Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people pay no monthly premium for Part A if they or their spouse paid Medicare taxes while working. You do pay a deductible of $1,676 per benefit period in 2025, plus daily coinsurance if your stay extends beyond 60 days.
Inpatient Hospital Care
The core of Part A is inpatient hospital coverage. Once you’re formally admitted as an inpatient, Part A pays for a semi-private room, meals, general nursing care, and medications administered as part of your treatment. It also covers operating and recovery room costs, lab tests, and other medically necessary services during your stay.
Your costs depend on how long you’re hospitalized within a single “benefit period.” A benefit period starts the day you’re admitted and ends once you’ve been out of the hospital (and not receiving skilled nursing care) for 60 consecutive days. Within each benefit period, here’s what you pay in 2025:
- Days 1 through 60: Nothing beyond the $1,676 deductible
- Days 61 through 90: $419 per day in coinsurance
- Days 91 and beyond: $838 per day, drawn from your lifetime reserve days
You get 60 lifetime reserve days total. These don’t reset with each benefit period. Once you’ve used all 60, you’re responsible for the full cost of any hospital days beyond day 90 in a benefit period. The benefit period itself, however, resets every time you go 60 days without inpatient care, meaning the deductible and day count start over.
Skilled Nursing Facility Care
Part A covers stays in a skilled nursing facility when you need daily skilled care like physical therapy, IV medications, or wound care. This is not the same as long-term custodial care, which Medicare does not cover. The care must require skilled medical professionals, not just help with daily activities like bathing or dressing.
To qualify, you typically need a prior inpatient hospital stay of at least three consecutive days (not counting the day you’re discharged). Time spent under “observation status” in the hospital doesn’t count toward those three days, which catches many people off guard. You must enter the skilled nursing facility within 30 days of leaving the hospital, and your doctor must certify that you need daily skilled care for a condition treated during your hospital stay or a new condition that developed while receiving skilled nursing care.
Part A covers up to 100 days per benefit period in a skilled nursing facility. The first 20 days are fully covered after the Part A deductible. Days 21 through 100 carry a daily coinsurance cost. After day 100, you pay everything out of pocket. Some Medicare Advantage plans and certain doctors participating in Accountable Care Organizations can waive the three-day hospital stay requirement, so it’s worth asking before assuming you won’t qualify.
Hospice Care
If you have a terminal illness and a doctor certifies that your life expectancy is six months or less, Part A covers hospice care. This benefit is broad and designed to keep you comfortable rather than cure the illness. Covered services include nursing care, prescription drugs for pain and symptom control, medical equipment like wheelchairs and walkers, physical and occupational therapy, counseling for both you and your family, and social worker services.
Hospice care also includes respite care, which gives your primary caregiver (often a family member) a break. You can stay in a Medicare-approved facility for up to five days at a time while your caregiver rests. You can use respite care more than once, though it’s intended for occasional use. Respite care is one of the few hospice costs you share: you pay 5% of the Medicare-approved amount.
Once you elect hospice, Medicare covers nearly all costs related to your terminal illness. You continue paying for any treatment of conditions unrelated to the terminal diagnosis under your regular Medicare benefits.
Home Health Services
Part A covers home health care when you meet specific conditions. You must be “homebound,” meaning that leaving your home is either a major physical effort, requires assistive devices like a wheelchair or walker, or isn’t recommended because of your condition. A health care provider must see you face-to-face, order the care, and a Medicare-certified home health agency must deliver it.
Covered services include part-time skilled nursing, physical therapy, occupational therapy, and speech therapy provided in your home. Home health aides who assist with personal care can also be covered as long as you’re also receiving skilled services. This benefit has no deductible and no coinsurance for the home health services themselves, making it one of the more affordable parts of Part A. It does not, however, cover full-time home care or help with household chores that aren’t related to your medical needs.
Inpatient Psychiatric Care
Part A covers mental health treatment when you’re admitted to a hospital. If you receive psychiatric care in a general hospital, the standard benefit period rules apply (the same day limits and coinsurance as any other inpatient stay). But if you’re treated in a freestanding psychiatric hospital, Part A imposes a lifetime cap of 190 days. Once those days are used, Part A will not pay for additional inpatient psychiatric hospital care regardless of medical need.
Blood Coverage
When you need blood during an inpatient stay, Part A covers it with one exception: the first three pints per benefit period. You’re responsible for those three pints, either by paying the hospital’s charges or by arranging to have the blood replaced through a blood bank or donation. If you replace the blood, you can’t be charged for it. Processing fees for storing and administering blood are covered from the first pint onward.
What Part A Does Not Cover
Part A’s scope is limited to the categories above. It does not cover long-term custodial care in a nursing home, which is the most common point of confusion. If you need help with daily activities but don’t require daily skilled medical care, that’s custodial care, and Medicare won’t pay for it.
Other notable exclusions: private rooms (unless medically necessary), private-duty nursing, routine dental care, hearing aids, eye exams for glasses, cosmetic surgery, and most care received outside the United States. Dental services are only covered in rare cases where they’re directly tied to a covered procedure, such as a heart valve replacement or an organ transplant.
What Most People Pay for Part A
Most people qualify for premium-free Part A based on their work history or their spouse’s. You need at least 40 quarters of coverage (roughly 10 years of paying Medicare taxes through payroll deductions) to avoid a monthly premium. If you don’t meet that threshold, you can still enroll in Part A, but you’ll pay a monthly premium that varies based on how many quarters you’ve earned.
Even with premium-free Part A, you’re still responsible for the $1,676 deductible each benefit period in 2025, plus any applicable daily coinsurance for longer stays. Many people purchase supplemental insurance (Medigap) specifically to help cover these out-of-pocket costs, particularly the coinsurance charges that add up quickly during extended hospitalizations.