As of 2022, it also includes optional drug coverage (Part D). Medicare can also refer to comprehensive plans offered by private companies (Part C/Medicare Advantage Plans) and supplemental plans (Medigap), also offered by private companies. First introduced in 1965, Medicare covered almost 63 million people in 2020, the most recent year for which comprehensive statistics are available. Medicare is an important part of your retirement plan. Learn the basics of what Part A does and how to sign up for it.

What Is Medicare Part A?

Part A is the hospital insurance portion of Medicare. Most people become eligible for Medicare when they turn 65, and they may be automatically enrolled if they’re receiving Social Security benefits. Otherwise, you have a limited window of time during which to sign up for Part A without having to pay a penalty. This is referred to as the initial enrollment period. It lasts for a total of seven months: three months before you become eligible for Medicare and three months after. You won’t pay a premium for Part A if you already receive Social Security retirement benefits or if you’re eligible for them.

What Does Medicare Part A Cover?

Part A covers a percentage of hospital or skilled nursing facilities based on benefit periods. A benefit period begins when you’re admitted and ends 60 days after you’re no longer receiving care. There is no limit on benefit periods.  Part A also covers 100% of hospice care and skilled intermittent home health care.

Inpatient Care in a Hospital

Inpatient care in a hospital pays for:

Hospital servicesSupplies that are part of your treatmentSemi-private roomsNursing careDrugs Meals

Part A coverage begins when you’re admitted under a physician’s orders to a hospital that accepts Medicare.  What you pay:

A $1,556 in 2022 for each benefit period, increasing to $1,600 in 2023$389 coinsurance after 61 days in 2022, increasing to $400 in 2023After 91 days, $778 in coinsurance for up to 60 days in 2022, increasing to $800 in 2023100% of charges once these benefits have expired

Skilled Nursing Facility Care

Skilled nursing facility care includes:

Short-term skilled nursing careOccupational, speech, and physical therapyMedical social services (medical social workers)Dietary counselingMedicationsA semi-private roomAmbulance services

This coverage pays after you’ve had a qualifying hospital stay of three days. Care ordered by a physician has to be for a qualifying condition that was treated during your hospital stay, or that began in a skilled nursing facility. What you pay:

100 days of skilled nursing care per benefit periodFirst 20 days: $0Day 21 through day 100: $194.50 in 2022, increasing to $200 in 2023Day 101 and beyond: all costs

Hospice Care

Hospice Care pays for:

Any items, services, or durable medical equipment that’s needed to relieve pain and manage symptoms, including drugs for pain managementMedical, nursing, and social servicesAide and homemaker servicesInpatient respite care received in a Medicare-certified facility to provide rest to the usual caregiver, such as a family member

Services can be provided in the home or at a Medicare-certified facility.  This coverage pays when a hospice doctor and your personal physician certify a life expectancy of six months or less. What you pay:

$0 for care$5 copay for prescriptions5% copay for the Medicare-approved amount for inpatient respite care

Home Health Care

Home health care coverage pays for:

Part-time skilled nursing care Home health aide Medical social services Physical, occupational, and speech therapy Durable medical equipment needed for care Osteoporosis injections for women

It pays when your physician certifies that you are homebound, puts you on a plan of care that requires one or more home health care services, and reviews that plan of care regularly. What you pay:

$0 for home health care20% copay for the Medicare-approved amount for durable medical equipment

What Doesn’t Medicare Part A Cover?

No part of Medicare covers long-term care or 24-hour-a-day custodial care. Custodial care is given at home or in a nursing home, such as a memory unit, and provides assistance with the six activities of daily living: eating, bathing, dressing, toileting, transferring, and continence.  Medicare also does not cover dental care, dentures, eye exams for glasses, hearing aids, acupuncture, cosmetic surgery, or routine foot care. 

How Part A Compares to Other Parts of Medicare

Part B

Part B is the counterpart to Medicare Part A. It covers regular exams and diagnostic services. It pays for:

Physician fees Diagnostic tests Preventive and screening services Ambulance services Durable medical equipment Mental health services

It pays when services have met Medicare guidelines. Medicare publishes a guide of services covered and their maximum fees.  What you pay: 

Most people pay the standard premium of $170.10 per month as of 2022, dropping to $164.90 in 2023.Most people pay 20% coinsurance for the cost of each Medicare-covered service or item after the deductible is reached.High-income earners or those who don’t sign up when they’re first eligible may pay more.You may have to pay an ongoing late fee if you enroll in part B after your initial enrollment period.

Part C

Part C is Medicare Advantage. It’s a comprehensive health plan offered by private insurance companies.  These plans have to cover at least what Medicare covers, including prescriptions, and many offer more coverage like dental and vision benefits. Medicare beneficiaries can enroll in Medicare Advantage instead of Parts A, B, and D. When it pays depends on the specific plan you enroll in, but benefits eligibility will be similar to other Medicare plans. You must enroll and pay for the Part B premium if you select Medicare Advantage. Some Medicare Advantage plans will pay the Part B premium for you, and others will charge an additional premium. Each Medicare Advantage plan has its own deductibles and copays.

Part D

Part D is Medicare-approved prescription drug coverage offered by private insurance companies. Medicare Part D is optional. You may have to pay an ongoing penalty if you enroll in Part D after your initial enrollment period. Prescriptions have to meet plan approval for use to be covered. Each plan has its own premiums, copay, and deductible.