Glossary
Medicare Part A, defined
The hospital side of the federal health program for people over the eligibility age and certain disabled people, covering inpatient stays, skilled nursing facility care after a qualifying stay, hospice and some home health services. There is usually no premium because the person or a spouse paid payroll taxes for long enough to earn it.
In practice
It is not free at the point of use: each benefit period carries a deductible, and long stays add daily coinsurance after a set number of days, with a limited reserve of extra days over a lifetime. Skilled nursing facility coverage is short, requires a prior inpatient stay of a minimum length, and is for rehabilitation rather than custodial care, which is the misunderstanding that surprises families most. Time spent under observation status in a hospital does not count as an inpatient stay. A supplement policy or an Advantage plan changes how these costs land. Enrolling is automatic for people already receiving Social Security; others must sign up. Nothing on this side of the program substitutes for long-term care coverage.
A worked example
Suppose a retiree is admitted for eight days after a fall and then spends twenty days in a skilled nursing facility for rehabilitation. Suppose the hospital deductible is $1,600; she pays that, the program pays the rest of the hospital stay, and the facility days are covered in full because the stay was short. A supplement policy would have paid the $1,600. Hypothetical figures.
Applies to: Medicare