Part A covers hospital stays, skilled nursing, hospice, and some home health care

Part A is the hospital insurance piece of Medicare. It pays for inpatient hospital stays, skilled nursing facility care after a hospital stay, hospice services, and some home health visits. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working for at least 10 years.

Even though there is no monthly premium for most people, Part A does have out-of-pocket costs when you use it. These costs come in the form of a deductible and coinsurance — amounts you pay before or after Medicare starts to pay.

Key Takeaways

  • Most people age 65 and older pay no monthly premium for Part A if they worked and paid Medicare taxes for at least 10 years.
  • Part A has a deductible you pay once per benefit period for hospital stays, and coinsurance for days beyond the first 60 days.
  • The deductible and coinsurance amounts change each year and are set by Medicare, not by individual insurance companies.
  • If you did not work long enough to may have access to for premium-free Part A, you can still enroll and pay a monthly premium based on your work history.
  • Part A does not cover doctor visits, outpatient care, prescription drugs, or long-term custodial care in a nursing home.

The deductible and coinsurance amounts for 2024

For 2024, the Part A deductible is $1,632 per benefit period. A benefit period starts the day you enter a hospital and ends 60 days after you leave without receiving any inpatient hospital or skilled nursing care. If you go back into the hospital after that 60-day gap, a new benefit period begins and you pay the deductible again.

After you pay the deductible, Medicare covers all costs for days 1 through 60 of a hospital stay. On days 61 through 90, you pay coinsurance of $408 per day. If you stay longer than 90 days, you can use your lifetime reserve days — 60 extra days Medicare gives you once in your lifetime. For each lifetime reserve day you use, you pay $816 per day. After your lifetime reserve days are gone, you pay all costs.

For skilled nursing facility care, you pay nothing for the first 20 days after a hospital stay of at least 3 days. On days 21 through 100, you pay $204 per day. After day 100, you pay all costs.

These amounts change every year

Medicare adjusts the Part A deductible, coinsurance, and skilled nursing facility costs each January based on inflation and healthcare costs. The 2024 amounts listed above will be different in 2025 and beyond. You can find the current year's amounts on Medicare.gov or by calling 1-800-MEDICARE.

Your state or local Area Agency on Aging can also tell you the current costs and answer questions about how they explore to your situation.

If you did not work long enough for premium-free Part A

If you or your spouse did not pay Medicare taxes for at least 10 years, you do not get premium-free Part A. You can still enroll in Part A and pay a monthly premium. The premium amount depends on how many years you or your spouse worked and paid Medicare taxes.

For 2024, the Part A premium ranges from about $278 to $556 per month, depending on your work history. Like the deductible and coinsurance, this premium amount changes each year. You will also still pay the deductible and coinsurance described above when you use hospital or skilled nursing care.

What Part A does not cover

Part A does not pay for doctor visits, outpatient surgery, prescription drugs, dental care, vision care, or hearing aids. It also does not cover long-term custodial care — the help with daily activities like bathing and dressing in a nursing home or assisted living facility. If you need that kind of care, you would need to pay out of pocket, use Medicaid if you may have access to, or have a long-term care insurance policy.

Part A also does not cover care in a skilled nursing facility unless you had a hospital stay of at least 3 days first. Many people think a nursing home stay is automatically covered by Medicare, but that is not the case.

How to find out your Part A costs before you need care

You can see your Part A coverage details and current deductible and coinsurance amounts by logging into your Medicare account at Medicare.gov. You can also call 1-800-MEDICARE and ask them to mail you a summary of your Part A coverage.

If you are thinking about a hospital or skilled nursing stay, ask the facility what your out-of-pocket costs will be based on your specific situation. The facility's billing department can often estimate your costs before you arrive, though the final bill may differ depending on your actual length of stay and the services you receive.

Part A works together with Part B and other coverage

Part A is just one piece of Medicare. Part B covers doctor visits and outpatient care. Many people also enroll in Part D for prescription drug coverage and either a Medigap policy or a Medicare Advantage plan to cover costs that Part A and Part B do not pay.

Understanding what Part A covers and what it costs helps you plan for healthcare expenses and decide whether you need additional coverage. If you are turning 65 or already on Medicare, reviewing your Part A coverage each year during the annual enrollment period can help you make sure you have the right plan for your needs.

Frequently Asked Questions

Do I have to pay for Part A if I am already on Social Security?

If you are receiving Social Security, Medicare Part A is usually deducted from your Social Security check automatically. If you are not yet on Social Security, you will receive a separate bill for Part A if you have a premium. Most people do not have a Part A premium because they worked long enough to may have access to for premium-free coverage.

What happens if I stay in the hospital longer than 90 days?

After 90 days, you can use your lifetime reserve days — 60 extra days Medicare gives you once in your lifetime. You pay $816 per day for each reserve day you use. Once your reserve days are used up, you pay all hospital costs yourself. This is why some people buy Medigap coverage to help pay for very long hospital stays.

Does Part A cover a nursing home stay right after I leave the hospital?

Part A covers skilled nursing facility care only if you had a hospital stay of at least 3 days first, and only if you go to the nursing home within 30 days of leaving the hospital. The nursing home must also be a Medicare-certified skilled nursing facility, not just any nursing home. Ask the facility whether it is Medicare-certified before you go.

Can I change my Part A coverage during the year?

Most people cannot change their Part A coverage outside the annual enrollment period, which runs from October 15 to December 7 each year. Changes take effect January 1. If you have a major life change like losing other health coverage, you may be able to make changes outside this window — call 1-800-MEDICARE to ask.

What if I do not enroll in Part A when I turn 65?

If you do not enroll in Part A when you first become may be able to access and you do not have other may have access to coverage, you may pay a higher premium later. You can enroll during the general enrollment period from January 1 to March 31, but your coverage will not start until July 1 of that year.