Medicare Part A
Medicare Part A and Medicare Part B coverage make up Original Medicare. But, what does Part A cover by itself? Well, Medicare Part A covers:
- Inpatient care in a hospital
- Nursing home care
- Hospice care
- Home health care
- Skilled nursing facility care
Inpatient Care
Medicare Part A covers inpatient care when:
• Your hospital accepts Medicare
• You have an official doctor’s order
• In some cases, the Utilization Review Committee of the hospital must approve your stay
Medicare Part A may not cover all hospital services during your stay. Covered services include general nursing, semi-private rooms, meals, medications required for inpatient treatment, and other supplies and services deemed medically necessary for your inpatient treatment.
Inpatient care in critical access hospitals, acute care hospitals, inpatient psychiatric facilities (limited to 190 days in your lifetime), inpatient rehabilitation facilities, and long-term care hospitals are coveraged. Inpatient care as part of a qualifying clinical research study is also covered.
Nursing Home Care
Most nursing home care is custodial — care that supports your daily activities (like getting dressed, bathing, and using the bathroom) or personal needs. Medicare Part A doesn’t cover custodial care if that’s the only kind of care you need, but it does cover inpatient care in a skilled nursing facility that’s not custodial or long-term care.
Skilled Nursing Care
Skilled nursing care is care provided by licensed health care workers. Medicare Part A covers skilled nursing facility care when:
• You have a qualifying hospital stay
• Daily skilled care is necessary
• You require skilled services for a medical condition
• Your skilled nursing facility is certified by Medicare
Hospice Care
Medicare Part A covers hospice care if a hospice doctor and your doctor have determined that you’re terminally ill with a life expectancy of 6 months or less. This is palliative care or comfort care, and is usually given to you in your home or a nursing home where you live.
Hospice care coverage includes:
• Medical, nursing, and social services
• Items, services, drugs, and equipment you need for symptom management and pain relief
• Aide and homemaker services
• Spiritual/grief counseling
Home Health Care
Medicare Part A covers your home health care if the following conditions are met:
• Your condition is expected to improve and/or you need a skilled therapist to support you
• You are under a doctor’s care and getting services under a care plan created and regularly reviewed by a doctor
• Your doctor determines you need one or more of the following: part-time skilled nursing care, speech-language pathology, physical therapy, or occupational therapy services
• A doctor has certified that you’re homebound
• The home health agency caring for you is Medicare certified
Medicare Part A also covers physical therapy, part-time skilled nursing care, speech-language pathology services, occupational therapy, medical social services, part-time home health aide services (personal hands-on care), injectable osteoporosis drugs for women, and necessary medical supplies for use at home, medical equipment, and injectable osteoporosis drugs.
However, it doesn’t cover 24-hour-a-day care at home, meal delivery, homemaker services (for example, cleaning and laundry) if this is only care you need, or custodial care (like getting dressed or using the bathroom) if this is the only kind of care you need.
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