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 anything toward these services, you must pay a deductible — a set dollar amount you cover yourself first. For 2024, the Part A deductible is $1,676 per benefit period. This amount changes each year.
The deductible applies once per benefit period, not once per year. A benefit period starts the day you enter a hospital or skilled nursing facility and ends 60 days after you leave. If you are readmitted within that 60-day window, you do not pay a second deductible. If you are readmitted after 60 days have passed, you pay the deductible again.
Part A also has coinsurance costs — amounts you pay per day after the deductible is met. These vary depending on how long you stay. For a hospital stay in 2024, you pay nothing for days 1–60 after you meet the deductible, $419 per day for days 61–90, and $838 per day for days 91 and beyond (up to 60 additional lifetime reserve days). Skilled nursing facility coinsurance is $209.50 per day for days 21–100 of a stay.
Key Takeaways
- The Part A deductible for 2024 is $1,676 and applies once per benefit period, not once per calendar year.
- A benefit period runs from the day you enter a hospital or skilled nursing facility through 60 days after discharge.
- After you pay the deductible, you may still owe coinsurance — a per-day cost that depends on the length of your stay.
- The deductible and coinsurance amounts increase each year, so check your Medicare materials annually for the current figures.
How the deductible works during a hospital stay
When you are admitted to a hospital, the hospital bills Medicare. Medicare applies your deductible to that bill first. Once you have paid $1,676 out of pocket, Medicare begins to pay its share. You do not pay the deductible all at once — the hospital collects it from you over time as your stay continues.
If your hospital stay costs less than the deductible, you pay the entire bill yourself. For example, if you spend two nights in the hospital and the total charge is $1,200, you pay $1,200 and Medicare pays nothing. If your stay costs $2,500, you pay $1,676 (the deductible) and Medicare covers the remaining $824.
After the deductible is met, you still owe coinsurance for days 61 and beyond. This means a long hospital stay can become expensive even after Medicare starts paying. Understanding both the deductible and the daily coinsurance helps you plan for costs.
Coinsurance: what you pay after the deductible
Coinsurance is different from a deductible. Once you have paid the deductible, Medicare covers most of your hospital bill — but you pay a set amount per day for certain days of your stay. In 2024, you pay nothing per day for the first 60 days, $419 per day for days 61–90, and $838 per day for days 91 and beyond (limited to 60 lifetime reserve days).
Skilled nursing facility stays work the same way. Days 1–20 are fully covered by Medicare after you meet the deductible. Days 21–100 cost you $209.50 per day. After day 100, you pay the full cost yourself.
These per-day costs add up quickly on extended stays. A 90-day hospital stay, for example, would cost you the $1,676 deductible plus $419 × 30 days = $12,570 in coinsurance, for a total of $14,246 out of pocket.
What happens if you have a second hospital stay in the same benefit period
If you are discharged from the hospital and readmitted within 60 days, you do not pay a second deductible. You are still in the same benefit period. However, you may owe coinsurance if your first stay used up some of your 60 free days.
For example, if your first stay was 50 days, you paid the deductible but no coinsurance. If you are readmitted for 20 more days, those 20 days fall within days 51–60 of your benefit period, so you still owe no coinsurance. But if your second stay extends beyond day 60, you owe $419 per day for the extra days.
Once 60 days have passed since your last discharge, a new benefit period begins. Any new hospital or skilled nursing facility stay triggers a new deductible.
How to find out what you will owe before admission
Before a planned hospital or skilled nursing facility stay, call the facility's billing department and ask them to estimate your out-of-pocket costs. Provide your Medicare number and the expected length of stay. They can tell you roughly what the deductible and coinsurance will be.
You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to confirm the current deductible and coinsurance amounts. Have your Medicare card handy. Medicare staff can walk you through what you would owe for a specific type of stay.
If cost is a concern, ask the hospital or facility about financial information programs. Many hospitals have programs for uninsured or underinsured patients, and some offer payment plans. You can also explore whether you may have access to for Medicaid or a Medigap policy, both of which can help cover Part A costs.
Medigap and Medicare Advantage: how they affect Part A costs
If you have a Medigap (supplemental insurance) policy, it may pay some or all of your Part A deductible and coinsurance. The amount depends on which Medigap plan you chose. Some plans cover the full deductible; others cover coinsurance only. Check your Medigap policy documents or call your insurance company to see what Part A costs they cover.
If you have Medicare Advantage instead of Original Medicare, your deductible and coinsurance work differently. Medicare Advantage plans set their own deductibles and coinsurance amounts, which may be lower or higher than Original Medicare. Your plan documents will show exactly what you owe for hospital and skilled nursing facility care.
If you are considering switching from Original Medicare to Medicare Advantage, or vice versa, compare the deductibles and coinsurance carefully. A plan with a lower deductible may have higher coinsurance, or the reverse.
Questions to ask your doctor or hospital
Before a hospital or skilled nursing facility stay, ask your doctor or the facility these questions:
- How many days do you expect my stay to last?
- Will I need skilled nursing facility care after the hospital, or can I go home?
- What is the estimated total bill, and how much will I owe out of pocket?
- Does the facility have a financial counselor who can review my costs before admission?
- If I cannot afford the out-of-pocket costs, what payment plans or information programs does the facility offer?
Frequently Asked Questions
Does the Part A deductible reset on January 1st?
No. The deductible resets when a benefit period ends, not on a calendar date. A benefit period ends 60 days after you leave the hospital or skilled nursing facility. If you are admitted in November and discharged in December, your benefit period may not end until February, and you would not owe a new deductible until then.
What if I have both Medicare and Medicaid?
Medicaid may pay your Part A deductible and coinsurance if you meet your state's income and asset limits. Contact your state Medicaid office to ask whether they cover Medicare cost-sharing. The answer varies by state.
Do I owe the deductible for home health services?
No. Home health services covered by Part A have no deductible or coinsurance. You pay nothing for medically necessary home health care ordered by your doctor, as long as you meet Part A's requirements (such as being homebound).
What if my hospital bill is less than the deductible?
You pay the full bill yourself. Medicare does not pay anything until the charges reach your deductible amount. If a short stay costs $800 and your deductible is $1,676, you owe $800 and Medicare owes nothing.
Can I use my lifetime reserve days to avoid coinsurance?
Lifetime reserve days are extra hospital days Medicare covers after day 90 of a benefit period, but you still owe coinsurance ($838 per day in 2024). You have only 60 lifetime reserve days total across your entire life with Medicare, so use them carefully. Once they are gone, you pay the full cost of any additional hospital days.