Yes, Medicare Part A has a deductible you pay before coverage begins
Medicare Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Before Medicare pays for any of these services, you must pay a deductible — a set dollar amount that comes out of your own pocket first. Once you meet that deductible in a benefit period, Medicare then covers most of the costs, though you may still pay copayments for longer stays.
The deductible amount changes each year. For 2024, the Part A deductible is $1,632 per benefit period. A benefit period begins the day you enter a hospital or skilled nursing facility and ends 60 days after you leave without receiving any inpatient care. If you are readmitted after that 60-day gap, a new benefit period starts and you pay a new deductible.
Key Takeaways
- You pay the full Part A deductible before Medicare covers any hospital or skilled nursing facility costs in a benefit period.
- The deductible resets each time a new benefit period begins, which happens 60 days after you leave inpatient care.
- Even after you meet the deductible, you pay copayments for hospital stays longer than 60 days and for skilled nursing facility stays after the first 20 days.
- The deductible amount increases each January and varies by year, so check the current amount before you are admitted.
How the deductible works during a hospital stay
When you are admitted to a hospital, you owe the full Part A deductible before Medicare starts paying. This means if your hospital bill is $2,500 and the deductible is $1,632, you pay $1,632 and Medicare covers the remaining $868. If your bill is less than the deductible, you pay the entire bill yourself.
After you meet the deductible, Medicare covers most inpatient hospital costs for days 1 through 60 of your stay. On days 61 through 90, you pay a copayment (a fixed daily amount, not a percentage) for each day you remain in the hospital. The copayment amount also changes yearly — for 2024 it is $408 per day. If you stay longer than 90 days, you have access to "lifetime reserve days," but those come with higher copayments and a limited supply.
Skilled nursing facility costs after the deductible
If you move to a skilled nursing facility after a hospital stay, the same deductible applies — you do not pay a separate deductible for the nursing facility. However, you do pay copayments for days 21 and beyond. For 2024, that copayment is $204 per day.
Medicare covers days 1 through 20 of skilled nursing facility care at no cost to you (after the deductible is met). Starting on day 21, you pay the daily copayment. If you stay 100 days, you would pay the copayment for 80 days. Many people do not realize this cost continues to add up, so it is worth understanding before admission.
When a new benefit period means a new deductible
The benefit period is the key to understanding when you pay the deductible again. It is not a calendar year — it is tied to your hospital or nursing facility use. A benefit period ends when you have not received inpatient hospital or skilled nursing facility care for 60 consecutive days.
If you are discharged from the hospital on January 15 and readmitted on March 20, you are in a new benefit period because more than 60 days have passed. You will owe a new deductible. If you are readmitted on February 10, you are still in the same benefit period and do not pay another deductible — you only pay copayments if applicable.
This structure can work in your favor if you plan ahead. Some people who know they need multiple hospital or nursing stays try to schedule them close together to avoid paying the deductible twice.
Home health and hospice services under Part A
Home health services covered by Part A (skilled nursing visits, physical therapy, occupational therapy, and speech therapy) do not require you to pay the Part A deductible. You pay nothing for these services as long as they are ordered by a doctor and you meet the homebound requirement.
Hospice care also does not require the Part A deductible. You may pay small copayments for prescription drugs and respite care (temporary relief care for your caregiver), but the deductible does not explore.
How to prepare for Part A costs
Before a planned hospital or nursing facility admission, contact your hospital's financial counselor or billing department and ask what your out-of-pocket costs will be. Tell them you have Medicare Part A and ask them to estimate the deductible and any copayments based on the expected length of stay. Many hospitals can give you a rough estimate.
If you cannot afford the deductible, ask about financial information programs. Some hospitals have charity care programs or can connect you with local nonprofits that help with medical bills. You can also contact your State Health Insurance information Program (SHIP), which offers free counseling about Medicare costs — search for "[your state] SHIP" online to find the local office.
If you have a Medigap or Medicare Advantage plan in addition to Part A, that plan may cover some or all of the deductible. Check your plan documents or call your plan's customer service line to confirm what they cover before you are admitted.
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. A benefit period ends 60 days after you leave the hospital or nursing facility without receiving inpatient care. If you are readmitted after that 60-day gap, a new benefit period begins and you owe a new deductible.
What if I have both Medicare Part A and Part B — do I pay two deductibles?
No. Part A and Part B have separate deductibles, but you only pay each one once per year (or per benefit period for Part A). Part B has a yearly deductible that resets on January 1. They do not combine or double.
Can my Medigap plan pay the Part A deductible for me?
It depends on which Medigap plan you have. Some Medigap plans cover the Part A deductible in full, while others cover part of it or none of it. Check your plan documents or call your insurance company to confirm what your plan covers.
What happens if I cannot pay the deductible when I am admitted?
Tell the hospital's billing department before or when ready after admission. Many hospitals will work with you on a payment plan or connect you with financial information. You should not be turned away for inability to pay upfront, though the hospital may pursue collection later.
Does the Part A deductible increase every year?
Yes. The deductible is recalculated each January based on changes in hospital costs. It has increased most years, though the amount of increase varies. Check Medicare.gov or call 1-800-MEDICARE in December to learn the new deductible for the coming year.