Understanding
Part A
Hospital Insurance
Part A helps cover inpatient hospital stays, short-term skilled nursing facility care, hospice, and some home health care. Most people don’t pay a monthly premium for Part A if they’ve worked and paid Medicare taxes long enough.
Premium Cost
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For most people: $0/month because they or a spouse paid Medicare taxes long enough (generally 40 quarters/10 years) to get “premium-free” Part A.
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If you don’t qualify for premium-free Part A:
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$285/month in 2025 if you had at least 30 quarters of coverage (but fewer than the 40).
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​$518/month in 2025 for those with fewer than 30 quarters (or certain disability categories)
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Dedutible
(Per Benefit Period)
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$1,676 for each inpatient hospital benefit period in 2025.
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A “benefit period” begins the day you’re admitted and ends when you’ve been out of the hospital/SNF for 60 days in a row. Each new benefit period you may pay a new deductible.
Inpatient Hospital Stay
(Cost-Sharing)
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Days 1-60: After you pay the deductible, you pay $0 per day.
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Days 61-90: $419 per day.
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Days 91-150: $838 per day (using your “lifetime reserve days”).
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After day 150: You pay all costs yourself.
Skilled Nursing Facility
(SNF) Stay cost-sharing
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Days 1-20: $0 per day.
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Days 21-100: $209.50 per day.
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Days 101+: You pay all costs.
Cost for Part A (Original Medicare)
Medigap (Supplement Plans)
Premium Cost
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options.$0-premium, though many counties offer $17 per month Advantage plan premiums are about Average Medicare
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You must continue paying your Medicare Part B premium ( $185 in 2025 ).
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View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Dedutible
(Per Benefit Period)
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Most Medicare Advantage (HMO/PPO) plans have no medical deductible for Part A/B services.
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Some plans may include a small annual deductible, typically $0 – $250 depending on plan design.
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View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Inpatient Hospital Stay
(Cost-Sharing)
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Typical inpatient cost is a daily copay of $200 – $350 per day for the first 3 – 7 days, then $0 per day thereafter for in-network hospital care.
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Costs count toward the plan’s annual out-of-pocket max ($3,500 – $8,300 typical).
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View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Skilled Nursing Facility
(SNF) Stay cost-sharing
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After a qualifying hospital stay, most plans charge $0 per day for days 1-20,
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Then $175 – $225 per day for days 21-100, depending on plan and network.
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All charges apply toward your plan’s annual in-network out-of-pocket maximum.
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View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Medicare Advantage (Part C)
When It Applies
You’re formally admitted to the hospital as an inpatient (not “observation”). Emergencies don’t need prior authorization; non-emergencies often do.
What's Covered
Room/board (semi-private room), meals, nursing, medications and supplies while admitted, operating room/ICU, labs, imaging, and other medically necessary inpatient services.
How Long You're
Covered
As long as the stay is medically necessary and your plan continues to authorize care (you’ll be notified if status or coverage changes).
What You'll Pay
Plan-set cost sharing—many plans charge a daily copay for the first few days (e.g., days 1–5), then often $0 after that; exact amounts vary by plan and network. Costs count toward your plan’s annual Part A/B out-of-pocket maximum. You must keep paying your Part B premium.
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Always ask: “Am I admitted as an inpatient or under observation?”
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Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
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Premium note: You must keep paying Part B (and Part A if not premium-free).
Inpatient Hospital Care
When It Applies
Short-term rehab in a Skilled Nursing Facility after a qualifying inpatient hospital stay (observation doesn’t count), or as allowed by your MA plan. Use an in-network, Medicare-certified SNF; prior authorization may be required.
What's Covered
Semi-private room/board, skilled nursing, physical/occupational/speech therapy, medications and supplies related to rehab, and medical social services. Not long-term custodial care.
How Long You're
Covered
Up to 100 days per benefit period as long as you continue to meet skilled-care criteria and the plan approves.
What You'll Pay
Often $0 for early days, then a per-day copay for later days—amounts vary by plan and network. Costs apply toward your plan’s annual Part A/B out-of-pocket maximum.
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Use an in-network, Medicare-certified SNF and get prior auth first.
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Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
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Premium note: You must keep paying Part B (and Part A if not premium-free).
Skilled Nursing Facility (SNF)
When It Applies
You’re homebound and your doctor orders part-time/intermittent skilled home health care from a Medicare-certified, in-network agency (prior authorization may apply).
What's Covered
Skilled nursing; physical/occupational/speech therapy; home health aide when skilled care is in place; medical social services; certain medical supplies from the agency. (Durable medical equipment is billed separately under Part B.)
How Long You're
Covered
Services are reviewed regularly and typically recertified every 60 days; they continue as long as you remain homebound, the care is medically necessary, and the plan approves.
What You'll Pay
Typically $0 for covered home health services with an in-network agency. You pay your plan’s cost share for DME (often about 20%); amounts vary by plan and supplier. Keep paying your Part B premium.
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Not 24/7 care; help with bathing/meals alone doesn’t qualify without a skilled need.
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Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
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Premium note: You must keep paying Part B (and Part A if not premium-free).
Home Health
When It Applies
You choose comfort-focused care for a terminal illness (your doctors certify life expectancy of 6 months or less). In Medicare Advantage, hospice is generally covered by Original Medicare; your MA plan still covers non-hospice benefits.
What's Covered
Care for pain and symptom control: physician and nursing services, home health aide, medications, medical equipment and supplies, social work and counseling, chaplain/grief support, short-term inpatient care, and short-term inpatient respite care.
How Long You're
Covered
Two 90-day periods, then renewable 60-day periods as long as you remain eligible and are recertified. You may change hospices once per period or revoke hospice at any time.
What You'll Pay
Usually $0 for hospice services; up to about $5 per prescription for symptom-control/pain-relief drugs; 5% of the Medicare-approved amount for inpatient respite care. You may owe your plan’s normal costs for care not related to your terminal illness.
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You can revoke hospice anytime to resume curative treatment.​
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Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
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Premium note: You must keep paying Part B (and Part A if not premium-free).
Hospice
Quick Basics about Part A
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Most people pay no monthly premium for Part A if they worked and paid Medicare taxes long enough.
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You’ll have a deductible and daily cost-sharing for longer hospital or skilled nursing stays.
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Part A does not cover long-term custodial care, private-duty nursing, or most dental/vision/hearing services.
***Disclaimer: The information above describes Medicare Advantage (Part C) plan coverage for Part A services. Costs, copays, coinsurance, and coverage rules vary by plan and provider network. This is not a description of Original Medicare. You must continue to pay your Medicare Part B premium.