What is Medicare Part A?
Medicare Part A is the hospital insurance component of Original Medicare. It covers inpatient care in hospitals, skilled nursing facilities, and hospice programs, as well as some home health services. Part A is one of two parts of Original Medicare — the other being Part B, which covers outpatient medical services.
Most people who are 65 or older and have worked for at least 10 years (40 quarters) paying Medicare taxes receive Part A without paying a monthly premium. This is often called "premium-free Part A." If you don't meet the work history requirement, you can still enroll in Part A by paying a monthly premium.
What Medicare Part A Covers
- Inpatient hospital stays (semi-private room, meals, nursing care)
- Skilled nursing facility (SNF) care after a qualifying hospital stay
- Hospice care for terminal illness
- Home health care (limited, medically necessary)
- Inpatient mental health care
- Blood transfusions (after first 3 pints)
- Long-term custodial care (nursing home care)
- Private-duty nursing
- Private room (unless medically necessary)
- Personal care items (TV, phone in hospital room)
- Most dental, vision, and hearing care
2026 Medicare Part A Costs
Hospital Inpatient Costs (per Benefit Period)
| Hospital Days | Your Cost | Coverage Status |
|---|---|---|
| Days 1–60 | $0 (after $1,736 deductible) | Full Coverage |
| Days 61–90 | $434/day coinsurance | Coinsurance Applies |
| Days 91–150 | $868/day (lifetime reserve days) | Reserve Days |
| Beyond 150 days | You pay all costs | No Coverage |
Skilled Nursing Facility (SNF) Costs
| SNF Days | Your Cost | Coverage Status |
|---|---|---|
| Days 1–20 | $0 | Full Coverage |
| Days 21–100 | $217/day coinsurance | Coinsurance Applies |
| Beyond 100 days | You pay all costs | No Coverage |
Who Qualifies for Medicare Part A?
Age 65 with Work History
You or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters). You receive premium-free Part A.
Disability (under 65)
You've received Social Security Disability Insurance (SSDI) benefits for 24 consecutive months. Enrollment is automatic.
ESRD or ALS
You have End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) or ALS (Lou Gehrig's disease) at any age.
Premium Part A (No Work History)
If you don't meet the work history requirement, you can buy Part A. In 2026: $311/month (30–39 quarters) or $565/month (fewer than 30 quarters).
When to Enroll in Part A
If you're already receiving Social Security benefits when you turn 65, you're automatically enrolled in Part A (and Part B) — no action required. If you're not yet receiving Social Security, you need to actively sign up during your Initial Enrollment Period (IEP).
Initial Enrollment Period (IEP)
A 7-month window centered on your 65th birthday month:
Unlike Part B, there is generally no late enrollment penalty for Part A if you qualify for premium-free coverage. However, if you must pay a premium for Part A and delay enrollment, you may face a 10% penalty added to your premium for twice the number of years you delayed.
What Part A Doesn't Cover
Medicare Part A has significant coverage gaps that can result in large out-of-pocket costs. Understanding these gaps is the first step toward choosing the right supplemental coverage.
Long-Term Custodial Care
Nursing home care for activities of daily living (bathing, dressing, eating) is not covered. Only skilled nursing care is covered, and only for up to 100 days.
No Out-of-Pocket Cap
There's no limit on what you can spend in a year. Multiple benefit periods or a very long hospital stay can cost tens of thousands of dollars.
Private Room Upgrade
Part A covers a semi-private room. If you want a private room, you pay the difference unless it's medically necessary.
Custodial Home Care
Part A covers skilled home health care (physical therapy, wound care) but not custodial care (help with daily activities) at home.