When asking what does Medicare Part A cover, the answer centers around what the U.S. federal hospital insurance program provides to seniors and certain disabled individuals. As of 2025, Medicare Part A continues to cover inpatient hospital care, skilled nursing facility care, hospice care, and some limited home health care services. Most Americans receive premium-free Part A because they or their spouse paid Medicare taxes for at least 40 quarters (10 years).
In 2025, the inpatient hospital deductible under Part A has increased to $1,676 per benefit period, with coinsurance charges beginning after day 60 of a hospital stay. These updates affect millions of Medicare beneficiaries nationwide, highlighting the importance of understanding what is and isn’t covered under Part A.
Table of Contents
Overview of Medicare Part A Coverage
Medicare Part A, commonly known as hospital insurance, pays for inpatient care and related services deemed medically necessary. Below is a breakdown of the types of care covered under this part of Medicare:
1. Inpatient Hospital Care
- Coverage includes semi-private rooms, meals, general nursing, and other hospital services and supplies.
- Care received in critical access hospitals and inpatient rehabilitation facilities is also included.
- Mental health care received in an inpatient psychiatric facility may be covered for a limited number of days.
2. Skilled Nursing Facility (SNF) Care
- Medicare Part A covers a stay in a skilled nursing facility if the patient had a qualifying hospital stay of at least three consecutive days.
- Coverage is limited to a certain number of days per benefit period.
- The focus is on short-term, medically necessary rehabilitation services such as physical, occupational, or speech therapy.
3. Hospice Care
- Part A covers hospice services for patients who are terminally ill and have a life expectancy of six months or less.
- Coverage includes medical care, pain management, counseling, and support for both patients and their families.
- Hospice care can be received at home, in a hospice facility, or in a hospital setting.
4. Home Health Care
- Limited home health care services are covered when medically necessary and prescribed by a doctor.
- This includes part-time skilled nursing care, physical therapy, and medical social services.
- To qualify, the patient must be homebound and require intermittent skilled care.
What Medicare Part A Does Not Cover
Despite its broad benefits, there are many health services and costs that Medicare Part A does not cover. These include:
- Routine doctor visits and outpatient care (covered under Part B instead).
- Prescription drugs taken outside a hospital or hospice setting (covered under Part D).
- Long-term custodial care in nursing homes if only non-medical assistance is needed.
- Private rooms, except when medically necessary.
- Personal care items such as toothpaste, razors, or televisions in hospital rooms.
- Costs incurred after certain coverage limits have been reached in a benefit period.
2025 Medicare Part A Costs
Even for those who receive Part A at no monthly premium, there are important out-of-pocket costs in 2025. Below is a summary of key figures:
| Coverage Type | 2025 Cost |
|---|---|
| Monthly premium (for most people) | $0 |
| Monthly premium (if not eligible for free Part A) | Up to $518 per month |
| Inpatient hospital deductible per benefit period | $1,676 |
| Coinsurance for inpatient days 61–90 | $419 per day |
| Coinsurance for lifetime reserve days (beyond day 90) | $838 per day |
| Skilled nursing facility coinsurance (days 21–100) | $209.50 per day |
| Out-of-pocket maximum | No cap under Original Medicare |
Understanding the Benefit Period
A benefit period in Medicare Part A begins the day a patient is admitted to a hospital or skilled nursing facility as an inpatient. It ends once the patient has been out of the hospital or skilled nursing care for 60 consecutive days.
- If a person is readmitted after 60 days, a new benefit period begins, and they must pay the deductible again.
- There is no limit to the number of benefit periods a person can have in a year, meaning multiple hospitalizations can result in multiple deductibles.
How Medicare Part A Works in Practice
To illustrate, let’s look at an example:
A Medicare beneficiary is hospitalized for 15 days in 2025.
- The beneficiary pays the $1,676 deductible for that benefit period.
- There is no coinsurance for the first 60 days of hospitalization.
- If the patient remains hospitalized beyond 60 days, they pay $419 per day up to day 90.
- After day 90, they can use up to 60 lifetime reserve days, paying $838 per day.
For a skilled nursing facility stay following a qualifying hospital stay:
- Days 1–20: $0 coinsurance.
- Days 21–100: $209.50 per day.
- After day 100: the patient pays all costs.
Who Qualifies for Medicare Part A
Eligibility for premium-free Part A generally depends on work history:
- You or your spouse paid Medicare taxes for at least 10 years (40 quarters).
- You are age 65 or older and eligible for Social Security or Railroad Retirement benefits.
- You may also qualify under age 65 if you have certain disabilities or End-Stage Renal Disease (ESRD).
If you don’t meet these requirements, you can still buy Part A coverage, paying the full monthly premium.
Recent 2025 Changes and Updates
Medicare costs and deductibles are updated each year. For 2025:
- The inpatient hospital deductible increased to $1,676 (up from $1,632 in 2024).
- Daily coinsurance rates for hospital stays and skilled nursing facilities also rose slightly.
- The premium for people who must buy into Part A increased to a maximum of $518 per month.
These adjustments reflect inflation and rising healthcare costs across the United States.
Tips for Managing Medicare Part A Costs
- Understand benefit periods: Track hospital stays carefully to avoid multiple deductibles.
- Plan for out-of-pocket costs: Even with free premiums, hospital stays can lead to significant expenses.
- Consider supplemental coverage: Medigap (Medicare Supplement) plans can help cover Part A deductibles and coinsurance.
- Verify inpatient status: Ask whether your hospital stay is classified as inpatient (covered under Part A) or outpatient (covered under Part B), as this affects your costs.
- Explore Medicare Advantage: These plans may offer lower cost-sharing for hospital stays, though coverage rules differ.
Frequently Asked Questions (FAQ)
Q1. Does Medicare Part A cover doctor visits?
No. Routine doctor visits and outpatient services are covered under Medicare Part B, not Part A.
Q2. Is Medicare Part A completely free?
Not always. Most people pay no monthly premium, but everyone must pay the deductible and coinsurance when using services.
Q3. How many benefit periods can I have per year?
There is no limit. Each new hospitalization after a 60-day break triggers a new benefit period and a new deductible.
Q4. Does Medicare Part A cover long-term nursing home care?
No. It only covers skilled nursing care for a limited time following a qualifying hospital stay—not long-term custodial care.
Q5. Does Medicare Part A include prescription drug coverage?
Only in certain inpatient or hospice settings. Routine prescriptions must be covered under a separate Part D plan.
Q6. What is the difference between Medicare Part A and Part B?
Part A covers inpatient and facility-based services, while Part B covers outpatient medical services, doctor visits, and preventive care.
Disclaimer
This article provides factual and current information about Medicare Part A coverage and costs for 2025. It is intended for general informational purposes only and does not constitute legal, financial, or medical advice. Individuals should consult Medicare representatives or licensed advisors for personalized guidance.
Understanding what does Medicare Part A cover helps Americans make better healthcare decisions, prepare for hospital costs, and ensure financial stability in retirement. Stay informed, verify your eligibility, and review updates each year to maximize your Medicare benefits.
