Most people pay nothing for Medicare Part A premiums

If you or your spouse paid Medicare taxes while working for at least 10 years, you do not pay a monthly premium for Part A. This is true whether you are 65 or older, or younger and on Medicare because of disability or end-stage renal disease. You have already paid for this coverage through payroll deductions during your working years.

If you do not have 10 years of Medicare tax history, you can still get Part A, but you will pay a monthly premium. The amount varies depending on how many quarters of coverage you have. In 2024, the premium ranges from about $278 to $557 per month, but these amounts change each year. Contact Social Security or Medicare directly to find out what your specific premium would be, since it depends on your exact work history.

Key Takeaways

  • Most people age 65 and older pay zero monthly premium for Part A if they worked and paid Medicare taxes for at least 10 years.
  • Part A has an annual deductible you pay once per hospital stay, which was $1,676 in 2024 but changes yearly.
  • After you meet the deductible, Medicare covers all hospital costs for the first 60 days of each hospital stay.
  • Days 61 through 90 of a hospital stay require a daily copayment, and days beyond 90 cost more or may not be covered at all.
  • Skilled nursing facility care, hospice, and home health services covered by Part A have different cost structures or no cost to you.

The deductible you pay per hospital stay

Even if you pay no monthly premium, you will pay a deductible when you are admitted to the hospital. This is a one-time cost per benefit period, not per day or per visit. In 2024, the Part A deductible is $1,676 for each hospital stay. Once you pay this amount, Medicare covers the rest of your hospital bills for that stay — up to a point.

The deductible resets each time a new benefit period begins. A benefit period starts when you enter the hospital and ends 60 days after you leave. If you go back to the hospital more than 60 days later, that is a new benefit period and a new deductible. If you return within 60 days, it is the same benefit period and you do not pay another deductible.

The deductible amount increases each year. Medicare announces the new amount in the fall for the following year. If you are on a fixed income, ask your hospital's financial counselor about payment plans or whether you might be may be able to access for Medicaid to help cover the deductible.

What Medicare covers after you pay the deductible

After you pay the deductible, Medicare Part A covers the full cost of a hospital room, meals, nursing care, medications, and medical equipment while you are an inpatient. This coverage lasts for the first 60 days of your hospital stay in each benefit period. You pay nothing out of pocket during these 60 days.

Days 61 through 90 of the same hospital stay are called "coinsurance days." During this time, you pay a daily copayment. In 2024, this copayment is $419 per day. Medicare still covers the hospital's costs; you are paying your share. If your hospital stay goes beyond 90 days, you have 60 additional "lifetime reserve days" you can use, but these cost $838 per day in 2024. Once you use your lifetime reserve days, Medicare stops covering hospital inpatient care for that stay.

These daily costs explore only to inpatient hospital stays. They do not explore to emergency room visits, outpatient surgery, or doctor visits, which are covered under Medicare Part B instead.

Skilled nursing facility costs under Part A

If you need skilled nursing care after a hospital stay — such as wound care, physical therapy, or medication management — Part A may cover a stay at a skilled nursing facility. You must have been in the hospital for at least three days first, and you must enter the nursing facility within 30 days of leaving the hospital.

For days 1 through 20 of a skilled nursing facility stay, Medicare covers all costs and you pay nothing. For days 21 through 100, you pay a daily copayment. In 2024, this copayment is $209.50 per day. After day 100 in each benefit period, Medicare stops covering skilled nursing facility care. The facility cannot charge you more than the copayment amount for covered services.

Home health and hospice care with no copayments

If your doctor orders home health care — such as nursing visits, physical therapy, or medical equipment — Part A covers it with no copayment or deductible. You pay nothing for the visits themselves. You may pay 20 percent of the cost of medical equipment like oxygen or a walker, but the equipment must be ordered by your doctor and provided by a Medicare-approved supplier.

Hospice care for people with a terminal illness is also covered by Part A with no copayment. You pay nothing for hospice services, though you may pay a small copayment (up to $5) for medications and respite care. Respite care is short-term inpatient care that gives your family caregiver a break.

How to know your exact costs before you go to the hospital

Your costs depend on the type of care you receive and how long you stay. Before a planned hospital stay or surgery, call the hospital's financial counselor and ask for an estimate of what you will owe. Bring your Medicare card. The counselor can tell you whether the deductible applies, what your copayments will be, and whether the procedure is covered.

If you receive an unexpected bill after your hospital stay, do not ignore it. Call the hospital's billing department and ask why you were charged. If you believe the charge is wrong, you have the right to appeal. Medicare's website has instructions for filing an appeal, or you can call 1-800-MEDICARE to ask for help.

Frequently Asked Questions

Do I have to pay the Part A deductible every time I go to the hospital?

No. You pay the deductible once per benefit period. A benefit period starts when you enter the hospital and ends 60 days after you leave. If you return to the hospital more than 60 days later, that is a new benefit period and you pay the deductible again. If you return within 60 days, you do not pay another deductible.

What happens if my hospital stay goes longer than 90 days?

You have 60 lifetime reserve days you can use across all your hospital stays. During these days, you pay a higher daily copayment ($838 per day in 2024). Once you use all 60 lifetime reserve days, Medicare stops covering inpatient hospital care. You would then owe the full cost of the hospital stay.

Do I pay anything for emergency room visits under Part A?

Emergency room visits are covered under Medicare Part B, not Part A. If you are admitted to the hospital from the emergency room, the Part A deductible applies to your hospital stay, not to the emergency room visit itself. Part B has its own deductible and copayments.

Can I get help paying my Part A costs if I have a low income?

You may be may be able to access for Medicaid, which can help pay Medicare deductibles and copayments. Medicaid rules vary by state. Contact your state Medicaid office or call 1-800-MEDICARE to find out whether you might be may be able to access and how the process works.

Does Part A cover nursing home care?

Part A covers skilled nursing facility care, which is different from a nursing home. Skilled nursing facilities provide medical care like wound care or physical therapy. Long-term custodial nursing home care is not covered by Medicare. If you need long-term care, you may need to pay out of pocket or explore Medicaid coverage.