Medicare, Part A...Explained

While Medicare is a government-run program, as a licensed insurance professional (or soon to be licensed professional), you will able to guide clients and then offer products that are sold by private insurance companies such as Medigap plans as a solution to missing coverages.

Two parts make up original Medicare: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medicare Part A covers Medicare inpatient care, including care received while in a hospital, a skilled nursing facility, and, in limited circumstances, at home.

When most people turn 65, they are automatically eligible for Medicare Part A if they have been collecting retirement benefits from the Social Security Administration or the Railroad Retirement Board. If they have a disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS), they may qualify for Medicare Part A before age 65. Other eligibility requirements include being either a United States citizen or keeping legal permanent residency for at least five consecutive years.

What Does Medicare Part A Cover?

When visiting their doctor advise your clients to ask them or other healthcare providers about the reasons, they need specific services or supplies. They will inform them if Medicare can cover their needs. It may be a situation where something that's usually covered, but the healthcare professional thinks that Medicare may not cover it that situation.  The situation will require the patient to read and sign a notice. The notice will state that the patient understands that they may have to pay for the item, service, or supply.

In General, Services Covered under Medicare Part A:

  • Hospital care (inpatient)

  • Limited home health services

  • Hospice care

  • Skilled nursing facility care (SNF), provided that custodial care not be the only care required

Under each of those services, the following may be covered...

Medicare Part A hospital care coverage:

  • Critical access hospitals

  • Acute care hospitals

  • Long-term care hospitals

  • Inpatient rehabilitation facilities

  • Mental health care

  • Participation in a qualifying clinical research study

Medicare Part A home health care benefits:

  • Part-time or intermittent skilled nursing care

  • Physical therapy

  • Speech-language pathology services

  • Medical social services

  • Occupational therapy

  • Part-time or intermittent home health aide services

Medicare Part A nursing home coverage:

  • Skilled nursing services

  • Medical social services

  • Semi-private room

  • Meals

  • Dietary counseling

  • Rehabilitation services, if deemed medically necessary to treat the illness

  • Medical supplies and equipment used in SNF

  • Medications received while in SNF care

  • Ambulance transportation to the closest provider if needed services are not provided at the SNF

Medicare Part A does not cover:

  • Most dental care

  • Routine foot care

  • Hearing aids and exams for fitting them

  • Acupuncture

  • Cosmetic Surgery

  • Long-term care

  • Eye examinations related to prescribing glasses


Medicare Part A has restrictions for example, regarding hospitalizations lasting 90 days or more at one time. Part A has limits on the number of days it will help pay for. This is true regarding the number of days of care in a skilled nursing facility that Part A will pay for as well. Private Medicare Part A will help pay for an unlimited number of hospice care visits and home health care visits; however, there are several conditions to meet to receive either kind of help. If you are an insurance professional struggling with all the different terms and regulations when it comes to healthcare, insurance school may be the answer. Our online classes may be able to help you.

Medicare, Medigap & Medicaid

Medicare Supplements (Medigap)...Coming Soon

Medicaid...Coming Soon

Medicare Part A...Now Playing

Medicare Part B

Medicare Part C

Medicare Part D

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