Key Takeaways

• Medicare Part A covers inpatient hospital care, but there are specific limits, timelines, and costs that can lead to confusion if you don’t look closely.

• Coverage under Part A doesn’t mean you won’t have out-of-pocket expenses. Deductibles, coinsurance, and coverage rules can catch you off guard if you’re not prepared.

Understanding the Foundation of Part A

Medicare Part A is often called hospital insurance, and it’s the part of Medicare that helps pay for inpatient care in hospitals, skilled nursing facilities, hospice, and some home health services. If you or your spouse paid Medicare taxes for at least 40 quarters, you qualify for premium-free Part A. But that doesn’t mean everything is covered without limits.

You might assume that hospital stays are fully taken care of just because you’re enrolled in Medicare. That’s not how it works. Instead, Medicare sets specific conditions and cost-sharing responsibilities you need to meet.

What Part A Covers—and What It Doesn’t

Part A covers a range of inpatient services, but it does so under certain circumstances and for limited durations.

Inpatient Hospital Stays

Medicare Part A helps cover:

• Semi-private rooms

• Meals during your stay

• General nursing services

• Drugs administered while in the hospital

• Operating room and recovery services

• Some supplies like bandages and surgical tools

What’s not covered:

• Private duty nursing

• Television or telephone in your room (if there’s a separate charge)

• Personal items such as razors or slippers

• First-day doctor services if not billed as part of your inpatient admission

Skilled Nursing Facility (SNF) Care

If you’re transferred to a skilled nursing facility after a qualifying hospital stay of at least three consecutive days, Part A may cover it. Coverage includes:

• Semi-private room

• Meals

• Skilled nursing care

• Physical and occupational therapy

• Medical social services

Limits to keep in mind:

• Only up to 100 days per benefit period are covered.

• The first 20 days are fully covered. Days 21 through 100 require coinsurance.

• After 100 days, you pay all costs unless you have other coverage.

Hospice Care

Part A covers hospice if your doctor certifies you have a terminal illness and you choose comfort care over curative treatment. Hospice coverage includes:

• Pain relief and symptom management

• Medical and support services

• Grief counseling for you and your family

• Short-term inpatient care for symptom control

Hospice doesn’t cover:

• Curative treatments

• Room and board (except during short-term inpatient stays)

Home Health Services

If you meet eligibility criteria, Medicare Part A may cover part-time or intermittent home health services:

• Skilled nursing care

• Physical, occupational, and speech therapy

• Medical supplies

But it doesn’t cover full-time care or homemaker services if those are the only needs.

The Cost Breakdown You Should Know

Even if you don’t pay a premium for Medicare Part A, it’s not entirely free. You’re still responsible for deductibles and coinsurance.

2025 Medicare Part A Costs

Here’s what you pay in 2025:

• Inpatient hospital deductible: $1,676 per benefit period

• Coinsurance for hospital stays:

  • Days 1–60: $0

  • Days 61–90: $419 per day

  • Days 91–150: $838 per day (lifetime reserve days)

  • After 150 days: You pay all costs

• Skilled Nursing Facility coinsurance:

  • Days 1–20: $0

  • Days 21–100: $209.50 per day

  • After 100 days: All costs are yours

These numbers are based on each benefit period, not each calendar year. A new benefit period begins when you haven’t received inpatient care for 60 consecutive days.

How Benefit Periods Work

Benefit periods often trip people up. Unlike a calendar year, a benefit period begins the day you’re admitted to a hospital or SNF as an inpatient. It ends when you haven’t received inpatient care for 60 days in a row.

Here’s what that means in practice:

• You could have multiple benefit periods in one year.

• You must pay the deductible for each new benefit period.

• Coinsurance amounts apply fresh with each new period.

So, multiple hospitalizations across a year could result in multiple deductibles and coinsurance costs.

Misunderstanding Observation Status

Not every hospital stay is an inpatient stay. If you’re under observation, even for multiple nights in a hospital bed, you may be classified as an outpatient. That means Part A may not apply at all.

Observation status is covered under Medicare Part B, not Part A. This can become a problem if you need to move to a skilled nursing facility afterward. If you weren’t admitted as an inpatient for at least three consecutive days, SNF coverage under Part A won’t apply.

Ask your care team about your admission status before you’re discharged—it affects both your current bill and your follow-up care.

What Happens After Lifetime Reserve Days?

Part A offers 60 lifetime reserve days that you can use when you’re in the hospital for more than 90 days in a single benefit period. Once you use all 60, they’re gone for good.

You’ll owe the full cost of care beyond 90 days if you’ve already used all your lifetime reserve days. That’s why planning ahead for long hospital stays matters.

Coordination with Other Coverage

If you have other insurance—like Medicaid, retiree benefits, or a supplemental plan—it may help pay some of the costs that Medicare Part A doesn’t cover. However, each of these types of insurance has its own rules about what they pay and when.

Medicaid may help with:

• Deductibles

• Coinsurance

• Skilled nursing care past 100 days (if you qualify)

But you need to meet income and asset requirements to get Medicaid support.

Timely Enrollment Matters

Most people are automatically enrolled in Part A at age 65 if they’re already getting Social Security. If you’re not automatically enrolled, it’s important to sign up during your Initial Enrollment Period (IEP):

• Starts 3 months before the month you turn 65

• Includes your birth month

• Ends 3 months after the month you turn 65

If you miss this window and don’t qualify for a Special Enrollment Period, you’ll have to wait until the General Enrollment Period (January 1 to March 31) and may face a late enrollment penalty.

The penalty for late enrollment in Part A (if you must pay a premium) is 10% and applies for twice the number of years you were eligible but didn’t enroll.

What to Watch for in 2025

While Part A has remained relatively stable, the rising hospital costs in 2025 make understanding your share of expenses even more critical. With coinsurance and deductibles increasing over time, you may face more out-of-pocket responsibility than expected.

Also, regulatory changes can affect coverage rules, including the criteria for SNF admissions or home health services. Staying informed through official Medicare updates or speaking to a licensed agent can keep you ahead of unexpected changes.

Avoiding Surprise Bills

To protect yourself from unexpected charges:

• Always ask if you’re inpatient or under observation

• Know the coverage limits for each service

• Understand benefit period resets

• Keep track of your lifetime reserve day usage

It’s easy to assume Part A has you covered, but assumptions can be expensive.

Staying Ahead of the Learning Curve

If you or a loved one expects a hospital stay in 2025, it’s worth taking time now to understand the specifics of your Medicare Part A coverage. Between timelines, eligibility requirements, benefit period resets, and rising costs, the term “hospital coverage” means more than it seems.

Speak to a licensed agent listed on this website for help reviewing your Medicare benefits and finding the best coverage combination for your healthcare needs.