Key Takeaways
- Medicare Part AMedicare Part A is hospital insurance, which covers the care you receive while admitted to a hospital, skilled nursing facility, or other inpatient facility. Medicare Part A is part of Original Medicare. provides coverage to U.S. citizens age 65 and older for inpatient stays in hospitals and similar medical facilities.
- Part A covers inpatient surgeries and lab tests, as well as drugs related to the inpatient stay.
- Part B of Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). covers medical services, including doctors.
- Medicare generally defines a hospital stay that qualifies for Part A coverage as “two or more nights of medically necessary hospital care.”
Medicare Part A is hospital insurance, helping to manage the costs of inpatient care. Part A works alongside Medicare Part B, which covers outpatient and medical services. Together, Part A and Part B form Original Medicare, the U.S. public health insurance program for older adults and people with certain disabilities.
Medicare Advantage plans (Part C) plans from private insurance carriers are required to offer at least the same level of coverage as Original Medicare, including Part A hospital coverage.
While people who have paid Medicare taxes through work for at least 10 years (and their spouses) don’t have to pay a monthly premium, it’s important to understand the Medicare Part A cost structure. Part A doesn’t pay for every expense related to inpatient care, so you should know what’s covered, what’s not, and what defines a qualifying hospital stay.
Still have questions? GoHealth has the answers you need.
Call TodayWhat Does Medicare Part A Cover?
Medicare Part A covers many of the expenses you may incur during a hospital stay, and it also covers inpatient services in semi-private rooms at similar facilities. For example, Part A covers short-term care in a skilled nursing facility or nursing home if you’re receiving doctor-approved treatment for a medical condition stemming from an inpatient hospital stay. Hospice care is also covered if you are terminally ill and accept palliative care for comfort instead of treatment for your illness.
Here’s a look at what Part A covers and corresponding costs:
- Inpatient hospital care: After you meet your deductible, Part A covers 100% for days 1-60. The deductible for an inpatient hospital stay in 2025 is $1,676. For a stay longer than 60 days, you will pay coinsurance.
- Skilled nursing facility stay: Part A covers 100% for days 1-20.
- Home health care: Part A covers 100% for eligible services. You pay 20% of the Medicare-approved amount for durable medical equipment.
- Hospice care: Part A covers 100%. You may pay up to $5 per prescription and 5% for inpatient respite care.
Most people get Medicare Part A without paying a monthly premium. However, for those who don’t meet the requirements of premium-free Part A, Medicare Part A costs can be $285 or $518 a month in 2025, based on how long you or your spouse worked and paid Medicare taxes.
Excluded From Part A Coverage
Even if Medicare Part A covers most of the costs for an inpatient stay, your coverage won’t include:
- A private room (unless medically necessary)
- Private-duty nursing
- Television and phone in your room (if there’s a separate charge for these items)
- Personal care items (like razors or slipper socks)
You are admitted when a doctor formally orders you to be treated as an inpatient after determining that your condition requires hospital care. It’s important to note that being in a hospital bed or receiving care in the emergency room or observation unit does not necessarily mean you have been admitted. You must receive an official inpatient designation to qualify for a Medicare Part A-covered stay.
Do All Hospitals Accept Medicare Part A?
Nearly all U.S. hospitals accept Medicare Part A. According to the American Hospital Association, 96% of hospitals receive payment either from Medicare or from Medicaid, the public health insurance program for U.S. adults with limited incomes, for at least half of inpatient days.
Notable exceptions include Veterans Affairs (VA) hospitals, which provide care to U.S. military veterans who qualify for VA benefits. These hospitals don’t bill Medicare.
Medicare Advantage and Part A
Every Medicare Advantage plan offers, at minimum, the same Part A and B coverage as Original Medicare. Often, Medicare Advantage plans go beyond what Original Medicare offers by including extra benefits, such as coverage for vision, dental, hearing, or even gym memberships.
Unlike Original Medicare, Medicare Advantage plans protect you with an annual out-of-pocket maximum — a dollar amount specific to your plan that limits how much you will have to pay out of your pocket for covered care in a plan year.
However, while Medicare Part A is accepted at hospitals across the country, Medicare Advantage plans are not. Plans vary based on where you live, and each plan has a provider network. To make the fullest use of your benefits, you generally must go to in-network hospitals, doctors, and pharmacies.
Inpatient vs. Outpatient Care
The key difference between inpatient and outpatient care is whether you are formally admitted to the hospital. You aren’t considered an inpatient until a doctor’s order formally admits you, even if you stay the night. You will be admitted if a healthcare provider determines that you need to stay through two midnights.
If your stay doesn’t meet the requirements of an inpatient stay, you usually need coverage from Medicare Part B. Part B is medical insurance and covers many outpatient expenses.
What to Know About Observation Stays
Observation stays can be confusing because they blur the line between inpatient and outpatient. Even if you spend multiple days receiving care in the hospital, you might still be classified under “observation status.” Why does this matter? Medicare Part A only covers inpatient hospital stays, and observation status falls under Medicare Part B.
Find the Medicare Plan that works for you.
Find My Ideal PlanPart A Terminology to Understand
To fully understand your Medicare Part A coverage, it helps to know some important terms:
- Benefit period: Measures your use of hospital and skilled nursing care under Part A. A benefit period begins the day you’re admitted and ends after you’ve been out of the facility for 60 days.
- Lifetime reserve day: On top of your covered days for a benefit period, Medicare Part A provides 60 additional hospital days, called lifetime reserve days. You begin to use lifetime reserve days after you’ve been hospitalized for more than 90 days in a single benefit period.
- Medically necessary: Original Medicare only covers services that are medically necessary, which includes tests or treatment needed to diagnose or treat an illness, injury, or condition based on accepted medical standards.
How Part A Works With Part B
Original Medicare’s two parts (A and B) work together to cover your healthcare needs. Medicare Part A will typically cover the costs of hospital stays, surgeries, and care in a skilled nursing facility, while Part B covers doctor visits, durable medical equipment, and preventative services.
For example, imagine you are admitted to the hospital for a medically necessary surgery and require physical therapy after being released. Part A will cover the care and services you received while you were admitted to the hospital. Once you are home, Medicare Part B will step in to help cover the costs of your follow-up doctor visits and physical therapy sessions.
If you require prescription medications at home, Original Medicare typically does not cover these. Instead, you would need a separate Medicare Part D prescription drug plan or Medicare Advantage Prescription Drug Plan (MAPD).
Get real Medicare answers and guidance – no strings attached.
Get Help NowPutting It All Together
Medicare Part A has you covered for an inpatient hospital stay, skilled nursing care, hospice and some home health care. Knowing what Part A covers – and what it doesn’t – can help you plan for potential healthcare costs. By understanding how Part A works within Original Medicare, you can ensure you have the coverage you need to stay healthy and secure.
Sources
- Inpatient hospital care. Medicare.gov.
- Skilled nursing facility (SNF) care. Medicare.gov.
- Are You a Hospital Inpatient or Outpatient? Medicare.gov.
Fact Sheet: Majority of Hospital Payments Dependent on Medicare or Medicaid. American Hospital Association.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.