Medicare Part A Hospital Coverage: What It Covers and What It Costs

Medicare Part A is often called "hospital insurance" -- and for most people, it is premium-free. But the cost structure for Part A services is unique and can be confusing. Here is a complete guide to what Part A covers and what you can expect to pay.

Most Medicare beneficiaries pay no premium for Part A:

• You or your spouse worked and paid Medicare taxes for at least 40 quarters (10 years)
• You receive or are eligible for Social Security or Railroad Retirement benefits

If you have fewer than 40 quarters of work:

• 30-39 quarters: $259/month premium (2021)
• Fewer than 30 quarters: $471/month premium (2021)

Part A covers medically necessary inpatient hospital care including:

• Semi-private room and board
• General nursing care
• Meals
• Medications administered during your stay
• Operating and recovery room
• Intensive care
• Lab tests, X-rays, and other diagnostic services
• Rehabilitation services during your stay

Does NOT cover: Private room (unless medically necessary), private-duty nursing, personal convenience items (TV, phone), or the first 3 pints of blood.

After a qualifying 3-day inpatient hospital stay, Part A covers up to 100 days of SNF care per benefit period (see our SNF coverage guide for details).

Part A covers hospice care for terminally ill beneficiaries who elect comfort care over curative treatment (see our hospice guide for details).

Part A covers some home health services -- skilled nursing and therapy -- for homebound beneficiaries. (Part B also covers home health in certain circumstances.)

Part A costs are organized around benefit periods -- not calendar years. A benefit period begins the day you are admitted to a hospital or SNF and ends when you have been out of a hospital or SNF for 60 consecutive days.

There is no limit on the number of benefit periods -- but each new benefit period comes with a new deductible.

Lifetime reserve days: You have 60 lifetime reserve days -- days 91-150 of a single hospital stay. Once used, they are gone permanently.

Medigap Plan G covers:

• The Part A deductible ($1,484 per benefit period)
• Hospital coinsurance for days 61-90 ($371/day)
• Lifetime reserve day coinsurance ($742/day)
• SNF coinsurance for days 21-100 ($217/day)
• An additional 365 days of hospital coverage after Medicare benefits are exhausted

With Plan G, a hospitalization of any length costs you nothing beyond the Part B deductible -- regardless of how many benefit periods you use in a year.

Patients in the hospital are either formally admitted as inpatients (covered under Part A) or placed under observation status (covered under Part B). Observation status does not count toward the 3-day qualifying stay for SNF coverage and can result in significantly higher out-of-pocket costs.

Always ask your care team whether you are admitted as an inpatient or under observation.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.