Image

Medicare Part A

Medicare Part A generally covers:
  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Nursing home care (inpatient care in a skilled nursing facility that is not custodial or long-term)
  • Hospice care
  • Home health care

Not sure if Medicare will cover your medical test or service?

Medicare’s free “What’s Covered” app delivers accurate cost and coverage information right on your smartphone. Now you can quickly see whether Medicare covers your service in the doctor’s office, the hospital, or anywhere else you use your phone. You can download the “What’s Covered” App on the Apple App Store or on Google Play.

What do I pay for Part A covered services?

Copayments, coinsurance, or deductibles may apply for each service.

Am I an inpatient or an outpatient?

Staying overnight in a hospital does not always mean you are an inpatient. Your doctor must order your hospital admission and the hospital must formally admit you for you to be an inpatient.

Without the formal inpatient admission, you are still an outpatient, even if you stay overnight in a regular hospital bed, and/or you’re getting emergency department services, observation services, outpatient surgery, lab tests, or X-rays.

You or your caregiver should always verify the hospital and/or your doctor if you’re an inpatient or an outpatient each day during your stay, since it affects what you pay and can affect whether you’ll qualify for Part A coverage in a skilled nursing facility. You can also ask a hospital social worker or patient advocate if you are unsure.

A “Medicare Outpatient Observation Notice” (MOON) is a document that lets you know you are an outpatient (and not an inpatient) in a hospital or critical access hospital. You must receive this notice if you are getting observation services as an outpatient for more than 24 hours. The MOON will tell you why you are an outpatient receiving observation services, rather than an inpatient. It will also let you know how this may affect what you pay while in the hospital, and for care you get after leaving the hospital.