Medicare Part A covers inpatient hospital stays, skilled nursing care, hospice, and home health services — but only after you meet your deductible, and only for the days and services Medicare deems medically necessary.
Part A is hospital insurance. It pays the bulk of the bill when you are admitted to a hospital as an inpatient, moved to a skilled nursing facility after a hospital stay, or receive hospice or home health care. You do not pay a monthly premium for Part A if you or your spouse paid Medicare taxes for at least 10 years — it is included in your Social Security. But you do pay out-of-pocket costs when you use it.
The amount you pay depends on how long you stay and what type of care you receive. Medicare's payment structure uses benefit periods and daily copayments, not a straightforward deductible-and-coinsurance model like Part B. Understanding what you owe at each stage prevents surprises when the bill arrives.
Key Takeaways
- Part A covers inpatient hospital care after you pay a deductible that resets each benefit period, which runs 60 days from your first hospital day.
- You pay a daily copayment for days 61 through 90 of a hospital stay, and a higher daily copayment for lifetime reserve days beyond that.
- Skilled nursing facility care is covered only if you were hospitalized for at least three consecutive days first, and you pay a daily copayment starting on day 21.
- Home health and hospice services have no copayment or deductible, but Medicare must determine the care is medically necessary and ordered by a doctor.
- The exact dollar amounts for deductibles and copayments change each year and are set by Medicare, not by your specific plan.
How the Part A Deductible Works
When you are admitted to a hospital as an inpatient, you pay a single deductible per benefit period. A benefit period starts the day you enter the hospital and ends 60 days after you leave — if you are readmitted within that 60-day window, you do not pay a new deductible. If you are readmitted after 60 days have passed, a new benefit period begins and you pay the deductible again.
The deductible amount changes annually. For 2024, the Part A deductible is $1,632 per benefit period. After you pay this, Medicare covers the full cost of your hospital room, meals, medications, lab work, imaging, and other inpatient services for days 1 through 60 of your stay.
If your hospital stay is short — say, three days — you pay the full deductible and then nothing more for that stay. Medicare covers the rest. You do not get a refund if you use only part of the benefit period.
Daily Copayments for Longer Hospital Stays
If you stay in the hospital longer than 60 days in a single benefit period, you begin paying a daily copayment. For days 61 through 90, you pay a copayment per day (in 2024, this is $408 per day). Medicare still covers the rest of your care.
Beyond day 90, Medicare offers lifetime reserve days — 60 additional days you can use across your entire lifetime if you need them. For each lifetime reserve day you use, you pay a higher daily copayment (in 2024, this is $816 per day). Once you exhaust your 60 lifetime reserve days, Medicare stops paying for hospital care in that benefit period, and you are responsible for all costs.
Most people never use lifetime reserve days because stays longer than 90 days are uncommon. But if you do use them, they are gone — you cannot get them back, and they do not reset each year.
Skilled Nursing Facility Coverage and Costs
Part A covers care in a skilled nursing facility (SNF) only if three conditions are met: you were hospitalized as an inpatient for at least three consecutive days, you are admitted to the SNF within 30 days of leaving the hospital, and the care is for a condition related to your hospital stay.
For days 1 through 20 of your SNF stay, Medicare covers the full cost after you have already paid the hospital deductible. Starting on day 21, you pay a daily copayment (in 2024, this is $204 per day). Medicare covers the rest. After day 100 in a single benefit period, Medicare stops paying, and you pay all costs yourself.
A common mistake is assuming Medicare will pay for a SNF stay without a prior hospital stay. It will not. If you go directly from home to a nursing facility, Part A does not cover it — you would need to pay out-of-pocket or use another insurance source.
Home Health and Hospice Services
Part A covers home health services — skilled nursing, physical therapy, occupational therapy, speech therapy, and medical social work — with no deductible and no copayment. A doctor must order the care, and Medicare must determine it is medically necessary. You must be homebound, meaning leaving home requires considerable effort and is medically contraindicated.
Hospice care is also covered by Part A with no copayment or deductible. You pay a small copayment only for prescription drugs and respite care (temporary relief for your caregiver). To receive hospice, your doctor must certify that you have six months or less to live, and you must choose hospice instead of curative treatment.
Neither home health nor hospice has a time limit built into the benefit structure the way hospital and SNF care do. As long as Medicare determines the care remains medically necessary and ordered by a physician, Part A continues to cover it.
What Part A Does Not Cover
Part A does not cover outpatient care — doctor visits, emergency room visits, lab work, or imaging done outside the hospital. That is Part B's role. Part A also does not cover custodial care, which is help with daily living activities like bathing, dressing, and eating when no skilled medical care is involved. Long-term custodial nursing home care is not covered by Medicare at all.
Part A does not cover private-duty nursing, a private room (unless medically necessary), or most dental, vision, and hearing services. If you need these services, you would need to pay out-of-pocket or have supplemental coverage.
How Your Costs Change Year to Year
Medicare adjusts Part A deductibles and copayments annually, usually in October, based on inflation and changes in hospital costs. The amounts for the coming year are announced in the fall and take effect January 1. This means your out-of-pocket costs can shift significantly from one year to the next.
If you have a Medigap (supplemental insurance) plan, it may cover some or all of your Part A copayments and deductibles, depending on which plan you have. If you have a Medicare Advantage plan, your costs work differently — you typically have a copayment per hospital day rather than a deductible, and the copayment structure varies by plan.
Frequently Asked Questions
Do I pay the Part A deductible every time I go to the hospital?
No. You pay it once per benefit period, which lasts 60 days from your first hospital day. If you are readmitted within 60 days, you do not pay a new deductible. If you are readmitted after 60 days, a new benefit period begins and you pay the deductible again.
What happens if I stay in the hospital for 120 days?
You pay the deductible for days 1–60, then a daily copayment for days 61–90, then a higher daily copayment for days 91–120 (using your lifetime reserve days). After day 100 in the benefit period, Medicare stops paying and you are responsible for all remaining costs.
Does Part A cover a nursing home stay if I have not been in the hospital?
No. Part A covers skilled nursing facility care only if you were hospitalized as an inpatient for at least three consecutive days first. If you go directly from home to a nursing home, Part A does not cover it.
If I use my lifetime reserve days, can I get new ones next year?
No. Your 60 lifetime reserve days are a one-time benefit across your entire life. Once you use them, they are gone. They do not reset each year or each benefit period.
Does Part A cover home health care with no copayment?
Yes, as long as a doctor orders it, Medicare determines it is medically necessary, and you are homebound. There is no deductible, copayment, or time limit — Part A covers it for as long as it remains medically necessary.