In general, Part A covers:
- Hospital care
- Skilled nursing facility care
- Hospice care
- Home health services
How much is covered?
|Services||Benefit||In 2019 Medicare pays||You pay in 2019|
First 60 days
All but $1,364
61st to 90th day
All but $341/day
91st to 150th day (60 reserve days may be used only once
All but $682/day
Beyond 150 days
Skilled nursing facility care
First 20 days
100% of approved amount
Days 80 days
All but $170.50/day
|Up to $170.50/day|
Beyond 100 days
Home health care
Unlimited, as long as you meet Medicare requirements for home health care benefits
100% of approved amount 80% of approved amount for durable medical equipment
|Nothing for services 20% of approved amount for durable medical equipment|
For as long as doctor certifies need
All but limited costs for outpatient drugs and inpatient respite care
|Limited cost sharing for outpatient drugs and inpatient respite care|
Unlimited during a benefit period if medically necessary
All but first three pints per calendar year
|For first three pints|
1 - Neither Medicare or Medigap insurance pay for most nursing home care (See Medicare & You 2019 booklet, page 28).
2 - A benefit period starts the first day you receive a Medicare-covered service in a qualified hospital. It ends when you’ve been out of a hospital (or other facility that provides skilled nursing or rehab services) for 60 days in a row. It also ends if you stay in a facility (other than a hospital) that provides skilled nursing or rehab services, but do not receive any skilled care there for 60 days in a row. If you enter a hospital again after 60 days, a new benefit period starts.
* If the hospital gets blood from a blood bank at no charge, you won’t pay for replacing it. If the hospital buys blood for you, you must either pay the hospital costs for the first three units of blood you get in a calendar year or have the blood donated by you or someone else.
Premium for Part A: Most people don't pay a premium, because they (or their spouse) worked for over 40 quarters. If you have fewer than 30 quarters of coverage, you pay $437/month in 2019. For 30-39 quarters of coverage, you pay $240/month in 2019.