Key Takeaways

• Medicare Part A only covers a portion of your hospital stay. Important limits include benefit period resets, daily coinsurance, and lack of coverage for non-hospital care.

• After 60 days in the hospital, you begin paying daily coinsurance. After 90 days, you enter lifetime reserve days, which are limited and not renewable.

What Medicare Part A Actually Covers

When you enroll in Medicare, Part A is usually the portion you’re automatically enrolled in. It’s often referred to as “hospital insurance” and primarily covers:

• Inpatient hospital care

• Skilled nursing facility (SNF) care (under specific conditions)

• Some home health care services

• Hospice care

However, the scope of coverage under Part A has very clear limits. If you assume it will pay for your entire hospital stay or any type of care that occurs in a hospital, you’re likely to face unexpected bills.

Coverage Limits Begin with the Benefit Period

Medicare Part A operates using a structure called a benefit period, not a calendar year. This is crucial to understand.

• A benefit period starts the day you are admitted to a hospital or SNF as an inpatient.

• It ends after you have not received any inpatient hospital or SNF care for 60 consecutive days.

• You can have multiple benefit periods in a single year.

Every time a new benefit period starts, you must pay the inpatient hospital deductible again. In 2025, that deductible is $1,676 per benefit period.

So even if you’re hospitalized twice in one year, say in February and again in July, you’ll pay the deductible both times if you were discharged more than 60 days before the second admission.

Daily Coinsurance Starts on Day 61

If your hospital stay exceeds 60 days within a single benefit period, Medicare Part A requires you to pay daily coinsurance.

Here’s how it works in 2025:

• Days 1–60: No daily coinsurance (only the deductible applies).

• Days 61–90: You pay $419 per day.

• Days 91–150: You begin using lifetime reserve days and pay $838 per day.

• After Day 150: Medicare stops paying entirely.

Lifetime Reserve Days Are Limited

Lifetime reserve days are exactly what they sound like: you have 60 of them to use in your entire life. They do not renew annually. Once they’re used up, you are responsible for all hospital costs beyond day 90 in any benefit period.

This is one of the most misunderstood aspects of Part A. Many people think the “lifetime” part refers to the coverage span, but it actually refers to a one-time reserve. After those 60 days are gone, they’re gone for good.

Part A Doesn’t Cover Observation or Outpatient Services

You may be in a hospital bed, receiving treatment, and even staying overnight — but that doesn’t mean Medicare Part A will pay.

Medicare only covers your stay under Part A if you are officially admitted as an inpatient. If you are in the hospital under “observation status,” it’s billed under Part B, and your out-of-pocket expenses can be much higher.

Observation status may apply if:

• You’re being evaluated to determine whether you should be admitted.

• You’re getting tests or receiving treatment, but not formally admitted.

This distinction affects not just billing but also your eligibility for follow-up skilled nursing facility care, which Part A will only cover if you’ve been an inpatient for at least three consecutive days.

Skilled Nursing Facility (SNF) Coverage Has Its Own Rules

Even when your hospital stay qualifies and leads to SNF care, you’re not covered indefinitely.

• You must have had a 3-day inpatient hospital stay (not counting the discharge day or days under observation).

• You must enter the SNF within 30 days of discharge.

Once you meet these conditions, here’s what’s covered in 2025:

• Days 1–20: Fully covered by Medicare Part A.

• Days 21–100: You pay a coinsurance of $209.50 per day.

• After Day 100: You are responsible for all costs.

If your stay is interrupted for more than 60 days, and you return to the SNF, a new benefit period begins, and you start again with a new deductible.

Hospice Care Under Part A Isn’t Entirely Free

Medicare Part A also covers hospice care for terminally ill patients who are expected to live six months or less. However, this coverage comes with limitations:

• You must agree to forgo curative treatment for your illness.

• You typically receive care at home, not in a hospital.

• You may have small copayments for prescriptions or inpatient respite care.

Hospice under Part A doesn’t mean unlimited support or full coverage of all services related to end-of-life care. Additional support may require other forms of coverage or out-of-pocket spending.

You Still Pay for Doctors and Specialists in the Hospital

If you’re admitted to a hospital, you might assume all your medical care is covered by Part A. But services provided by physicians, specialists, or consultants while you’re in the hospital are generally billed under Medicare Part B, not Part A.

This includes:

• Surgeons

• Anesthesiologists

• Radiologists

• Consultants who check in during your stay

You’re still responsible for your Part B deductible and 20% coinsurance, unless you have secondary coverage.

What Happens After Hospital Discharge?

Medicare Part A doesn’t pay for care after you leave the hospital unless it meets the SNF or home health care criteria.

If you need help recovering at home but don’t qualify for skilled home health services, you will need to:

• Pay out of pocket

• Use Medicare Part B for some therapies

• Consider other options like Medicaid (if eligible) or supplemental coverage

Additionally, non-medical assistance like help with bathing, dressing, or cooking — known as custodial care — is not covered by Medicare Part A.

How You Can Prepare for the Gaps

Understanding where Medicare Part A stops helps you plan accordingly. Here’s how you can protect yourself:

• Keep track of hospital benefit periods, especially if you have multiple admissions in a year.

• Be alert to inpatient vs. observation status, and ask about your status during hospital stays.

• Understand your lifetime reserve day usage, especially if you have chronic conditions that could lead to extended admissions.

• Plan for care after discharge, which may involve non-covered services.

• Explore additional coverage options that help pay for coinsurance, extended stays, or home care services.

These proactive steps help prevent surprises and financial strain during a medical crisis.

The Reality of Part A Limits in 2025

While Part A is a crucial part of your Medicare benefits, it’s not designed to handle every aspect of hospitalization or recovery. Its structure is focused on acute, short-term care — not long-term or recurring hospital stays.

Even with no monthly premium for most people, the costs can add up quickly once you’re past 60 days in the hospital, need SNF care beyond 20 days, or reach the edge of your lifetime reserve.

To ensure peace of mind and financial protection, it’s important to understand where Medicare Part A coverage stops — and what that means for you.

For tailored guidance, get in touch with a licensed agent listed on this website who can walk you through your Medicare options, including how to fill the gaps Part A leaves behind.