Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people qualify for premium-free Part A at age 65 if they or a spouse paid Medicare taxes for at least 10 years (40 quarters) of work. Here’s what each benefit includes and what you’ll pay out of pocket.
Inpatient Hospital Stays
This is the core of Part A. When you’re admitted to a hospital as an inpatient, Part A covers your semi-private room, meals, general nursing care, medications, and other hospital services and supplies related to your treatment. The key word here is “inpatient.” If you’re placed under observation status, even overnight, that counts as outpatient care and falls under Part B instead. This distinction matters more than most people realize, especially when it comes to qualifying for nursing facility coverage afterward.
For 2026, here’s how the cost sharing breaks down per benefit period:
- Days 1 through 60: You pay the $1,736 deductible once, then $0 per day.
- Days 61 through 90: You pay $434 per day in coinsurance.
- Lifetime reserve days (up to 60 total): You pay $868 per day. These are a one-time bank of extra days you can use if a hospitalization stretches past 90 days. Once they’re gone, they don’t renew.
A “benefit period” starts the day you’re admitted as an inpatient and ends when you’ve been out of the hospital or skilled nursing facility for 60 consecutive days. If you’re readmitted after that, a new benefit period begins and you pay the deductible again.
Skilled Nursing Facility Care
Part A covers up to 100 days per benefit period in a skilled nursing facility, but only when you meet specific conditions. You must have a qualifying inpatient hospital stay of at least 3 consecutive days (not counting the discharge day), enter the facility within 30 days of leaving the hospital, and need daily skilled care like physical therapy or intravenous medications.
The 3-day rule trips people up frequently. Time spent in the hospital under observation status does not count toward those 3 days, even if you were there for several nights. Only time classified as an inpatient admission qualifies.
For the cost sharing in 2026:
- Days 1 through 20: $0 per day after you pay the $1,736 deductible.
- Days 21 through 100: $217 per day.
- Days 101 and beyond: You pay the full cost. Part A coverage stops entirely.
It’s worth emphasizing: this is not long-term care coverage. Part A pays for short-term rehabilitation and skilled nursing after a hospital stay. If you need ongoing custodial care (help with daily activities like bathing or dressing without a skilled medical need), Medicare does not cover it.
Hospice Care
Part A covers hospice care when a doctor certifies a life expectancy of 6 months or less. To qualify, you accept comfort-focused care instead of treatments aimed at curing your terminal illness, and you sign a statement choosing hospice. This doesn’t mean you lose all Medicare coverage. You still have benefits for any conditions unrelated to your terminal diagnosis.
Hospice takes a team approach covering medical, physical, emotional, and spiritual needs. It also supports family members and caregivers. Your hospice benefit should cover everything related to your comfort and symptom management, including nursing visits, pain medication, medical equipment, and counseling. You pay a copayment of up to $5 for each outpatient prescription for pain and symptom management. There’s no deductible for hospice services.
Hospice care is typically provided at home, though it can include short inpatient stays for pain or symptom management that can’t be handled in a home setting.
Home Health Services
Part A covers certain home health services if you’re considered “homebound” and need part-time or intermittent skilled care. Being homebound means leaving your home requires considerable effort due to illness or injury, whether that means needing a wheelchair, special transportation, or another person’s help.
Covered services include:
- Skilled nursing care: wound care, injections, IV therapy, nutrition therapy, monitoring of serious or unstable conditions, and patient or caregiver education.
- Therapy: physical therapy, occupational therapy, and speech-language pathology.
- Medical social services.
- Home health aide care: help with bathing, grooming, walking, feeding, and changing bed linens, but only if you’re also receiving skilled nursing or therapy services at the same time.
Home health aide visits alone don’t qualify. There has to be a skilled care need driving the services. When you do qualify, Part A covers these services with no deductible and no coinsurance.
Inpatient Psychiatric Care
Part A covers inpatient mental health care in both general hospitals and freestanding psychiatric hospitals, but with one important limit. If you receive care in a specialty psychiatric hospital, Medicare imposes a lifetime cap of 190 days. Once you’ve used those 190 days across your entire lifetime, Part A will not pay for additional care in that type of facility. This limit does not apply to psychiatric care received in a general hospital’s psychiatric unit.
Blood
If you need blood during a covered hospital stay or at a skilled nursing facility, Part A covers it with one catch: you’re responsible for the first 3 pints per calendar year. You can either pay the cost of those 3 units or arrange for donated blood to replace them. After the first 3 pints, Part A covers the rest.
What Part A Does Not Cover
The biggest gap in Part A is long-term custodial care. If you need ongoing help with daily activities but don’t require skilled medical services, Medicare won’t pay for it, whether that care happens at home or in a facility. This is the coverage gap that catches many families off guard, particularly when a parent with dementia needs full-time assistance.
Part A also does not cover private-duty nursing, personal convenience items like a phone or television in your hospital room, or a private room unless medically necessary. Concierge medicine arrangements and any care that isn’t deemed medically necessary are excluded as well.
Who Qualifies for Premium-Free Part A
Most people don’t pay a monthly premium for Part A. You qualify for premium-free coverage at 65 if you or your spouse earned enough work credits through Medicare-taxed employment, generally 40 quarters (10 years). People under 65 can also qualify through disability or end-stage renal disease.
If you don’t have enough work credits, you can still buy Part A by paying a monthly premium. That premium can increase by up to 10% if you were eligible to enroll but delayed signing up without qualifying for a special enrollment period.