What Is Medicare Part A?
Medicare Part A is the hospital insurance component of Medicare. It covers the costs of being admitted to a hospital as an inpatient, as well as care in skilled nursing facilities, hospice care for terminal illness, and some home health services. Part A is often called "hospital insurance," though its coverage extends beyond just hospital stays.
Most Medicare beneficiaries receive Part A premium-free because they (or their spouse) worked and paid Medicare taxes for at least 40 quarters (10 years). If you have fewer than 40 quarters, you can still buy Part A by paying a monthly premium.
What Part A Covers
Inpatient Hospital Care
When you're formally admitted to a hospital as an inpatient, Part A helps pay for:
- A semi-private room (or private room when medically necessary)
- Meals and general nursing care
- Drugs administered as part of your inpatient treatment
- Lab tests, X-rays, and other diagnostic services
- Operating and recovery room costs
- Blood transfusions (after first 3 pints)
- Intensive care, coronary care, and other special care units
- Inpatient rehabilitation services
Skilled Nursing Facility (SNF) Care
After a qualifying hospital stay of at least 3 consecutive inpatient days, Part A covers care in a Medicare-certified skilled nursing facility (SNF) — such as physical therapy, occupational therapy, speech-language pathology, and skilled nursing care. The key word is "skilled" — custodial care (help with daily activities like bathing and dressing) is not covered by Medicare.
| SNF Stay Days | Your Cost (2025) |
|---|---|
| Days 1–20 | $0 (fully covered) |
| Days 21–100 | $209.50/day coinsurance |
| Beyond 100 days | 100% your cost (no Medicare coverage) |
Hospice Care
Medicare Part A covers hospice care for beneficiaries with a terminal illness and a life expectancy of 6 months or less (as certified by a doctor). Hospice focuses on comfort and quality of life rather than curative treatment. Coverage includes:
- Nursing care and physician services
- Drugs for symptom management and pain relief (copay up to $5 per prescription)
- Home health aide and homemaker services
- Medical social services and counseling
- Short-term inpatient care for pain management
- Respite care (short-term inpatient care to give family/caregivers a rest)
- Grief support for family members
Home Health Care
Part A (and Part B) can cover medically necessary, intermittent home health services ordered by a doctor, including skilled nursing care, physical therapy, occupational therapy, and speech-language pathology. To qualify, you must be homebound and under a doctor's care. There is no deductible for home health services covered by Medicare, and you pay $0 for the services themselves (though you may pay 20% for durable medical equipment).
Inpatient Mental Health Care
Part A covers inpatient psychiatric hospital care. Note: There is a lifetime limit of 190 days for care in a freestanding psychiatric hospital (this limit does not apply to psychiatric care in a general hospital).
What Part A Does NOT Cover
- Private-duty nursing
- Private room (unless medically necessary)
- Personal care items (TV, phone rental, personal hygiene items)
- Custodial or long-term care (help with daily activities)
- Most dental, vision, or hearing care
- Care outside the United States (with few exceptions)
Part A Costs in 2025
| Cost Type | 2025 Amount |
|---|---|
| Monthly premium (40+ work quarters) | $0 |
| Monthly premium (30–39 quarters) | $278 |
| Monthly premium (under 30 quarters) | $505 |
| Hospital deductible (per benefit period) | $1,676 |
| Hospital days 1–60 coinsurance | $0 (after deductible) |
| Hospital days 61–90 coinsurance | $419/day |
| Hospital days 91–150 (lifetime reserve) | $838/day |
| Beyond 150 days (lifetime reserve exhausted) | 100% your cost |
| SNF days 1–20 | $0 |
| SNF days 21–100 | $209.50/day |
| SNF beyond 100 days | 100% your cost |
Understanding the Benefit Period
A benefit period begins the day you are admitted as an inpatient and ends when you have been out of the hospital (and not in a SNF) for 60 consecutive days. There is no limit to the number of benefit periods you can have — but each new benefit period comes with a new $1,676 deductible.
For example, if you are discharged from the hospital and readmitted 61 days later, a new benefit period begins and you owe another deductible. If you are readmitted within 60 days, you are still in the same benefit period.
Lifetime Reserve Days
Each beneficiary has 60 lifetime reserve days that can be used once you exceed 90 inpatient days in a single benefit period. These days are not renewable — once used, they're gone. You pay $838/day for each lifetime reserve day used (2025).
How to Reduce Part A Costs
- Buy a Medigap plan: Plans like Medigap Plan G cover the $1,676 hospital deductible, daily coinsurance, and skilled nursing coinsurance — greatly reducing your out-of-pocket exposure. Learn about Medigap →
- Consider Medicare Advantage: Medicare Advantage plans have their own cost structures (often lower per-day hospital costs) and include an annual out-of-pocket maximum. Learn about MA →
- Request an itemized bill: Hospital bills often contain errors. Review your itemized statement carefully and dispute any charges for services you didn't receive.
- Appeal hospital decisions: If you believe you were incorrectly classified as an outpatient (observation) rather than inpatient, you can appeal.