Medicare Part A is hospital insurance. It covers inpatient hospital stays, skilled nursing facility care, hospice, and home health services. Most people pay no monthly premium for Part A because they or a spouse paid Medicare taxes for at least 10 years. The costs you do pay come in the form of deductibles and coinsurance when you actually use services.
Inpatient Hospital Care
This is the core of Part A. When you’re admitted to a hospital as an inpatient, Part A covers your semi-private room, meals, general nursing care, medications administered during your stay, and other hospital services tied to your treatment. It does not cover a private room unless it’s medically necessary, private-duty nursing, personal care items like razors or slipper socks, or separate charges for a phone or television in your room.
For 2025, you pay a $1,676 deductible for each benefit period (more on that below). After that, days 1 through 60 are fully covered. Days 61 through 90 cost you $419 per day in coinsurance. If you need to stay beyond 90 days, you can tap into lifetime reserve days, which cost $838 per day. You get 60 lifetime reserve days total, and once they’re used, they don’t renew.
How Benefit Periods Work
A benefit period starts the day you’re admitted as an inpatient and ends when you’ve been out of the hospital or skilled nursing facility for 60 consecutive days. This matters because you pay the $1,676 deductible once per benefit period, not once per year. If you’re hospitalized, go home, and are readmitted within 60 days, you’re still in the same benefit period and won’t owe another deductible. But if more than 60 days pass between stays, a new benefit period begins and the deductible resets.
There’s no limit on how many benefit periods you can have over your lifetime. The day counts for coinsurance (61 through 90) also reset with each new benefit period.
Skilled Nursing Facility Care
Part A covers care in a skilled nursing facility, but only under specific conditions. You must first have a qualifying inpatient hospital stay of at least 3 consecutive days. The day you’re admitted counts, but the day you’re discharged does not. Time spent in the emergency room or under observation before admission does not count toward those 3 days, even if you stayed overnight.
Once you qualify, Part A covers up to 100 days per benefit period. Covered services include a semi-private room, meals, skilled nursing care, physical therapy, occupational therapy, speech-language pathology, medical social services, medications, medical supplies, dietary counseling, and ambulance transportation when other transport would endanger your health.
The first 20 days are fully covered. Days 21 through 100 require coinsurance. After day 100, Part A stops paying entirely. And the care must involve skilled services like physical therapy or IV injections that require trained medical professionals. If all you need is help with bathing, dressing, or eating, that’s considered custodial care, and Part A doesn’t cover it.
What Custodial Care Means
This is the single biggest gap in Part A coverage and catches many people off guard. Most nursing home care is custodial, meaning it involves non-skilled personal care like help with bathing, dressing, using the bathroom, eating, or getting in and out of bed. Medicare does not pay for custodial care when that’s the only type of care you need. Long-term stays in a nursing home for this kind of daily assistance require other funding, whether that’s Medicaid, long-term care insurance, or out-of-pocket payment.
Home Health Services
Part A covers home health care when you meet two conditions: you need part-time or intermittent skilled care, and you’re considered homebound. Homebound means you need help from another person or a device like a wheelchair or walker to leave your home, leaving isn’t recommended because of your condition, or getting out requires a major effort.
Covered services include skilled nursing care (wound care, IV therapy, injections, monitoring of serious illness), physical therapy, occupational therapy, speech-language pathology, and medical social services. Home health aide care is also covered, but only if you’re simultaneously receiving one of those skilled services. Aide care includes help with walking, bathing, grooming, changing bed linens, and feeding. Durable medical equipment and medical supplies for home use are covered too.
“Part-time or intermittent” generally means up to 8 hours of combined skilled nursing and aide services per day, with a maximum of 28 hours per week. In some cases, your provider can authorize up to 35 hours per week for a short time. There’s no requirement for a prior hospital stay to qualify for home health services, and there’s no coinsurance. You pay nothing for covered home health care under Part A.
Hospice Care
Part A covers hospice when two doctors certify that you have a terminal illness with a life expectancy of 6 months or less. You must agree to receive comfort-focused care rather than treatments aimed at curing your illness, and you sign a statement choosing hospice care. Hospice takes a team approach, addressing medical, physical, social, emotional, and spiritual needs for both you and your family.
Part A covers hospice services with very low out-of-pocket costs. For outpatient prescription drugs related to pain and symptom management, you pay a copayment of up to $5 per prescription. Hospice benefits can continue beyond 6 months as long as your doctor recertifies that your condition remains terminal.
Inpatient Psychiatric Care
Part A covers inpatient mental health care at general hospitals using the same rules as any other hospital stay. However, if you’re treated in a freestanding psychiatric hospital rather than a general hospital, Part A imposes a lifetime limit of 190 days. Once you’ve used those 190 days, Part A will not cover any additional inpatient psychiatric hospital care for the rest of your life. This limit does not apply to psychiatric care received in a general hospital’s psychiatric unit.
The Blood Deductible
Part A has a separate rule for blood transfusions. You’re responsible for the first 3 pints of whole blood (or equivalent units of packed red cells) you receive in each benefit period. You can either pay the provider’s charges for those pints or replace them by arranging for donated blood. Processing, administration, and storage fees are covered from the first pint onward. If you replace the blood, you can’t be charged for those deductible pints.
What Part A Costs if You Don’t Get It Free
Most people qualify for premium-free Part A because they or a spouse worked and paid Medicare taxes for at least 10 years (40 quarters). If you don’t meet that threshold, you can still buy Part A. The monthly premium depends on how long you or your spouse worked. For 2026, the premium is either $311 or $565 per month, with the higher amount applying to those with fewer qualifying work quarters.
Even with premium-free Part A, you’re still responsible for the per-benefit-period deductible, daily coinsurance for longer stays, and the blood deductible. Many people purchase supplemental insurance (Medigap) or enroll in a Medicare Advantage plan to help cover these out-of-pocket costs.