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
-
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.
-
If you don’t qualify for premium-free Part A:
-
$311/month in 2026 if you or your spouse paid Medicare taxes for 30–39 quarters.
-
$565/month in 2026 for those with fewer than 30 quarters (or certain disability categories)
-
Dedutible
(Per Benefit Period)
-
$1,736 for each inpatient hospital benefit period in 2026.
-
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)
-
Days 1-60: After you pay the deductible, you pay $0 per day.
-
Days 61-90: $434 per day.
-
Days 91-150: $868 per day (using your “lifetime reserve days”).
-
After day 150: You pay all costs yourself.
Skilled Nursing Facility
(SNF) Stay cost-sharing
-
Days 1-20: $0 per day.
-
Days 21-100: $217 per day.
-
Days 101+: You pay all costs.
Cost for Part A (Original Medicare)
Medigap (Supplement Plans)
Premium Cost
-
Some Medicare Advantage Plans have a $0 plan premium. Premiums and other costs vary by plan.
-
You must continue paying your Medicare Part B premium to stay in your plan.
-
View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Dedutible
(Per Benefit Period)
-
Deductibles vary by Medicare Advantage Plan. Some plans may have a $0 medical deductible
-
Some plans may have separate deductibles for certain services or prescription drugs.
-
View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Inpatient Hospital Stay
(Cost-Sharing)
-
Inpatient hospital costs vary by plan. Many Medicare Advantage Plans charge a copayment for each of the first several days of an inpatient hospital stay. Your specific copayment or coinsurance depends on your plan.
-
In-network Part A and Part B costs count toward the plan’s annual out-of-pocket limit. The limit varies by plan.
-
View Summary of Benefits / Evidence of Coverage (SOB-EOC)
Skilled Nursing Facility
(SNF) Stay cost-sharing
-
-
Skilled Nursing Facility copayments and coverage requirements vary by Medicare Advantage Plan. Some plans may waive Medicare’s 3-day inpatient hospital stay requirement. Check your plan for specific costs and coverage requirements..
-
-
All charges apply toward your plan’s annual in-network out-of-pocket maximum.
-
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
Your copayment or coinsurance for an inpatient hospital stay varies by Medicare Advantage Plan. In-network Part A and Part B costs count toward your plan’s annual out-of-pocket limit. You must continue paying your Part B premium to stay in your plan.
-
Always ask: “Am I admitted as an inpatient or under observation?”
-
Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
-
Premium note: You must keep paying Part B (and Part A if not premium-free).
Inpatient Hospital Care
When It Applies
Short-term skilled nursing or rehabilitation care when you meet your Medicare Advantage Plan’s coverage requirements. Your plan may require an inpatient hospital stay before SNF care, or it may waive that requirement.
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
Coverage for Skilled Nursing Facility care varies by Medicare Advantage Plan. Check your plan’s Evidence of Coverage for coverage requirements and limits.
What You'll Pay
Your copayment or coinsurance for Skilled Nursing Facility care varies by Medicare Advantage Plan. Check your plan for specific costs.
-
Use an in-network, Medicare-certified SNF and get prior auth first.
-
Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
-
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 a doctor or other health care provider orders part-time or intermittent skilled home health care from a Medicare-certified home health agency.
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
Home health services can continue as long as you meet Medicare’s eligibility requirements and continue to need part-time or intermittent skilled services.
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.
-
Not 24/7 care; help with bathing/meals alone doesn’t qualify without a skilled need.
-
Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
-
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). If you're in a Medicare Advantage Plan, Original Medicare covers your hospice care. Your Medicare Advantage Plan can still cover services that aren't related to your terminal illness or related conditions.
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.
-
You can revoke hospice anytime to resume curative treatment.
-
Plans differ: Copays, prior auth, and networks vary by plan/county—see your EOC.
-
Premium note: You must keep paying Part B (and Part A if not premium-free).
Hospice
Quick Basics about Part A
-
Most people pay no monthly premium for Part A if they worked and paid Medicare taxes long enough.
-
You’ll have a deductible and daily cost-sharing for longer hospital or skilled nursing stays.
-
Original Medicare does not cover long-term custodial care, private-duty nursing, or most routine dental, vision, and 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.