Key Takeaways

• Medicare Part A in 2025 covers many hospital-related expenses, but it does not cover every bill you may encounter during a hospital stay. Certain services, limits, and timeframes can leave you with unexpected costs.

• Understanding the coverage caps, benefit periods, and what counts as inpatient care is essential to avoiding major financial surprises when relying on Part A.

What Medicare Part A Is Designed to Cover in 2025

Medicare Part A is commonly known as hospital insurance. It primarily helps pay for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. In 2025, many beneficiaries still assume that once admitted to a hospital, Medicare will handle every bill. That isn’t the case.

Here’s what Part A typically includes:

• Inpatient hospital care (after you are formally admitted)

• Semi-private room, meals, nursing, and hospital services

• Skilled nursing facility (SNF) care, but only under specific conditions

• Hospice care for those with a terminal illness

• Limited home health care when prescribed

Each of these categories has coverage boundaries, and in many cases, those limits are reached sooner than people expect.

Understanding the 2025 Part A Deductible and Cost Sharing

As of 2025, Medicare Part A charges a deductible of $1,676 per benefit period. This isn’t an annual deductible—it can apply multiple times per year depending on your hospital usage.

• A benefit period begins the day you are admitted as an inpatient and ends when you’ve been out of the hospital or a skilled nursing facility for 60 consecutive days.

• If you are re-admitted after those 60 days, a new benefit period starts, and you’ll owe the deductible again.

Beyond the deductible, you’re also responsible for coinsurance costs:

• Days 1–60: No daily coinsurance after deductible is met.

• Days 61–90: You pay $419 per day.

• Days 91–150: You pay $838 per day, using your 60 lifetime reserve days.

• After 150 days: You pay all costs.

This structure means a prolonged hospital stay can result in major out-of-pocket expenses.

Not Every Hospital Stay Qualifies as Inpatient

Many Medicare beneficiaries assume that if they spend a night in a hospital bed, they are covered under Part A. But that’s not necessarily true.

• Inpatient care requires a doctor’s formal admission order.

• Observation status—even if you stay overnight—falls under Part B, not Part A.

This distinction can cause unexpected charges, especially when follow-up care like a skilled nursing facility is needed. For SNF care to be covered under Part A, you must have had at least three consecutive days as an inpatient, not counting the day of discharge.

Skilled Nursing Facility Care Has Strict Eligibility Rules

In 2025, Medicare Part A continues to offer limited coverage for care in a skilled nursing facility—but it only kicks in if:

• You have a qualifying inpatient hospital stay of 3 consecutive days.

• You enter the SNF within 30 days of leaving the hospital.

• Your doctor certifies that you need daily skilled care.

If you meet these conditions:

• Days 1–20: You pay nothing.

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

• After 100 days: You pay all costs.

SNF care is not long-term custodial care. If you need help with basic activities (bathing, eating, etc.) without medical care, that is not covered under Part A.

You May Still Get Billed for Doctor Services During a Hospital Stay

Even if Part A covers your hospital room and basic care, it won’t cover everything that happens during your stay. Physician services are typically billed under Part B, not Part A.

These may include:

• Specialists who consult on your case

• Surgeons, anesthesiologists, or radiologists

• Lab tests ordered by outside providers

• Medical equipment or supplies not part of your room and board

So even while staying in a Medicare-approved facility, you may still see multiple bills—and Part B cost-sharing rules apply to those.

Hospice Care Coverage: Focused but Limited

Medicare Part A does provide comprehensive coverage for hospice care, but you must meet strict eligibility criteria:

• Your doctor must certify a terminal illness with life expectancy of 6 months or less.

• You must agree to forgo curative treatment.

Once you qualify, Medicare covers:

• Nursing and physician services

• Pain management and symptom control

• Drugs related to your terminal illness

• Short-term respite care for caregivers

What’s not covered:

• Room and board if you receive care at home

• Treatment aimed at curing your condition

Additionally, you may still owe a small copayment for prescription drugs and respite care, even under hospice.

Home Health Services Are Limited Under Part A

Part A covers certain home health services—but again, not unconditionally.

To qualify in 2025:

• Your doctor must certify that you are homebound.

• You must need intermittent skilled nursing care or therapy.

• Services must be provided by a Medicare-approved agency.

If approved, you can receive care such as:

• Skilled nursing

• Physical or occupational therapy

• Speech-language pathology

However, routine personal care (e.g., help with bathing or meal prep) is not covered if it is the only care you need.

What Happens When You Use Up Lifetime Reserve Days?

Every Medicare beneficiary has 60 lifetime reserve days for hospital stays that go beyond 90 days. Once you use them up, they are not replenished.

In 2025:

• These days cost $838 per day.

• They are optional—you can choose not to use them.

• If you use all 60, any inpatient stay longer than 90 days becomes 100% your financial responsibility.

That’s a long-term risk if you have multiple long hospital stays throughout your lifetime. It’s a key reason why many choose additional coverage beyond Original Medicare.

What Part A Won’t Cover at All in 2025

There are entire categories of services that fall completely outside Medicare Part A coverage:

• Outpatient care or observation status

• Long-term custodial care

• Private-duty nursing

• Private hospital rooms (unless medically necessary)

• Personal comfort items like TV or phone rental

• Blood (first three pints, unless donated to replace)

These exclusions apply even if you are in a Medicare-certified facility. Knowing the difference between what’s covered and what’s not can help you plan ahead.

Why Understanding the Benefit Period Matters So Much

Because the Part A deductible resets with each benefit period, not each calendar year, the timing of your hospital stays can significantly affect your costs.

For example:

• A January admission and another in March (after 60+ days out of care) each trigger separate deductibles.

• Multiple hospitalizations in one year can add up quickly, especially if you hit days 61+.

This timing nuance is one of the most misunderstood aspects of Medicare Part A, and one that can lead to surprise bills.

Planning Ahead: What You Can Do

While you can’t change how Medicare works, you can prepare yourself to avoid unexpected expenses:

• Track your benefit periods—know when they start and end.

• Ask for written confirmation of your inpatient status.

• Review your Medicare Summary Notices (MSNs) for accuracy.

• Consider supplemental coverage to fill Part A gaps.

• Speak with a licensed agent listed on this website to better understand your options.

Being proactive helps you minimize the risks of relying solely on Original Medicare.

Gaps in Coverage Can Affect You Quickly

Medicare Part A in 2025 remains foundational to your hospital care, but its structure leaves key gaps—especially around time-based limits, cost-sharing, and eligibility rules.

If you assume it covers everything, you may be financially vulnerable. That’s why reviewing your Medicare plan each year and speaking with a licensed agent listed on this website is a smart move. They can help ensure your hospital care needs are fully supported—before the bills start arriving.