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Medicare Part A
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Important Points
Medicare Part A covers your inpatient hospital coverage, skilled nursing facilities, and hospice care.
Medicare Part A cost $0/month for most people - as long as they worked at least 10 years in the U.S. and paid payroll taxes.
Medicare Part A covers a majority of these costs, but you are still responsible for the deductible and coinsurance.
Medicare Part A is considered your hospital coverage. It provides your "inpatient" care
It's best to think of inpatient care as your "room & board" in the hospital. It will cover a semi-private room with a bed and all your regular meals while you are there. It will also cover any necessary medical supplies, lab services, or medications administered to you by the hospital.
Inpatient care can be received at a critical access hospital, an acute care hospital, an inpatient rehab facility or an inpatient mental healthcare hospital.
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What does Medicare Part A cover?
In addition to covering hospitalization, Medicare Part A also covers your post-hospital skilled nursing and short-term post-hospital home health care, as long as it is medically necessary. It covers hospice services that may include social services, DME, counseling, and palliative care. It also provides short-term respite care so caregivers can have a rest.
Medicare Part A provides for some home health care services you receive in the hospital or immediately following a hospital stay. These can include medical social services, skilled nursing care, and physical therapy. Home health aid services are usually only covered when skilled nursing is also occurring.
Medicare Part A does NOT cover long-term care, like extended stays in a nursing home. You may consider purchasing long-term care insurance if this is something you want to plan for.
There are certain procedures that would fall under Part B instead of Part A. One example of this would be outpatient surgeries. If you need to determine whether something is inpatient or outpatient, you can always consult with your Medicare insurance broker for guidance.
In general, Medicare Part A covers hospital-related care for immediate or acute care of an injury or illness.
What does Medicare Part A cost?
Is Medicare Part A free? (FOR MOST PEOPLE, BUT NOT ALWAYS)
Most people will pay nothing for Medicare Part A when they reach the age of 65, because they have already pre-paid it. During our working years we all pay taxes that are specifically for our future Medicare Part A hospital coverage during retirement. These taxes go to offset the cost of Part A when you start receiving it. While most people assume that the Medicare tax they pay through their payroll is for the entire Medicare program, it only goes towards Medicare Part A.
As long as you have worked for 10 years (40 working quarters) in your lifetime in the U.S., you will generally pay nothing for Medicare Part A. If you do not have this work history, you can purchase Part A as long as you have been a legal resident or green card holder for at least 5 years. Most cases where people have to pay for Medicare Part A are situations when someone has recently immigrated to the United States close to their retirement years and don't have the work history to get it for free.
If you do not have 40 working quarters, you can pay a premium to receive Medicare Part A. Premiums in 2025 are $505 per month if you have less than 30 working quarters or $278 per month for people with 30-39 working quarters.
If you have close to 40 working quarters, it may be wise to keep working for a year or two in order to complete the working quarters you need to offset this cost.
When should I enroll in Medicare Part A?
If you are already taking your Social Security income benefits, then enrollment in Part A will be automatic. When this is the case, you will receive your Medicare card in the mail 2-3 months before you turn 65. Your coverage will start on the 1st day of the month that you turn 65.
Keep an eye on the mail for your card. It is a red, white, and blue card printed on heavy card stock paper. It may be a good idea to laminated your card when you receive it so it stays in good shape over the years. Keep this card safe and treat it the same way you would treat your Social Security card. It will be very important going forward and you will need it throughout your retirement years.
If you are not already receiving Social Security income benefits or Railroad Retirement income benefits, then enrollment in Medicare Part A is not automatic and you will need to take action to sign up. Starting three months prior to your 65th birthday you can apply for Medicare Part A by contacting the Social Security Administration or, if you worked for the railroad, the Railroad Retirement Board.
Here is a list of ways you can contact these entities to enroll in Medicare Part A:
Online (at Social Security) - It's the easiest and fastest way to sign up and get any financial help you may need. (You'll need to create your secure my Social Security account to sign up for Medicare or apply for benefits)
Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772
What is my Cost-sharing under Part A?
Medicare Part A coverage will pay for a lot, however, you will have some cost-sharing that you are responsible for.
Each year CMS (The Center for Medicare Services) determines the Medicare Part A deductible and coinsurance that you will be responsible for during the following year. These are the cost-sharing amounts that you will pay when using your Part A benefits. In 2025, you can expect to pay:
A $1,632 deductible for EACH inpatient hospital stay when you have not been in the hospital during the previous 60 days.
$408 per day for days 61-90 of a consecutive hospital stay
$800 per day for days 91-150 of a consecutive hospital stay
Any and all costs past your lifetime reserve days
What are lifetime reserve days?
Unless you have a Medigap (Medicare Supplement) plan, Medicare Part A will give you 60 lifetime reserve days. These "reserve days" begin when you have a hospital stay lasting more than 90 consecutive days. For example, if you have a hospital stay that lasts 120 consecutive days, you will have used 30 of your lifetime reserve days.
If you later have another hospital stay that lasts 120 consecutive days, you will have used up 60 (30 + 30) of your lifetime reserve days total. Once you have used up all of your lifetime reserve days (60), you will be responsible for the full cost of hospitalization starting on day 91 for any hospital stay lasting longer than 90 days.
Cost for Skilled-nursing facilities
Medicare Part A covers the first 20 days in a skilled-nursing facility. In 2025 your copay for days 21-100 would be $204 per day. Medigap policies and Part C Medicare Advantage plans can help cover these costs and can help you significantly reduce your financial exposure.
Frequently asked questions about Medicare Part A:
How much is Medicare Part A?
Most people will have a $0 monthly premium for Medicare Part A as long as they have worked at least 10 years in the U.S. However, if you don't qualify for a $0 monthly premium, you could pay as much as $505 per month for Part A.
If you would like help with your Medicare insurance needs or want to learn more about Medicare hospital coverage, call our insurance experts at (866) 440-1885 for a FREE consultation.
How do I sign up for Medicare Part A only?
If you have creditable coverage through your employer or your spouse's employer, you can delay Medicare past age 65. However, many people will enroll in Part A for secondary hospital coverage. You can apply for Part A through the Social Security Administration.
What is the difference between Medicare Part A and Part B?
Medicare Part A is your inpatient hospital coverage, and Part B covers outpatient medical services.
Key Points
Before Medicare Part A helps cover most of your costs, you do need to meet the Part A deductible.
Medicare Part A helps cover your inpatient room and board, meals, hospice care, skilled nursing, and home health care.
Most people will qualify for premium-free Part A, but others may have a premium if they have not worked for at least 10 years in the U.S.
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