend on how long you or your spouse worked and paid Medicare taxes.
If you or your spouse didn’t work for at least 40 quarters (10 years), you can still qualify for Medicare Part A at age 65. The cost of your premium changes based on how long you worked.
Here’s a look at how much your Part A monthly premium will cost in 2021 based on the total amount of time you’ve worked over your life:
|Total time worked||Part A monthly premium|
|40 quarters or more||$0|
|fewer than 30 quarters||$471|
Of course, a free premium doesn’t mean you won’t pay anything for hospital care. There are other costs involved with Medicare Part A, several of which have increased for 2021.
A deductible is the amount you pay out of pocket before Part A starts covering the costs of your care. In 2021, you’ll pay $1,484 for each benefit period.
A benefit period starts the day you’re admitted as an inpatient to a hospital, skilled nursing facility, or any other inpatient facility. This period ends when you haven’t received hospital or skilled care for 60 consecutive days.
Ask your care providers if you’re considered an inpatient or an outpatient on each day of your stay. Whether you’re considered an inpatient or an outpatient can affect your coverage and how much you have to pay.
After you’ve paid your deductible for Part A, you may have to pay daily coinsurance costs for your care. Whether you have to pay coinsurance and how much it will cost depends on how long you’ve received inpatient care.
Here is a table that shows the range of coinsurance costs in 2021 for Part A inpatient care:
|Length of stay||Coinsurance cost|
|days 1–60||$0 per day|
|days 61–90||$371 per day|
|day 91 and beyond (reserve days)||$742 per day|
After 90 days of inpatient hospital care, you enter what Medicare calls lifetime reserve days. Medicare covers 60 lifetime reserve days in total over your lifetime. After you meet your lifetime reserve days, you’re expected to pay all costs.
If you’re receiving care at a skilled nursing facility, your coinsurance costs will be a bit different. These are the coinsurance costs in 2021 if you’re admitted to a skilled nursing facility:
|Length of stay||Coinsurance cost|
|days 21–100||$185.50 per day|
|day 100 and beyond||all costs|
Typically, you must be age 65 to enroll in Medicare. To receive Medicare Part A free of charge, you must meet the following criteria:
- You’ve worked and paid Medicare taxes at least 40 quarters or roughly 10 years. If your spouse worked, but you did not, you can still qualify.
- You receive (or are eligible for) Social Security or Railroad Retirement Board benefits.
- You or your spouse are or were Medicare-covered government employees.
Other people may also qualify for Medicare Part A based on their health, such as if they have:
The federal government automatically enrolls some people in Medicare Part A. You’re automatically enrolled in Part A if you meet the criteria listed above.
If you none of those sound like you, then you’ll need to apply for Medicare Part A.
For the most part, signing up for Medicare Part A depends on when you turn age 65.
You have a 7-month time period during which you can enroll. You can enroll as early as 3 months before your birth month, during your birth month, and up to 3 months after your 65th birthday.
If you don’t enroll during this time period, you could face financial penalties that result in you having to pay more for your healthcare coverage. This also delays how fast your Medicare benefits begin.
You can sign up for Medicare Part A (and Part B) during the general enrollment period from January 1 to March 31, but you may face penalty fees.
If you require hospitalization or skilled nursing care, Medicare Part A can vastly offset your costs. For most people, it’s the benefit of having paid Medicare taxes while working.
While the Social Security Administration automatically enrolls many beneficiaries in Medicare parts A and B, not all people are automatically enrolled.
There are several ways to accomplish this if you or a loved one is approaching age 65 when your open enrollment period occurs.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.