Health Insurance Mastery Practice Exam

Which healthcare service is often excluded from Medicare Part A?

1. Emergency room visits

2. Room and board in a hospital

3. Outpatient therapy services

4. Care in a skilled nursing facility

The correct answer is: Outpatient therapy services

Medicare Part A primarily covers inpatient hospital stays, care in skilled nursing facilities, hospice care, and some home health care. Outpatient therapy services, however, are not covered under Medicare Part A; instead, they fall under Medicare Part B. This distinction is essential because Part B is specifically designed to cover outpatient care, which includes physicians' services, outpatient hospital services, and certain home health care services. In contrast, the other services mentioned in the question are included in the coverage of Part A. Emergency room visits are considered to be part of the immediate hospital care services that Medicare Part A can cover if the patient is subsequently admitted to the hospital. Room and board in a hospital is a core aspect of what Part A covers during inpatient stays. Similarly, care in a skilled nursing facility is also a component of coverage under Medicare Part A when certain conditions are met following a hospital stay. Thus, outpatient therapy services are the only option that is typically excluded from Medicare Part A's coverage.