What Medicare Part A Covers: Hospital and Inpatient Care

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

Medicare Part A is hospital insurance. It pays for care you receive as an inpatient — meaning you are admitted to a hospital or facility overnight — rather than care you get as an outpatient in a doctor's office or emergency room. Part A also covers skilled nursing facilities, hospice care for terminal illness, and home health services ordered by a doctor.

Part A is automatic. If you are 65 or older and have worked in the United States for at least 10 years, you are enrolled in Part A when you turn 65, even if you do not sign up. You pay a monthly premium only if you or your spouse did not pay Medicare taxes for that full 10 years. Most people pay nothing for Part A itself, though you will pay a deductible and coinsurance when you use it.

Key Takeaways

Part A covers the cost of a hospital room, meals, and basic care during an inpatient stay, after you pay a deductible of $1,676 per benefit period in 2024.
Skilled nursing facility care is covered for up to 100 days per benefit period if you were hospitalized first and meet other conditions, with you paying coinsurance after day 20.
Home health services ordered by your doctor are covered with no deductible or coinsurance, but only if you are homebound and the care is medically necessary.
Hospice care is covered for people with a terminal diagnosis, and Part A pays for most costs including medications and equipment related to your terminal condition.
Part A does not cover outpatient care, doctor visits, prescription drugs, or long-term custodial care in a nursing home.

Hospital inpatient stays and what Part A pays

When you are admitted to a hospital as an inpatient, Part A covers your room, meals, nursing care, lab tests, imaging, and medications given to you in the hospital. It does not cover the doctor's fee — that is covered by Medicare Part B — but it does cover the facility itself.

You pay a deductible of $1,676 per benefit period in 2024. A benefit period starts the day you enter the hospital and ends 60 days after you leave. If you go back into the hospital more than 60 days later, a new benefit period begins and you pay the deductible again. After you pay the deductible, Part A covers all approved hospital costs for days 1 through 60 of your stay.

For days 61 through 90, you pay coinsurance of $419 per day in 2024. If you stay longer than 90 days, you can use lifetime reserve days — 60 extra days Medicare gives you once in your lifetime — and pay $838 per day for those days. After your lifetime reserve days are used, you pay all costs.

Skilled nursing facility care after hospitalization

Part A covers care in a skilled nursing facility (SNF) — a nursing home or rehabilitation center — but only under specific conditions. You must have been hospitalized for at least three consecutive days first, and you must enter the SNF within 30 days of leaving the hospital. The care must be for the same condition you were hospitalized for, or a condition that developed during your hospital stay.

Part A covers up to 100 days per benefit period. For days 1 through 20, Part A pays all approved costs and you pay nothing. For days 21 through 100, you pay coinsurance of $209.50 per day in 2024, and Part A covers the rest. After day 100, you pay all costs yourself.

Part A covers the room, meals, nursing care, therapy, and medical equipment in the SNF. It does not cover custodial care — help with bathing, dressing, or eating — unless it is part of a skilled service like physical therapy. If you need a nursing home only for custodial care and not for skilled medical care, Part A does not cover it.

Home health services with no deductible

Part A covers home health services ordered by your doctor if you are homebound — meaning you cannot leave home without help and it is medically contraindicated for you to leave. Services must be medically necessary and provided by a Medicare-approved home health agency.

Covered services include skilled nursing visits, physical therapy, occupational therapy, speech therapy, and home health aide services. Part A covers these with no deductible and no coinsurance — you pay nothing. Medical equipment like oxygen, walkers, and hospital beds is also covered.

Home health services are different from custodial care or housekeeping. If you need help with meals or cleaning but not skilled medical care, home health does not cover it. Your doctor must order the services and document that they are medically necessary for your condition.

Hospice care for terminal illness

Part A covers hospice care if your doctor certifies that you have a terminal illness and six months or less to live. Hospice focuses on comfort and quality of life rather than cure. Part A covers doctor visits, nursing care, medications related to your terminal condition, medical equipment, counseling, and respite care — temporary care that gives your family a break.

You pay nothing for hospice services covered by Part A, except a small coinsurance for medications and inpatient respite care. If you choose hospice, you are saying you want comfort care instead of curative treatment, though you can change your mind and return to regular Medicare coverage if your condition improves.

What Part A does not cover

Part A does not cover outpatient care — visits to a doctor's office, emergency room, or urgent care center where you are not admitted to the hospital. Those are covered by Part B. Part A also does not cover prescription drugs you take at home; those are covered by Part D or a Part C plan.

Part A does not cover long-term custodial care in a nursing home if you do not need skilled medical care. It does not cover private duty nursing, personal care attendants, or homemaker services. It does not cover dental care, vision care, hearing aids, or routine foot care.

Part A does not cover care outside the United States except in very limited situations — Canada or Mexico for emergency care if you are closer to that country than to the US, or certain care in Canada if you live in the US near the Canadian border.

Understanding benefit periods and how they reset

A benefit period is how Medicare counts your hospital and SNF use. It starts the day you enter a hospital or SNF as an inpatient and ends 60 days after you leave. The deductible applies once per benefit period, not once per year.

If you leave the hospital, stay home for 60 days or more, and then go back to the hospital, a new benefit period starts and you pay the deductible again. If you go back within 60 days, you are still in the same benefit period and do not pay another deductible — but you also do not get another 90 days of coverage. Your remaining days from the first stay are what you have left.

This is different from how insurance usually works. It rewards you for staying out of the hospital for two months, but it can be expensive if you have multiple short stays close together.

Questions to ask your doctor or Medicare

Before a hospital stay or SNF admission, ask your doctor whether the stay will be inpatient or observation. Observation stays are outpatient and Part A does not cover them the same way — you pay Part B coinsurance instead of the Part A deductible. Ask whether your condition qualifies for SNF coverage and how many days you might need.

Call Medicare at 1-800-MEDICARE (1-800-633-4227) if you have questions about what a specific service will cost you, or if you receive a bill you think is wrong. You can also ask for an itemized bill from the hospital or facility to see exactly what was charged.

Frequently Asked Questions

Does Part A cover observation stays in the hospital?

No. Observation is outpatient care, even if you stay overnight. Part B covers observation, and you pay Part B coinsurance instead of the Part A deductible. This matters because observation does not count toward the three-day hospital stay required for SNF coverage. Ask your doctor or the hospital whether your admission is inpatient or observation.

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

You can use lifetime reserve days — 60 extra days Medicare gives you once in your lifetime. You pay $838 per day in 2024 for each reserve day used. After your reserve days are gone, you pay all hospital costs yourself. A new benefit period (and new reserve days) do not start until 60 days after you leave the hospital.

If I need a nursing home, does Part A always cover it?

No. Part A covers SNF care only if you were hospitalized first for at least three consecutive days, enter the SNF within 30 days, and need skilled medical care — not just help with daily living. If you need a nursing home for custodial care only, Part A does not cover it and you pay out of pocket or use Medicaid if you may have access to.

Do I pay anything for home health services?

No. Part A home health has no deductible and no coinsurance. You pay nothing as long as the services are ordered by your doctor, provided by a Medicare-approved agency, and you are homebound. Medical equipment is also covered at no cost to you.

Can Part A cover care outside the United States?

Generally no. Part A covers emergency care in Canada or Mexico only if you are closer to that country than to a US hospital, or if you live in the US near the Canadian border. Planned care outside the US is not covered. Travel insurance or a supplemental plan may cover some international care.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.