Medicare Part A is the hospital insurance component of Original Medicare. While most people are familiar with the concept of Medicare, many are surprised to learn exactly what Part A covers — and what it doesn’t — and how the cost structure works.
If you’re approaching Medicare eligibility, already enrolled, or helping a family member navigate their coverage, this guide explains everything you need to know about Medicare Part A in 2025.
What Is Medicare Part A?
Medicare Part A is one of two components that make up Original Medicare (the other is Medicare Part B, which covers outpatient care). Part A covers inpatient services — care you receive when you are formally admitted to a hospital, skilled nursing facility, or certain other facilities.
Part A is administered directly by the federal government through the Centers for Medicare & Medicaid Services (CMS). Coverage is standardized nationally — the same services are covered regardless of where you live.
What Does Medicare Part A Cover?
Inpatient Hospital Care
The primary function of Part A is covering inpatient hospital stays — situations where a doctor formally admits you to a hospital. Part A covers:
- Semi-private room (or private if medically necessary)
- Meals during your inpatient stay
- General nursing care
- Hospital services and supplies used during your stay
- Inpatient prescription drugs administered as part of your hospital care
- Physical, occupational, and speech therapy provided during the inpatient stay
- Operating room and recovery room services
- Intensive care and other special care units
Part A covers inpatient care at acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals.
What counts as “inpatient”? You are an inpatient when a doctor formally writes an order admitting you to the hospital. Simply being in a hospital overnight doesn’t make you an inpatient — if you’re there for “observation,” you are technically an outpatient and Part B (not Part A) covers your care. This distinction matters enormously for what you pay.
Skilled Nursing Facility (SNF) Care
Medicare Part A covers short-term care in a skilled nursing facility (SNF) — but only under specific conditions:
- You had a qualifying hospital stay of at least 3 consecutive inpatient days (observation days don’t count)
- You need skilled care — skilled nursing care, physical therapy, occupational therapy, or speech-language pathology services — not just custodial care (help with daily activities)
- You are admitted to the SNF within 30 days of your qualifying hospital stay
- A doctor certifies that you need daily skilled care
If you meet these conditions, Part A covers SNF care as follows:
| Days in SNF | What You Pay (2025) |
|---|---|
| Days 1–20 | $0 (fully covered) |
| Days 21–100 | $209.50/day coinsurance |
| After 100 days | 100% — Medicare pays nothing |
This 100-day limit is per benefit period, not per year. Many people are surprised to learn that Medicare doesn’t cover long-term nursing home care — only short-term skilled rehabilitative care.
Home Health Care
Medicare Part A (and Part B) covers home health care services when all of the following are true:
- A doctor certifies that you’re homebound (leaving home requires considerable effort)
- You need skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy
- The home health agency is Medicare-certified
Covered home health services include:
- Skilled nursing care (up to 8 hours per day, up to 28 hours per week in most cases)
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Medical supplies and certain durable medical equipment (partially)
Home health care is a covered benefit at no cost to you when the above conditions are met. There is no prior hospital stay required for home health under Part A (unlike SNF care).
Medicare does not cover custodial or personal care — help with bathing, dressing, eating, or other activities of daily living — unless skilled care is also being provided at the same time.
Hospice Care
Medicare Part A covers hospice care for terminally ill beneficiaries who:
- Have a life expectancy of 6 months or less (certified by a doctor)
- Choose comfort care (hospice) over curative treatment for the terminal illness
- Use a Medicare-approved hospice program
Hospice care is broadly covered. Part A covers:
- Physician and nursing services
- Medications for pain relief and symptom management
- Medical equipment (wheelchairs, walkers, etc.)
- Short-term inpatient care for symptom management
- Inpatient respite care (temporary placement in a facility to give family caregivers a break)
- Grief counseling for family members
Your cost for hospice care is minimal:
- $0 for most hospice care
- $5 or less for each prescription drug for pain and symptom management
- 5% of the Medicare-approved amount for inpatient respite care
Choosing hospice care means focusing on comfort rather than cure. If you decide to resume treatment or recover unexpectedly, you can revoke the hospice election at any time.
Inpatient Psychiatric Care
Medicare Part A covers inpatient care in a psychiatric hospital, up to 190 days in a lifetime. This is separate from the regular inpatient hospital benefit days and applies specifically to freestanding psychiatric hospitals.
Inpatient psychiatric care in a general hospital (rather than a freestanding psychiatric hospital) counts against your regular Part A benefit days.
What Part A Does NOT Cover
Understanding the limits of Part A is equally important:
- Custodial care — long-term nursing home care for help with daily activities is not covered by Medicare at all
- Most dental care, vision, and hearing care — not covered
- Outpatient care — covered under Part B, not Part A
- Outpatient prescription drugs — covered under Part D
- Private-duty nursing — not covered
- Care outside the United States — with very limited exceptions
The absence of long-term care coverage is a significant gap. Medicare is not a substitute for long-term care insurance.
How Much Does Medicare Part A Cost in 2025?
Premium
Most people pay $0 premium for Part A. You qualify for premium-free Part A if:
- You (or a spouse) worked and paid Medicare taxes for at least 40 quarters (10 years)
If you have 30–39 quarters of Medicare-covered employment, your Part A premium in 2025 is $285/month.
If you have fewer than 30 quarters of Medicare-covered employment, your Part A premium is $518/month.
These situations are relatively uncommon — most Americans qualify for premium-free Part A through their own or a spouse’s work history.
Benefit Period Deductible
Part A uses benefit periods rather than a simple annual deductible. A benefit period begins when you’re admitted to a hospital or SNF and ends when you’ve been out of the hospital or SNF for 60 consecutive days.
The Part A deductible applies per benefit period, not per year.
In 2025, the Part A deductible is $1,676 per benefit period.
If you’re hospitalized multiple times in a year and each stay is separated by more than 60 days, you pay the $1,676 deductible each time — unlike Part B’s single annual deductible.
Inpatient Hospital Coinsurance
After the deductible, Part A pays in full for the first 60 days of each inpatient hospital stay. For extended stays:
| Inpatient Days | Your Cost (2025) |
|---|---|
| Days 1–60 | $0 (after deductible) |
| Days 61–90 | $419/day |
| Days 91–150 | $838/day (lifetime reserve days) |
| After 150 days | 100% — Medicare pays nothing |
Lifetime reserve days: Each Medicare enrollee has 60 “lifetime reserve days” that can be used after the standard 90 inpatient days in a benefit period. These reserve days can only be used once — they do not reset each benefit period.
The Observation Status Problem
A significant issue many Medicare beneficiaries encounter: observation status. When hospitals place you on observation status rather than formally admitting you, you are legally an outpatient — even if you spend several nights in the hospital.
This matters for two reasons:
- Cost: Observation care is billed under Part B, not Part A. Your cost-sharing is different and potentially higher.
- SNF qualification: Days in observation status don’t count toward the 3-day qualifying inpatient stay needed for Part A to cover skilled nursing facility care.
Always ask your doctor or the hospital whether you have been formally admitted or are on observation status. If you’re in observation, ask whether admission is clinically appropriate for your situation.
How Part A Fits With Other Coverage
Part A + Part B together form Original Medicare — the foundation for most Medicare decisions.
With Medigap (Medicare Supplement): If you have Original Medicare and add a Medigap plan, the Medigap plan covers most of Part A’s cost-sharing: the deductible, the daily coinsurance, and often extra hospital days beyond Medicare’s limits. Plan G, the most popular Medigap plan, covers the Part A deductible and all coinsurance.
With Medicare Advantage (Part C): Medicare Advantage plans cover everything Part A and Part B cover, but through a private insurer. Your cost-sharing structure is different from Original Medicare and varies by plan.
When to Enroll in Part A
If you’re entitled to premium-free Part A, you should generally enroll at 65 even if you’re still working — there’s no premium, so there’s no cost to enrolling. Your Part A coverage won’t cost you anything.
If you pay a premium for Part A, the enrollment timing decisions parallel those for Part B. See our Medicare enrollment periods guide for the full enrollment timeline.
Key Takeaways
- Medicare Part A covers inpatient hospital stays, skilled nursing facility care (up to 100 days), hospice care, and some home health care
- Most people pay no premium for Part A if they’ve worked 40+ quarters
- The 2025 Part A deductible is $1,676 per benefit period — not per year — so multiple hospital stays can trigger multiple deductibles
- Part A does not cover long-term custodial care in a nursing home — only short-term skilled rehabilitative care
- Observation status is a common pitfall: if you’re not formally admitted, your stay isn’t covered by Part A and doesn’t count toward the SNF qualifying period
- Medigap plans (particularly Plan G) eliminate most Part A out-of-pocket costs after the deductible
Understanding Part A is one piece of the Medicare puzzle. For the full picture, see what Medicare Part B covers and how Medicare Advantage compares to Original Medicare.