Most people pay nothing for Medicare Part A
If you or your spouse paid Medicare taxes while working, you do not pay a monthly premium for Medicare Part A — the hospital insurance part of Medicare. You become may have access to to it at 65 if you have enough work credits, usually 40 quarters (10 years) of covered employment. This is true whether you are still working or retired.
You will, however, pay other costs when you actually use hospital services. These are separate from the premium and depend on what kind of care you receive and how long you stay.
Key Takeaways
- Most people pay zero dollars per month for Part A coverage if they have 10 years of work history under Social Security.
- When you use hospital services, you pay a deductible for each hospital stay, plus daily copayments if you stay longer than 60 days.
- The deductible amount changes each year — in 2024 it is $1,632 per hospital stay.
- If you do not have enough work credits, you can buy Part A coverage, but the monthly premium ranges from roughly $275 to $550 depending on your work history.
- Skilled nursing facility care and home health services covered by Part A have their own cost structure separate from the hospital deductible.
The deductible you pay per hospital stay
When you are admitted to a hospital as an inpatient, you pay a deductible before Medicare starts to pay. In 2024, this deductible is $1,632 per benefit period. A benefit period begins the day you enter the hospital and ends 60 days after you leave without being readmitted.
This means if you are admitted twice in the same benefit period — for example, you go home after 30 days and return 20 days later — you pay the deductible only once for both stays. If you are readmitted after 60 days have passed, you pay a new deductible.
After you pay the deductible, Medicare covers the full cost of your hospital stay for days 1 through 60. You pay nothing more during those first 60 days.
Daily copayments for longer hospital stays
If you stay in the hospital longer than 60 days in a single benefit period, you begin to pay a daily copayment. In 2024, this copayment is $408 per day for days 61 through 90. Medicare still covers the rest of the cost; you pay only your share.
If you need to stay even longer — beyond 90 days — you have access to 60 additional lifetime reserve days. These are days you can use once in your lifetime, and they cost $816 per day in 2024. After you exhaust your lifetime reserve days, you pay all costs yourself until you leave the hospital.
These amounts change each year. Medicare announces the new figures in the fall for the following year.
Skilled nursing and home health costs under Part A
If your hospital stay qualifies you for skilled nursing facility (SNF) care, Part A covers it under specific conditions. You must have been an inpatient for at least three consecutive days, and you must be admitted to the SNF within 30 days of leaving the hospital. Part A covers the first 20 days with no cost to you.
For days 21 through 100 in the same benefit period, you pay a daily copayment of $204 in 2024. After day 100, you pay all costs yourself.
Home health services covered by Part A — such as skilled nursing or physical therapy in your home — have no deductible or copayment if the services are medically necessary and you meet the homebound requirement. You may pay 20 percent of the cost of durable medical equipment (like a wheelchair or oxygen) that Part A covers.
What happens if you do not have enough work credits
If you reach 65 and do not have 40 work credits under Social Security, you cannot get Part A for free. You can buy coverage, but you will pay a monthly premium. The amount depends on how many credits you do have.
If you have 30 to 39 credits, the premium is roughly $275 per month in 2024. If you have fewer than 30 credits, the premium is roughly $550 per month. These figures change yearly. Your Social Security statement shows how many credits you have earned.
Even if you buy Part A this way, you still pay the same deductibles and copayments as anyone else when you use hospital services.
When Part A costs change and how to find current amounts
Medicare adjusts deductibles, copayments, and premiums every January 1st based on inflation and program costs. The amounts for the current year are published on Medicare.gov in October of the previous year. Your Medicare Summary Notice — a document you receive in the mail each year — also lists your specific costs.
If you are turning 65 or newly enrolled in Medicare, ask your Social Security office or call 1-800-MEDICARE to confirm your work credit count and whether you will pay a premium. If you already have Medicare, your online account at Medicare.gov shows your current deductible and copayment amounts.
Questions to ask your doctor or Medicare
Before a planned hospital stay, ask your doctor whether the admission will be inpatient (which triggers Part A costs) or observation (which may be covered differently). Ask whether your stay is likely to exceed 60 days, so you understand what your out-of-pocket costs might be.
If you receive a hospital bill that seems wrong, call the number on your Medicare Summary Notice or contact 1-800-MEDICARE. You have the right to dispute charges you believe are incorrect.
Frequently Asked Questions
Do I have to pay Part A premiums if I am still working at 65?
No. If you have 40 work credits, you are may have access to to free Part A at 65 regardless of whether you are still employed. You do not have to be retired to receive it. However, you may want to delay enrolling in Part B (medical insurance) if you have employer coverage, to avoid paying premiums for both.
What is the difference between the deductible and copayment?
The deductible is a one-time amount you pay per hospital stay before Medicare begins to pay anything. Copayments are daily charges you pay only if your stay exceeds 60 days. You pay the deductible first; copayments explore only after that threshold.
If I am readmitted to the hospital 45 days after discharge, do I pay a new deductible?
No. Since 45 days is less than 60 days, you are still in the same benefit period. You pay the deductible only once per benefit period, even if you are admitted multiple times. A new deductible applies only after 60 days have passed since your last discharge.
Does Part A cover the cost of my medications while I am in the hospital?
Yes. Medications you receive as an inpatient are covered by Part A as part of your hospital stay. You do not pay separately for them. Part D (prescription drug coverage) covers medications you take at home after discharge.
What should I do if I cannot afford the Part A deductible?
Talk to the hospital's financial counselor before or during your stay. Some hospitals have programs to reduce or waive costs for patients with low income. You can also contact your state Medicaid office to see whether you may have access to for help paying Medicare costs.