What medicare part a covers is one of the most important things to understand before turning 65. Medicare Part A is often called “hospital insurance” because it pays for inpatient care when you are admitted to a hospital. However, it covers far more than hospital stays alone. Part A also helps pay for skilled nursing facility care, hospice services, and certain home health visits.
Approximately 99% of Medicare beneficiaries receive Part A premium-free, according to CMS. For the remaining 1%, premiums can reach several hundred dollars per month. Understanding these benefits helps you avoid surprise bills and plan for out-of-pocket costs that Medicare does not fully eliminate.
What Medicare Part A Covers for Inpatient Hospital Stays
The core benefit of Part A is inpatient hospital coverage. When your doctor admits you to a hospital, Part A pays for a semi-private room, meals, nursing services, medications, and other medically necessary supplies. You pay the Part A deductible once per benefit period. In 2026, that deductible is $1,736. After meeting it, your first 60 days of inpatient care are fully covered with no daily coinsurance.
Stays beyond 60 days get more expensive. For days 61 through 90, you owe $434 per day in coinsurance. After day 90, you can tap into 60 lifetime reserve days at $868 per day. These reserve days do not renew. Once you use all 60, they are gone permanently. As a result, extended hospital stays can become very costly without supplemental coverage from a Medigap policy or Medicare Advantage plan.
A benefit period starts the day you are admitted as an inpatient. It ends after you have gone 60 consecutive days without receiving inpatient hospital or skilled nursing care. There is no limit on how many benefit periods you can have. Each new benefit period resets your deductible and day count.
Skilled Nursing, Hospice, and Home Health Benefits
Beyond hospital stays, what medicare part a covers extends to three additional categories of care. Skilled nursing facility care is available after a qualifying hospital stay of at least 3 consecutive days. Part A pays the full cost for the first 20 days in a skilled nursing facility. From day 21 through day 100, you pay $217 per day in coinsurance. After day 100, Part A coverage ends entirely. It is important to note that Part A does not cover long-term custodial care in a nursing home.
Hospice care is another significant Part A benefit. If a doctor certifies a terminal illness with a life expectancy of 6 months or less, Part A covers hospice services. These include pain management, counseling, medication for symptom control, and respite care for family caregivers. Most hospice services require little to no out-of-pocket cost. You can receive hospice care at home, in a hospice facility, or in a hospital setting.
Home health services round out what medicare part a covers. Part A pays for medically necessary part-time skilled nursing care and therapy services in your home. A doctor must order these services, and a Medicare-certified home health agency must provide them. Typically, you pay nothing for covered home health visits. In most cases, Part A handles the cost when you are homebound and need intermittent skilled care.
Eligibility, Enrollment, and What Part A Does Not Cover
Most people qualify for premium-free Part A at age 65. The requirement is 40 quarters of Medicare-covered employment — roughly 10 years of work history. Your spouse’s work record can also qualify you. If you already receive Social Security benefits, enrollment is automatic. Otherwise, you should sign up through the Social Security Administration during your Initial Enrollment Period, which begins 3 months before your 65th birthday.
People with fewer than 40 quarters can still buy Part A. Those with 30 to 39 quarters pay a reduced monthly premium. Those with fewer than 30 quarters pay the full premium. Late enrollment may also trigger a 10% penalty that lasts twice as long as the period you delayed. For example, if you waited 2 years to enroll, you would pay the penalty for 4 years.
Knowing what medicare part a covers also means knowing what it excludes. Part A does not pay for outpatient doctor visits, prescription drugs, dental care, vision exams, hearing aids, or cosmetic procedures. These services fall under Medicare Part B, Part D, or are not covered by Original Medicare at all. Additionally, Part A will not cover care that is not medically necessary. SHIP counselors in your state can help you understand gaps in your coverage and find solutions.
Frequently Asked Questions
Is Medicare Part A really free for most people?
Yes. If you or your spouse worked and paid Medicare taxes for at least 10 years, you qualify for premium-free Part A. Roughly 99% of beneficiaries meet this threshold. However, you still pay deductibles and coinsurance when you use services.
What medicare part a covers for skilled nursing — does it include long-term care?
No. Part A only covers up to 100 days per benefit period in a skilled nursing facility, and only after a qualifying 3-day hospital stay. Long-term custodial care, such as help with daily activities like bathing and dressing, is not covered. For that, you would need long-term care insurance or Medicaid.
What happens if I use all 60 lifetime reserve days?
Once your 60 lifetime reserve days are exhausted, Part A stops covering hospital stays beyond day 90 in any benefit period. At that point, you are responsible for 100% of the costs. As a result, many beneficiaries purchase a Medigap plan from insurers like Blue Cross, Aetna, or Mutual of Omaha to protect against these expenses. You can compare options at Medicare.gov.
What medicare part a covers — does it include emergency room visits?
Part A covers emergency care only if you are formally admitted as an inpatient. If you visit the emergency room but are treated and released — or held under observation status — those services typically fall under Part B instead. The distinction between inpatient admission and observation status significantly affects your out-of-pocket costs.
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Official Sources & Resources
For verified information on Medicare regulations and consumer protection:
- Medicare.gov (Official Site): medicare.gov
- CMS (Centers for Medicare & Medicaid Services): cms.gov
- NAIC (National Association of Insurance Commissioners): naic.org
- KFF Medicare Research: kff.org/medicare
- Social Security Administration: ssa.gov
Content last reviewed April 2026. If you notice any outdated information, please contact us.