Key Takeaways

• Medicare Part A covers hospital stays and related services, but it isn’t completely free. Understanding costs like deductibles and coinsurance can help you plan ahead.

• Eligibility depends on work history and Social Security credits, but you may still qualify even if you haven’t worked the required number of years.

What Medicare Part A Actually Covers

Medicare Part A is often called “hospital insurance,” but that name doesn’t fully explain what it includes. Here’s what you can expect:

• Inpatient hospital care – This includes stays in hospitals for medical conditions, surgeries, or serious illnesses. Covered services include meals, nursing care, and some medications.

• Skilled nursing facility (SNF) care – If you need short-term recovery care after a hospital stay of at least three days, Medicare Part A can help cover skilled nursing services, physical therapy, and more.

• Home health care – If your doctor prescribes it, you may be eligible for limited home health services like physical therapy and nursing care.

• Hospice care – For those with terminal illnesses, Medicare Part A covers palliative care, pain management, and support services.

You Still Have Out-of-Pocket Costs

Even though many people qualify for Medicare Part A without paying a monthly premium, that doesn’t mean it’s completely free. Here’s what you might pay:

• Deductible – In 2025, the hospital deductible is $1,676 per benefit period. That means you have to pay this amount before Medicare Part A starts covering your hospital stay.

• Coinsurance for longer hospital stays – After 60 days in the hospital, you’ll start paying a daily coinsurance of $419 per day. If your stay lasts more than 90 days, you’ll use your lifetime reserve days at a cost of $838 per day.

• Skilled nursing facility coinsurance – The first 20 days in a skilled nursing facility are fully covered, but after that, you’ll owe $209.50 per day for days 21-100.

Understanding these costs ahead of time can help you plan for unexpected medical expenses.

Not Everyone Gets Medicare Part A for Free

You might have heard that Medicare Part A is “premium-free,” but that’s only true for people who have worked long enough and paid Medicare taxes. Here’s how eligibility works:

• If you (or your spouse) have worked at least 40 quarters (10 years) in a job that paid Medicare taxes, you qualify for premium-free Part A.

• If you’ve worked 30-39 quarters, you can get Part A, but you’ll pay a monthly premium of $284 in 2025.

• If you’ve worked fewer than 30 quarters, the monthly premium is $518 in 2025.

• Even if you’ve never worked, you may still qualify based on your spouse’s work history.

Coverage Isn’t Unlimited

While Medicare Part A helps cover hospital stays, there are limits you should know about:

• Hospital stays are covered in benefit periods – A benefit period starts the day you’re admitted to a hospital and ends once you’ve gone 60 consecutive days without inpatient care. If you’re hospitalized again after that, a new benefit period begins, and you’ll owe the deductible again.

• Lifetime reserve days are limited – You get only 60 lifetime reserve days to use after day 90 of a hospital stay. Once they’re gone, Medicare Part A won’t cover additional days, and you’ll pay the full cost.

• Skilled nursing care isn’t long-term care – Medicare Part A only covers short-term skilled nursing care. If you need long-term nursing home care, you’ll have to look at other options like Medicaid or private savings.

You Need to Sign Up at the Right Time

Some people are automatically enrolled in Medicare Part A, but others need to take action to sign up. Here’s when you should enroll:

• If you’re already receiving Social Security benefits – You’ll be automatically enrolled in Medicare Part A at age 65.

• If you’re not receiving Social Security yet – You must sign up during your Initial Enrollment Period (IEP), which lasts for seven months (three months before your 65th birthday, your birth month, and three months after).

• If you miss your IEP – You may have to wait for the General Enrollment Period (January 1 – March 31) and could face late penalties.

If you’re still working and have employer coverage, you may be able to delay enrolling without a penalty, but check the rules for your specific situation.

Medicare Part A Works Best When Combined With Other Coverage

While Medicare Part A covers hospital stays, it doesn’t include everything you might need for a complete healthcare plan. Here’s what it doesn’t cover:

• Doctor visits and outpatient services (covered by Medicare Part B)

• Prescription drugs (covered by Medicare Part D)

• Routine dental, vision, and hearing care (only covered by some supplemental plans)

Because of these gaps, most people combine Medicare Part A with other coverage to reduce out-of-pocket costs and get more comprehensive benefits.

Plan Ahead So You’re Not Caught Off Guard

Medicare Part A provides essential hospital coverage, but understanding its limits and costs can help you avoid unexpected medical bills. Make sure you know when to enroll, how much you’ll pay, and what services are included. If you’re unsure about your options, speaking with a licensed agent listed on this website can help you make informed decisions for your healthcare future.