Medicare Part A

Medicare Part A is the hospital-insurance portion of Original Medicare. It primarily covers inpatient hospital care, limited skilled-nursing facility care, hospice services and certain home health services.

Although many people qualify for premium-free Part A, the coverage is not completely free. Medicare Part A has a hospital deductible, daily coinsurance for longer inpatient stays and specific eligibility requirements for skilled-nursing care.

Understanding how Part A works is especially important if you are approaching age 65, continuing to work, contributing to a Health Savings Account or deciding between Original Medicare and Medicare Advantage.

What Does Medicare Part A Cover?

Medicare Part A helps cover four principal categories of care:

Inpatient hospital care
Skilled-nursing facility care
Hospice care
Certain home health services

Part A does not pay every expense associated with these services. Deductibles, coinsurance, benefit-period rules and medical-necessity requirements may apply.

Inpatient Hospital Care

Medicare Part A may cover the hospital services you receive after you are formally admitted as an inpatient.

Covered inpatient hospital services may include:

Semi-private hospital rooms
Meals
General nursing services
Medications administered as part of inpatient treatment
Operating-room and recovery-room services
Certain laboratory tests and medical supplies
Inpatient rehabilitation
Inpatient mental-health care, subject to Medicare’s limitations

Part A generally pays the hospital facility charges. Services provided by doctors, surgeons, anesthesiologists and other medical professionals during the hospital stay are ordinarily covered under Medicare Part B.

Inpatient Status vs Observation Status

Spending a night in the hospital does not automatically make you an inpatient.

A hospital may place you under observation while it determines whether you need to be formally admitted. Observation services are generally considered outpatient care and are ordinarily covered under Medicare Part B rather than Part A.

Your status can affect:

Which Medicare deductible applies
Your hospital out-of-pocket expenses
Whether the stay counts toward skilled-nursing facility eligibility
How a Medicare Supplement policy pays the claim

Ask whether you have been formally admitted as an inpatient if you are uncertain about your hospital status.

Skilled-Nursing Facility Care

Medicare Part A may cover limited care in a Medicare-certified skilled-nursing facility when Medicare’s requirements are satisfied.

Under the standard rules, you generally must:

Have a qualifying inpatient hospital stay of at least three consecutive days
Enter the skilled-nursing facility within a limited period, usually 30 days after leaving the hospital
Need daily skilled-nursing or rehabilitation services
Receive care for a condition treated during the qualifying hospital stay or a related condition
Receive the services in a Medicare-certified facility

Time spent in the hospital under observation generally does not count toward the three-day inpatient requirement.

Medicare does not require you to improve continuously to receive covered skilled care. Coverage may also be available when skilled services are necessary to maintain your condition or prevent or delay further deterioration.

Skilled-nursing coverage is not the same as long-term nursing-home coverage. Medicare does not ordinarily cover an indefinite stay because someone needs help with bathing, dressing, eating or other daily activities.

Hospice Care

Medicare Part A covers hospice services for eligible beneficiaries with a terminal illness.

To qualify:

You must have Medicare Part A.
A hospice doctor and your regular doctor, if you have one, must certify that you are terminally ill with a life expectancy of six months or less.
You must choose comfort care instead of treatment intended to cure the terminal illness.
You must receive care through a Medicare-approved hospice provider.

Hospice services may include:

Nursing care
Pain and symptom management
Medications related to the terminal illness
Medical equipment and supplies
Social-work services
Grief and family counseling
Short-term inpatient care
Short-term respite care
Home health aide services related to hospice care

Hospice coverage can continue beyond six months when the hospice doctor properly recertifies that you remain eligible.

Home Health Services

Medicare Part A and Medicare Part B may cover certain home health services, depending on the circumstances.

Covered services may include:

Part-time or intermittent skilled-nursing care
Physical therapy
Speech-language pathology
Continued occupational therapy
Certain home health aide services when skilled care is also required
Medical social services
Injectable osteoporosis drugs for certain eligible patients

You generally must be homebound, need qualifying skilled care and receive services through a Medicare-certified home health agency.

Medicare does not ordinarily cover:

Twenty-four-hour home care
Meal delivery
Homemaker services unrelated to a covered care plan
Personal or custodial care when that is the only care you need

What Are the 2026 Medicare Part A Costs?

Medicare Part A uses benefit periods rather than one annual hospital deductible.

2026 Inpatient Hospital Costs

For each inpatient hospital benefit period in 2026:

Deductible: $1,736
Days 1–60: $0 daily coinsurance after the deductible
Days 61–90: $434 per day
Days 91–150: $868 per day while using lifetime reserve days
After day 150: You pay all costs

You receive a total of 60 lifetime reserve days. These days do not reset after they are used.

What Is a Medicare Part A Benefit Period?

A benefit period begins the day you are admitted to a hospital or skilled-nursing facility as an inpatient.

It ends after you have gone 60 consecutive days without receiving inpatient hospital or skilled-nursing facility care.

A new benefit period can mean a new $1,736 deductible. Because there is no limit to the number of benefit periods you can have in a year, it is possible to owe the Part A deductible more than once during the same calendar year.

2026 Skilled-Nursing Facility Costs

For each qualified skilled-nursing facility benefit period in 2026:

Days 1–20: $0 per day
Days 21–100: $217 per day
Days 101 and beyond: You pay all costs

These costs assume you continue meeting Medicare’s coverage requirements. Medicare can stop paying before day 100 if you no longer need qualifying skilled care.

Hospice and Home Health Costs

Covered hospice care generally has no deductible.

You may pay:

Up to $5 for each prescription used for pain relief and symptom control at home
Five percent of the Medicare-approved amount for inpatient respite care
Your usual deductibles and coinsurance for treatment unrelated to the terminal illness

Covered home health services generally have no copayment. You ordinarily pay 20 percent of the Medicare-approved amount for covered durable medical equipment.

Is Part A Free?

Most beneficiaries do not pay a monthly Medicare Part A premium.

You generally qualify for premium-free Part A if you or your spouse worked and paid Medicare taxes for at least 40 quarters, which is approximately ten years.

In 2026, if you must purchase Part A:

The monthly premium is $311 if you or your spouse paid Medicare taxes for 30–39 quarters.
The monthly premium is $565 if fewer than 30 quarters of Medicare-covered work are available.

You generally must also enroll in Medicare Part B if you purchase Part A.

Premium-free does not mean cost-free. The Part A deductible, hospital coinsurance and skilled-nursing coinsurance can still apply.

Who Is Eligible for Part A?

Medicare Part A is generally available to:

People age 65 or older who meet Medicare’s eligibility requirements
Certain people under age 65 who have received Social Security disability benefits for the required period
People with Amyotrophic Lateral Sclerosis, also called ALS
Certain people with End-Stage Renal Disease

Eligibility for premium-free Part A is commonly based on your own employment history or that of a current, former or deceased spouse.

Someone who does not qualify for premium-free Part A may be able to purchase it if the applicable citizenship or lawful-residency requirements are satisfied.

Do You Automatically Get Medicare Part A at 65?

Some people are automatically enrolled, while others must actively apply.

If you are receiving Social Security or Railroad Retirement Board benefits at least four months before turning 65, you will generally be enrolled automatically in Medicare Part A and Part B.

Your Medicare card should arrive before the coverage begins.

If you are not receiving those benefits before age 65, you generally must apply through the Social Security Administration.

Your Initial Enrollment Period ordinarily lasts seven months:

Three months before the month you turn 65
The month you turn 65
Three months after the month you turn 65

People who continue working may have additional enrollment rights based on current employer coverage.

Should You Enroll in Part A If You Are Still Working?

Many people enroll in premium-free Medicare Part A at age 65 even if they continue working. However, that is not automatically the correct decision for everyone.

Consider:

Whether you or your spouse are actively employed
The size of the employer
Whether the employer plan remains primary
Whether you contribute to a Health Savings Account
Whether the employer coverage requires Medicare enrollment
Whether you have retiree or COBRA coverage
When you expect the employment or coverage to end

For someone age 65 or older, coverage from an employer with 20 or more employees generally pays before Medicare. Medicare generally pays first when the employer has fewer than 20 employees, although different coordination rules can apply in certain situations.

COBRA and retiree coverage are not treated the same as insurance based on current active employment. Relying on those forms of coverage can create Medicare enrollment problems.

Check directly with the employer’s benefits administrator before delaying Medicare.

How Does Part A Affect HSA Contributions?

Once you are enrolled in any part of Medicare, you can no longer make or receive tax-deductible contributions to a Health Savings Account.

You can continue using money already in the HSA for qualified medical expenses. The restriction applies to new contributions, not to using the existing account balance.

This becomes especially important when someone enrolls in premium-free Part A after age 65.

Premium-free Part A can begin retroactively for as many as six months when you apply after age 65, but it cannot begin before your first month of Medicare eligibility. HSA contributions made during the retroactive Medicare period may become excess contributions.

If you plan to enroll after age 65, Medicare advises stopping HSA contributions at least six months before applying for Medicare or Social Security benefits.

Coordinate the timing with your benefits administrator or tax professional before submitting the Medicare application.

What Happens If You Delay Part A?

Someone eligible for premium-free Part A can generally enroll later without paying a Part A late-enrollment penalty.

The larger concerns are:

HSA contribution timing
Whether employer insurance will pay correctly
Gaps in hospital coverage
Retroactive Part A coverage
Proper coordination with Medicare Part B

Someone who must purchase Part A may face a late-enrollment penalty if enrollment is delayed without a qualifying reason.

The purchased-Part-A penalty generally increases the monthly premium by 10 percent. The higher premium is generally paid for twice the number of years enrollment was delayed.

What Does Part A Not Cover?

Medicare Part A generally does not cover:

Routine doctor visits
Most outpatient medical care
Most outpatient prescription drugs
Routine dental care
Routine vision examinations
Eyeglasses
Hearing aids
Long-term custodial nursing-home care
Private-duty nursing
A private hospital room unless medically necessary
Personal convenience items in the hospital
Twenty-four-hour home care
Most healthcare received outside the United States
Services that Medicare determines are not medically necessary

Some of these services may be covered by Medicare Part B, Medicare Part D, another insurance policy or Medicaid.

Medicare Part A vs Medicare Part B

Medicare Part A and Medicare Part B make up Original Medicare.

Part A primarily covers:

Inpatient hospital care
Limited skilled-nursing facility care
Hospice care
Certain home health services

Part B primarily covers:

Doctor and specialist services
Outpatient hospital care
Preventive services
Diagnostic testing
Physical therapy
Durable medical equipment
Ambulance services
Certain medications administered in a medical setting

Part A may cover the hospital facility during an inpatient stay, while Part B covers the doctors treating you during that same stay.

Having Part A alone does not provide complete medical coverage.

How Does Part A Work With a Medicare Supplement?

A Medicare Supplement policy works with Original Medicare rather than replacing it.

All standardized Medicare Supplement plans provide coverage for Medicare Part A hospital coinsurance and up to 365 additional hospital days after Medicare benefits are exhausted.

Depending on the plan letter, a Medicare Supplement may also pay all or part of:

The Medicare Part A deductible
Skilled-nursing facility coinsurance
Hospice-care coinsurance or copayments
The first three pints of blood

Medicare Supplement Plan G and Plan N both cover the full Medicare Part A deductible and Part A hospital coinsurance.

Medicare first determines whether the service is covered. The remaining claim information is generally sent electronically to the Medicare Supplement insurance company, which pays according to the standardized benefits of the policy.

How Does Part A Work With Medicare Advantage?

To enroll in Medicare Advantage, you generally must have Medicare Part A and Part B and continue paying the Medicare Part B premium.

The Medicare Advantage company administers your Part A and Part B benefits. The plan may use its own:

Hospital copayments
Deductibles
Provider network
Service area
Referral requirements
Prior-authorization rules
Maximum out-of-pocket limit

Medicare Advantage hospital costs do not necessarily follow Original Medicare’s $1,736 benefit-period deductible and daily coinsurance schedule.

Review the plan’s Evidence of Coverage and Summary of Benefits to determine what you would pay for inpatient hospital and skilled-nursing care.

Does Original Medicare Have an Out-of-Pocket Maximum?

Original Medicare Part A and Part B do not have a yearly out-of-pocket maximum.

A person could experience:

More than one Part A benefit-period deductible
Daily hospital coinsurance during a long stay
Skilled-nursing facility coinsurance
Medicare Part B deductibles and coinsurance

A Medicare Supplement policy can help pay many of these expenses. Medicare Advantage plans instead establish an annual limit for covered Part A and Part B services, although the limit and the costs incurred before reaching it vary by plan.

The Bottom Line

Medicare Part A primarily covers inpatient hospital care, limited skilled-nursing facility care, hospice care and certain home health services.

Most people qualify for premium-free Part A, but hospital deductibles and coinsurance still apply. In 2026, the inpatient hospital deductible is $1,736 for each benefit period.

Part A enrollment requires additional planning if you are still working, covered through an employer or contributing to an HSA. Enrolling too early can interfere with HSA contributions, while delaying coverage without understanding the employer coordination rules can create coverage problems.

Review your employment, insurance, HSA and retirement circumstances before deciding when to enroll.

Frequently Asked Questions

What does Part A cover?

Medicare Part A primarily covers inpatient hospital care, limited skilled-nursing facility care, hospice care and certain home health services.

How much is the Part A deductible in 2026?

The 2026 Part A inpatient hospital deductible is $1,736 for each benefit period. It is not a once-per-year deductible.

Can I pay the Part A deductible more than once in a year?

Yes. A new benefit period begins after you have gone 60 consecutive days without inpatient hospital or skilled-nursing facility care. A new benefit period can require another Part A deductible.

Does Part A cover emergency-room care?

Emergency-room care is generally covered under Medicare Part B unless you are formally admitted as a hospital inpatient. If admitted, certain hospital services may be covered under Part A.

Does Part A cover doctors while I am hospitalized?

Part A generally covers the inpatient hospital facility. Services provided by doctors, surgeons, anesthesiologists and other medical professionals are ordinarily covered under Medicare Part B.

Does Part A cover nursing homes?

Part A may cover limited skilled-nursing facility care when Medicare’s requirements are satisfied. It generally does not cover long-term custodial nursing-home care.

Can I have Part A without Part B?

Yes. Some people enroll in premium-free Part A while delaying Part B because they remain covered through current employment. This decision should be coordinated carefully with the employer plan and HSA rules.

Can I contribute to an HSA after enrolling in Part A?

No. You cannot make or receive new HSA contributions for months in which you are enrolled in Medicare. You may continue using the money already in the account for qualified medical expenses.

Can I use Part A anywhere in the United States?

Original Medicare can generally be used with Medicare-participating hospitals and providers throughout the United States. Medicare Advantage plans may have separate network and service-area rules.

Does Part A cover healthcare outside the United States?

Original Medicare generally does not cover care received outside the United States except in limited situations. Certain Medicare Supplement plans include limited foreign-travel emergency benefits.

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