Medicare Part A premiums and deductibles

Most people do not pay a monthly premium for Medicare Part A if they or their spouse paid Medicare taxes for at least 10 years while working. If you meet that requirement, Part A is free when you turn 65. However, you will still pay a deductible — the amount you must pay out of your own pocket before Medicare starts to cover hospital care.

For 2024, the Part A deductible is $1,676 per hospital stay. This means if you are admitted to the hospital, you pay the first $1,676 of your hospital bills. After you meet that deductible, Medicare covers the rest of your inpatient hospital care for up to 60 days in a row. If your hospital stay lasts longer than 60 days, you will owe a daily coinsurance amount — $419 per day for days 61 through 90.

These dollar amounts change each year. Medicare announces the new amounts in the fall for the following year, so the 2025 amounts will be different from what is listed here. You can find the current year's amounts on Medicare.gov or by calling 1-800-MEDICARE.

Key Takeaways

  • If you worked and paid Medicare taxes for at least 10 years, you pay no monthly premium for Part A, but you do pay a deductible when you are admitted to the hospital.
  • The 2024 Part A deductible is $1,676 per hospital stay, and Medicare covers inpatient hospital care for up to 60 days after you meet it.
  • If your hospital stay lasts longer than 60 days, you owe a daily coinsurance amount ($419 per day in 2024 for days 61 through 90).
  • Part A also covers skilled nursing facility care, hospice care, and some home health services, each with different cost-sharing rules.
  • Dollar amounts change yearly, so check Medicare.gov or call 1-800-MEDICARE to confirm the current year's costs before you need care.

What Part A covers and what you pay

Part A covers four types of care: inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Each type has its own cost structure. Understanding what you owe for each one helps you plan for medical expenses.

For skilled nursing facility care — care in a facility after a hospital stay — you pay nothing for the first 20 days if Medicare covers your stay. From day 21 through day 100, you owe $209.50 per day in 2024. After day 100, you pay all costs. For home health services, you pay nothing if Medicare covers the visit, though you may owe 20 percent of the cost of any medical equipment. Hospice care is covered with little or no cost to you, though you may pay a small amount for prescription drugs and respite care.

If you did not work long enough to get free Part A

If you did not pay Medicare taxes for 10 years, you can still get Part A by paying a monthly premium. In 2024, the premium is $278 per month if you paid Medicare taxes for 7 to 9 years, or $505 per month if you paid for fewer than 7 years. You will also pay the same deductibles and coinsurance amounts as people who get Part A for free.

Some people who do not may have access to for free Part A choose to buy it anyway because they want hospital coverage. Others decide the monthly cost is too high and rely on Part B and Part D instead. Talk with a Social Security representative about whether buying Part A makes sense for your situation.

How Part A fits with other Medicare coverage

Part A covers hospital and facility care, but it does not cover doctor visits, outpatient care, or prescription drugs. Most people who have Part A also sign up for Part B, which covers doctor visits and outpatient services. Part B has its own monthly premium and deductible.

If you want prescription drug coverage, you need Part D. If you want coverage beyond what Original Medicare offers — such as vision, dental, or hearing — you may choose a Medicare Advantage plan instead of Original Medicare. These choices affect your total out-of-pocket costs, so it is worth comparing your options when you first turn 65 or during the annual open enrollment period in the fall.

When costs are higher: hospital readmission and long stays

The Part A deductible applies per hospital stay, not per year. If you are discharged and then readmitted within a short time, you may owe another full deductible. Medicare considers a new stay to have begun if you have been out of the hospital for 60 days or more, or if you were in a skilled nursing facility for 60 days or more between hospital stays.

If your hospital stay is very long — beyond 90 days — your costs rise further. From day 91 through day 150, you owe $838 per day in 2024. After day 150, Medicare covers nothing and you pay all costs. These extended stays are rare, but they can happen with serious illnesses or injuries. If you face a long hospital stay, ask the hospital social worker about financial resources or payment plans.

Reducing your Part A costs

You cannot lower the deductible or coinsurance amounts Medicare sets, but you can reduce your overall costs by understanding what Part A covers and planning ahead. If you know you will need a hospital stay or skilled nursing care, ask your doctor and the facility what Medicare will cover so there are no surprises.

Some people buy a Medigap policy (also called supplemental insurance) to help pay the deductibles and coinsurance that Original Medicare does not cover. Medigap premiums vary by plan and location, but they can be worth the cost if you use hospital or facility care regularly. Others choose a Medicare Advantage plan, which often has lower or no deductibles but may limit which doctors and hospitals you can use.

Frequently Asked Questions

Do I have to pay for Part A if I am still working?

You can sign up for Part A at 65 even if you are still working and have employer health insurance. If you delay signing up, you may face a penalty later. However, if your employer has 20 or more employees, your employer plan is primary and Medicare is secondary, so you may want to wait. Talk with your employer's benefits office and Social Security before you turn 65.

What happens if I cannot pay the deductible?

Contact the hospital's billing or financial information office before or right after admission. Many hospitals have programs to help uninsured or underinsured patients pay bills. You can also ask about payment plans. Do not ignore the bill — working with the hospital early gives you more options than waiting for a collection notice.

Does Part A cover nursing home care?

Part A covers skilled nursing facility care, which is different from custodial nursing home care. Skilled care means you need medical care or rehabilitation after a hospital stay. Custodial care — help with daily activities like bathing or eating — is not covered by Part A. Medicare will tell you whether your care qualifies as skilled.

Can I use Part A at any hospital?

Part A works at any hospital that accepts Medicare, which includes nearly all hospitals in the United States. If you use an out-of-network hospital, your coverage and costs are the same. However, if you are in a Medicare Advantage plan instead of Original Medicare, you may have to use in-network hospitals to avoid higher costs.

What if the deductible amount changes after I am admitted?

The deductible that applies is the one in effect on the date you are admitted to the hospital. If you are admitted on January 1 and the deductible changes on January 2, you pay the deductible from January 1. Once you have paid the deductible for that stay, you do not pay it again if you stay longer.