Medicare Part A is hospital insurance. It covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people don’t pay a monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years, but you’ll still face a deductible and coinsurance when you use services.
Inpatient Hospital Stays
The core of Part A is coverage for time spent as an inpatient in a hospital. This includes a semi-private room, meals, general nursing care, medications administered during your stay, and other hospital services and supplies. If you need surgery, lab tests, or intensive care while admitted, Part A covers those too.
The key word here is “inpatient.” If you’re at the hospital but classified under “observation status,” you’re technically an outpatient, and Part A won’t apply. This distinction matters more than most people realize, especially when it comes to qualifying for skilled nursing coverage afterward (more on that below). Always ask whether you’ve been formally admitted as an inpatient.
Part A also covers inpatient psychiatric care. If you’re treated in a general hospital’s psychiatric unit, the standard hospital rules apply. But if you’re in a freestanding psychiatric hospital, Part A has a lifetime cap of 190 days. Once you’ve used those 190 days across your entire time on Medicare, Part A won’t cover additional stays at that type of facility.
How Benefit Periods Work
Medicare doesn’t measure hospital coverage by calendar year. Instead, it uses “benefit periods.” A benefit period starts the day you’re admitted as an inpatient and ends once you’ve gone 60 consecutive days without receiving inpatient hospital or skilled nursing care. If you’re hospitalized again after that 60-day gap, a new benefit period begins, and your costs reset.
This matters because your deductible and coinsurance are tied to each benefit period, not to each hospital visit. If you’re discharged and readmitted within the same benefit period, you won’t pay the deductible again. But your day count keeps running from where it left off. There’s no limit on the number of benefit periods you can have over your lifetime.
What You Pay for Hospital Stays
For each benefit period in 2025, Part A coverage breaks down by how many days you spend in the hospital. The first 60 days are covered after you pay the deductible. Days 61 through 90 come with daily coinsurance on top of that. Beyond day 90, you dip into “lifetime reserve days,” a one-time pool of 60 extra days that carry a higher daily coinsurance. Once those lifetime reserve days are gone, they don’t renew.
One often-overlooked cost: blood. If the hospital has to purchase blood for you, you’re responsible for the first 3 pints per calendar year. You can avoid that charge if someone donates blood on your behalf.
Skilled Nursing Facility Care
Part A covers stays in a skilled nursing facility when you need daily skilled care like wound management, physical therapy, or intravenous therapy. But there’s a major prerequisite: you must first have a qualifying inpatient hospital stay of at least 3 consecutive days. The clock starts the day you’re admitted as an inpatient but doesn’t count the day you’re discharged. Observation hours don’t count toward those 3 days.
Coverage is limited to 100 days per benefit period. The first 20 days are fully covered after your hospital deductible. Days 21 through 100 require daily coinsurance of $209.50 in 2025 (up from $204.00 in 2024). After day 100, you’re responsible for all costs. Part A only covers skilled care in a certified facility. It does not cover long-term custodial care, which is the type of help most people think of when they picture a nursing home: assistance with daily activities like eating, dressing, and bathing when no skilled medical need exists.
Home Health Services
Part A covers home health care when you’re homebound and need skilled medical services on a part-time or intermittent basis. “Homebound” means leaving your home is a major effort because of illness or injury. You might need a wheelchair, walker, or another person’s help to get out. You can still qualify if you leave for medical appointments, religious services, or adult day care.
Covered home health services include:
- Skilled nursing care: wound care, injections, IV therapy, monitoring of serious or unstable conditions, and caregiver education
- Therapy: physical therapy, occupational therapy, and speech-language pathology
- Home health aide services: help with bathing, grooming, walking, feeding, and changing linens, but only if you’re also receiving skilled nursing or therapy
- Medical social services
- Durable medical equipment: items like hospital beds, wheelchairs, and walkers for use at home
- Medical supplies: wound dressings, catheters, and similar items
“Part-time or intermittent” generally means up to 8 hours of combined skilled nursing and aide services per day, capped at 28 hours per week. In some cases, your provider can authorize up to 35 hours per week for a short period. There’s no coinsurance or deductible for home health services covered under Part A.
Hospice Care
Part A covers hospice care for people with a terminal illness who choose comfort-focused treatment rather than curative care. A doctor must certify that life expectancy is 6 months or less. Once you elect hospice, your hospice team coordinates everything: medical care, pain management, emotional and spiritual support, and help for your family or caregiver.
Hospice coverage is notably comprehensive. It includes nursing visits, medications for pain and symptom control, medical equipment, counseling, and short-term respite care so caregivers can take a break. Your out-of-pocket costs are minimal: up to $5 per prescription for pain and symptom management drugs, and 5% of the Medicare-approved amount for inpatient respite care. The hospice benefit can be renewed if your condition persists, so there’s no hard time limit as long as you continue to meet eligibility.
What Part A Does Not Cover
Part A has clear boundaries. It does not pay for long-term custodial care in a nursing home, which is the gap that catches many people off guard. It also doesn’t cover most dental care (cleanings, fillings, extractions, dentures), routine eye exams for glasses, hearing aids or hearing exams for fitting them, cosmetic surgery, or massage therapy. Private hospital rooms aren’t covered unless medically necessary.
If a doctor or provider has opted out of Medicare entirely, Part A won’t cover their services except in emergencies. And any service that isn’t considered medically necessary, even if it takes place in a hospital, falls outside Part A’s scope. When you’re unsure whether something is covered, ask the hospital’s billing department before the service is provided. Getting a written notice of non-coverage gives you the option to appeal if you disagree with the decision.