What Medicare Part A Covers at Age 65

Medicare Part A is hospital insurance that becomes available when you turn 65. This section of the guide explains what services are and are not covered under Part A so you can understand what protection it offers.

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Part A covers inpatient hospital stays, which means overnight stays where you occupy a hospital bed. This includes semi-private rooms, meals, nursing care, medications given during your hospital stay, lab tests, X-rays, and surgery performed at the hospital. If you need emergency care at a hospital's emergency room, Part A covers the services provided there if you are admitted as an inpatient within three days. Part A also covers the cost of blood transfusions after the first three pints, which you or a donor may replace.

Beyond hospital stays, Part A covers skilled nursing facility care. This applies when you need recovery care after a hospital stay of at least three consecutive days. A skilled nursing facility provides medical care beyond what can be given at home, such as physical therapy, medication management, or wound care. Part A covers up to 100 days of skilled nursing care per benefit period, though you share costs after day 20.

Part A also covers hospice care for people with terminal illnesses expected to live six months or less. Hospice focuses on comfort rather than curing an illness. This includes pain management, emotional support, and spiritual counseling. Additionally, Part A covers some home health services when ordered by a doctor, such as part-time nursing care, physical therapy, or occupational therapy.

What Part A does not cover is important to know. It does not pay for private duty nursing, television or telephone services in your hospital room, or personal care items. Part A does not cover long-term custodial care in nursing homes unless it is skilled care following a hospital stay. Doctor fees during a hospital stay are not covered by Part A—that is where Medicare Part B comes in. Understanding these boundaries helps you anticipate out-of-pocket costs.

Practical Takeaway: Review the specific services listed above and think about which ones might matter for your health situation. Write down any questions about coverage gaps so you can research them further or speak with Medicare directly at 1-800-MEDICARE.

How to Enroll in Medicare Part A When You Turn 65

This section describes the process for becoming part of Medicare Part A at age 65 and the different ways this can happen. Most people do not need to take action to get Part A—it happens automatically—but knowing the details matters.

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If you are already receiving Social Security benefits when you turn 65, Medicare Part A enrollment occurs automatically. Social Security sends Medicare information to you about three months before your 65th birthday. You will receive a welcome package with your Medicare card. This card shows you have Part A coverage starting on the first day of the month you turn 65, or the month after, depending on your birth date. For example, if you turn 65 on March 15, your Part A coverage may begin April 1. You do not need to take any action in this situation.

If you are not yet receiving Social Security benefits at age 65, you must take action to join Medicare Part A. You can contact Social Security at 1-800-772-1213 to set up Medicare coverage. You can also visit your local Social Security office in person or go online to ssa.gov. When you contact them, tell them you are turning 65 and want to join Medicare. Social Security will walk you through the process. This typically involves confirming your personal information and citizenship status. You should do this during your initial enrollment period, which is the seven-month window that includes the three months before you turn 65, the month you turn 65, and the three months after.

Another way to join is through the Centers for Medicare and Medicaid Services, or CMS, which runs the Medicare program. You can call 1-800-MEDICARE or visit Medicare.gov to learn about enrollment. The Medicare website has a tool to check your enrollment status and see what coverage you have. You can also use this tool to understand your costs under different Medicare plans.

Certain groups of people become part of Medicare earlier than age 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become part of Medicare at that point, regardless of age. If you have end-stage renal disease (ESRD), meaning your kidneys no longer work, you may become part of Medicare regardless of age. If you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you become part of Medicare right away without waiting for age 65.

Practical Takeaway: Mark your calendar for three months before your 65th birthday to check whether you need to take action. If you do not receive Social Security benefits, contact Social Security or Medicare directly using the phone numbers or websites listed above to begin the enrollment process.

Understanding Costs and Out-of-Pocket Expenses Under Part A

Medicare Part A is not free, even though many people think of it as "free" because no monthly premium is required if you paid Medicare taxes while working. This section describes the real costs you will face when using Part A services in 2024 and 2025.

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The main costs under Part A are the deductible and coinsurance amounts. In 2024, the Part A deductible is $1,632 per benefit period for an inpatient hospital stay. A benefit period begins when you are admitted to a hospital and ends 60 days after you are discharged without being readmitted. If you are admitted again after 60 days, a new benefit period starts and you pay a new deductible. After you meet the deductible, you do not pay anything for the first 60 days of a hospital stay. For days 61 through 90 of a hospital stay in the same benefit period, you pay $408 per day in 2024. After 90 days, Medicare Part A covers up to 60 "lifetime reserve days." These are additional days you can use one time in your life, and they cost $816 per day.

For skilled nursing facility care, you pay nothing for the first 20 days if the stay follows a qualifying hospital stay of at least three days. For days 21 through 100, you pay $204 per day in 2024. After 100 days in a benefit period, skilled nursing facility care is not covered by Part A. Many people do not reach day 100, so they do not pay this full amount.

Home health services covered by Part A have no deductible or coinsurance if the services are provided by a Medicare-participating agency and ordered by your doctor. You may pay 20 percent of the cost of durable medical equipment, such as wheelchairs or oxygen equipment, but the equipment provider must accept Medicare payment.

Hospice care has different cost rules. You typically pay nothing for hospice services themselves, but you may pay small amounts for medications and respite care (a break for family caregivers). You also pay up to 5 percent of the cost of medications and up to $5 per day for respite care.

One important fact: if you do not meet the three-day hospital stay requirement before moving to a skilled nursing facility, Part A will not cover the nursing facility care at all. This is called the "three-day qualifying hospital stay" rule, and it catches many people off guard. For example, if you spend two days in the hospital and then go to a nursing home, Part A covers zero days because the hospital stay was too short.

Practical Takeaway: Save the 2024 and 2025 deductible and coinsurance numbers listed above. Use these to estimate your out-of-pocket costs if you think you might need a hospital stay. Remember that these costs change every year, so check Medicare.gov or call 1-800-MEDICARE to confirm current amounts when you actually need care.

Part A Compared to Part B and Other Medicare Options

Medicare has different parts, each covering different services. This section explains how Part A fits with Part B and describes other Medicare choices you have at age 65. Understanding all your options helps you make informed decisions about your coverage.

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Medicare Part B is medical insurance that covers doctor visits, outpatient services, preventive care, and some medical equipment. While Part A covers inpatient care, Part B covers what happens in doctors' offices, clinics, and hospital outpatient departments. Part B requires a monthly premium that you