2021 Medicare Hospital Insurance (PartA) Covered Services

Medicare PartA, often called hospital insurance, helps eligible individuals cover the cost of inpatient hospital stays, skillednursing facility care, hospice, and some home health services. Below is a concise guide to the services that were covered under the 2021 Medicare PartA benefit.

1. Inpatient Hospital Care

When you are admitted as an inpatient, PartA helps pay for:

• Room and board a semiprivate room is the standard; a private room may be covered if medically necessary.
• Meals meals provided by the hospital while you are an inpatient.
• Nursing services routine nursing care, medication administration, and monitoring.
• Durable medical equipment (DME) items such as wheelchairs, walkers, or oxygen equipment needed during the stay.
• Hospital services lab tests, Xrays, surgeries, and other medically necessary procedures.

Coverage begins after you meet the deductible ($1,484 in 2021). After the deductible, Medicare pays 100% of approved costs for up to 60 days per benefit period. Days 6190 require a daily coinsurance amount ($371 per day in 2021). Beyond 90 days, you enter lifetime reserve days (up to 60 total) with a higher daily coinsurance ($742 per day in 2021). After the reserve days are exhausted, you are responsible for all costs.

2. SkilledNursing Facility (SNF) Care

Medicare PartA may cover up to 100 days of skillednursing care after a qualifying hospital stay of at least three days. Covered services include:

• Daily skilled nursing or therapy (physical, occupational, speech) provided by qualified staff.
• Medical social services that support the patients health.
• Necessary medical supplies and equipment related to the skilled care.

Cost sharing:

• Days120 no coinsurance.
• Days21100 $185 per day in 2021.
• Days101+ you pay the full cost.

3. Hospice Care

If you are terminally ill with a life expectancy of six months or less, Medicare PartA pays for hospice services, regardless of where they are provided. Covered hospice benefits include:

• Doctors services related to the terminal illness.
• Nursing care.
• Medical social services.
• Home health aide support (up to 5 hours per day).
• Medically necessary equipment, drugs, and supplies.
• Grief counseling for family members.

There is no deductible for hospice; however, for any inpatient respite care (shortterm stays for caregiver relief) a daily coinsurance of $104 applies in 2021.

4. Home Health Services

When a physician orders home health care and you are homebound, PartA can cover:

• Skilled nursing visits.
• Physical, occupational, or speech therapy.
• Medical social services.
• Supplies and equipment needed for the therapy (e.g., walkers, lifts).

Medicare does not pay for 24hour care, meals, or homemaker services (like housekeeping). The services must be intermittent or part of a prescribed treatment plan.

5. Inpatient Psychiatric Facility Care

PartA covers up to 190 days of inpatient psychiatric care per lifetime, provided the care is medically necessary. Covered items include room and board, nursing care, medication, and related services.

6. Blood Transfusions

When a blood transfusion is required during a covered PartA stay, Medicare pays for the blood itself at no cost to the beneficiary and covers the administration fees.

**Note: ** All services must be provided by Medicareapproved facilities and providers. Prior authorization may be required for certain procedures or extended stays.

7. How to Verify Coverage

Before you or a loved one receives care, you can:

• Contact the hospitals billing office and ask if the service is Medicarecovered.
• Call Medicare directly at 1800MAIN555 (18006267915).
• Use the Medicare.gov Find care tool to locate providers that accept PartA.

8. Frequently Asked Questions

Q: Does PartA cover outpatient services?

A: In general, PartA is limited to inpatient and related services. Outpatient services are typically covered under PartB.

Q: What is a benefit period?

A: A benefit period starts the day you are admitted as an inpatient and ends when you have not received inpatient hospital care or skillednursing care for 60 consecutive days. A new benefit period begins if you are readmitted after that gap.

Q: Can I receive PartA benefits if I have other insurance?

A: Yes. If you have other coverage (e.g., employer health plans), Medicare typically pays second, after the primary insurer, unless you have a medicare secondary payer (MSP) situation where Medicare pays first.

Q: What happens if I exceed my lifetime reserve days?

A: After you use all 60 lifetime reserve days, you are responsible for the full cost of any additional inpatient days.

9. Key Takeaways

• PartA mainly covers inpatient hospital stays, SNF, hospice, home health, and certain psychiatric services.
• Pay attention to deductibles, coinsurance, and lifetime limits (e.g., reserve days for hospital stays).
• All services must be medically necessary and provided by a Medicareapproved facility.
• Check coverage before receiving care to avoid unexpected outofpocket costs.

For detailed, uptodate information, visit Medicare.gov or contact your State Health Insurance Assistance Program (SHIP).