Medicare Part A is the portion of Original Medicare that covers inpatient and facility-based care. It helps pay for hospital stays, skilled nursing facility care, hospice care, and home health services. Most people qualify for it at age 65 without paying a monthly premium, making it the foundation of Medicare coverage for millions of Americans.
What Part A Covers
Part A focuses on care that involves being admitted to a facility or receiving skilled services at home. The four main categories are:
- Inpatient hospital care: stays where you’re formally admitted as an inpatient, including surgeries, overnight monitoring, and treatments that require hospital-level care.
- Skilled nursing facility care: short-term rehabilitation in a nursing facility after a qualifying hospital stay, such as physical therapy following a hip replacement.
- Hospice care: comfort-focused care for people with a terminal illness, covering pain management, counseling, and related services.
- Home health care: part-time skilled nursing or therapy services delivered in your home when you meet specific criteria.
Part A does not cover outpatient doctor visits, prescription drugs you pick up at a pharmacy, or routine lab work. Those fall under Part B or Part D.
How Hospital Coverage Works
Hospital coverage under Part A revolves around something called a “benefit period.” A benefit period starts the day you’re admitted as an inpatient and ends once you’ve gone 60 consecutive days without receiving inpatient hospital or skilled nursing facility care. There’s no limit on how many benefit periods you can have over your lifetime, but you pay a new deductible each time one begins.
For 2026, the inpatient hospital deductible is $1,736 (up from $1,676 in 2025). After you pay that deductible, here’s what your costs look like during a single benefit period:
- Days 1 through 60: $0 per day.
- Days 61 through 90: $419 per day in coinsurance (2025 figure).
- Beyond day 90: you start using “lifetime reserve days,” which cost $838 per day. You get 60 of these total across your lifetime, and once they’re gone, they don’t renew.
The practical takeaway: a straightforward hospital stay of a week or two costs you only the deductible. But extended hospitalizations get expensive fast once you pass the 60-day mark.
Skilled Nursing Facility Coverage
Part A covers up to 100 days of skilled nursing facility care per benefit period, but only if you meet a specific requirement first: you need a qualifying inpatient hospital stay of at least three consecutive days. The clock starts the day you’re admitted as an inpatient, but the discharge day doesn’t count. Time spent in the emergency room or under “observation status” before admission doesn’t count either, which catches many people off guard.
Once you’re in a skilled nursing facility, cost-sharing follows a clear schedule. For 2026, the first 20 days are covered in full after you’ve paid the hospital deductible. Days 21 through 100 come with a daily coinsurance of $217. After day 100, Medicare stops paying entirely and you’re responsible for the full cost.
This coverage is specifically for skilled care like physical therapy, wound care, or IV medications. It is not coverage for long-term custodial stays where you simply need help with daily activities like bathing, dressing, or eating.
Hospice Care
Part A covers hospice care when two doctors (your hospice doctor and your regular doctor, if you have one) certify that you have a terminal illness with a life expectancy of six months or less. To enroll, you sign a statement choosing comfort-focused palliative care instead of treatments aimed at curing your illness.
Once you’re in hospice, the benefit is designed to cover essentially everything you need related to your terminal condition. That includes nursing care, medical equipment, counseling, and drugs for pain and symptom management. You pay a copayment of up to $5 per prescription for those symptom-control medications. Medicare will not, however, cover prescription drugs intended to cure the illness rather than manage symptoms.
Hospice coverage doesn’t expire after six months. If you’re still terminally ill, the hospice doctor or nurse practitioner can recertify you after a face-to-face visit, and coverage continues.
Home Health Services
Part A helps cover skilled nursing care and therapy delivered in your home, but the eligibility rules are specific. You must be considered “homebound,” meaning that leaving your home either isn’t recommended because of your condition or requires considerable effort, like needing a wheelchair, walker, or another person’s help. You can still leave for medical appointments, religious services, or adult day care and maintain your homebound status.
The care itself must be part-time or intermittent. In most cases, that means up to 8 hours per day of combined skilled nursing and home health aide services, with a weekly cap of 28 hours. For short stretches, your provider can authorize up to 35 hours per week if medically necessary. If you need more than part-time skilled care on an ongoing basis, you won’t qualify for home health coverage under Part A.
What Part A Does Not Cover
The biggest gap in Part A coverage is long-term care. Medicare does not pay for extended stays in a nursing home when the purpose is help with daily living rather than skilled medical treatment. This includes assistance with bathing, dressing, eating, and getting around, sometimes called custodial care. Most health insurance, including Medigap supplemental policies, also excludes long-term care. If you need this type of support, you pay the full cost unless you have separate long-term care insurance or qualify for Medicaid.
Part A also won’t cover private-duty nursing, personal care aides outside of the home health benefit, or any services that aren’t medically necessary.
Who Qualifies and What It Costs
Most people get Part A automatically at 65 without a monthly premium. This “premium-free” Part A is available if you or your spouse earned enough work credits through payroll taxes over your career. The standard threshold is 40 quarters of coverage (roughly 10 years of work). People who qualify based on disability or end-stage renal disease may need a different number of quarters depending on their situation.
If you haven’t earned enough work credits, you can still enroll in Part A, but you’ll pay a monthly premium. The exact amount depends on how many quarters you’ve accumulated. People with 30 to 39 quarters pay a reduced premium, while those with fewer than 30 quarters pay the full rate.
Regardless of whether you pay a premium, the deductibles and coinsurance amounts described above apply to everyone. Many people buy a Medigap supplemental policy or enroll in a Medicare Advantage plan specifically to reduce these out-of-pocket costs, particularly the $1,736 hospital deductible that resets with each benefit period.