What Is Medicare Part A? Hospital Coverage and Eligibility Explained

Medicare Part A is the hospital insurance component of Medicare, covering inpatient hospital care, skilled nursing facility services, hospice care and some home health services. About 99% of enrollees pay no monthly premium because they or their spouse paid Medicare taxes for at least 40 quarters, per CMS. It's one of four parts of the federal program, alongside Part B for outpatient care, Part D for prescription drugs and Medicare Advantage as a private bundled alternative. 

• Inpatient hospital care
• Skilled nursing facility care (requires a prior 3-day qualifying inpatient hospital stay)
• Hospice care (requires physician certification of terminal illness with a life expectancy of six months or less)
• Some home health care (requires meeting Medicare's homebound criteria)

Part A eligibility starts at age 65 for U.S. citizens and permanent legal residents with at least five consecutive years of U.S. residency. If you or your spouse paid Medicare taxes for at least 40 quarters, you pay no monthly premium. Those with 30 to 39 quarters pay $311 per month in 2026; those with fewer than 30 quarters pay $565 per month, per CMS.

Part A covers four service categories: inpatient hospital care, skilled nursing facility care, hospice care and home health services. Each category has distinct eligibility conditions and cost-sharing rules. What Medicare Part A doesn't cover is just as important to understand before you enroll, since gaps like long-term custodial care and prescription drugs require separate coverage.

After you meet the $1,736 benefit-period deductible in 2026, Part A covers your inpatient hospital stay, per CMS. Days 1 through 60 carry no additional cost-sharing. From day 61 through 90, co-insurance runs $434 per day, and lifetime reserve days (a one-time pool of 60 days) cost $868 per day. Inpatient mental health care at freestanding psychiatric hospitals carries a 190-day lifetime cap; no such cap applies inside general hospital psychiatric units. 

Covered:

• Semi-private room, meals and general nursing care
• Hospital services, supplies and equipment
• Inpatient mental health care (190-day lifetime limit at freestanding psychiatric hospitals only) 
  

Not covered:

• Private duty nursing or private rooms unless medically necessary
• Personal items such as toiletries, TV and phone charges
• Physician fees during your stay, billed separately under Part B

Part A covers skilled nursing facility (SNF) care only after a qualifying inpatient hospital stay of at least three consecutive days. Observation status and outpatient time don't count toward this requirement. Three days minimum, billed as inpatient. You must enter the SNF within 30 days of discharge, and re-entering within 30 days of leaving doesn't require another 3-day hospital stay. But after day 100, Part A pays nothing.

Covered services include skilled nursing care, physical and occupational therapy, speech-language therapy, meals, dietary counseling, medical social services, medications and supplies used at the facility, and ambulance transport to essential services unavailable at the SNF when other transport would endanger your health.

Two physicians must certify a life expectancy of six months or less for Part A's hospice benefit to apply, and you must choose comfort care over curative treatment. Care can be delivered at home or in a Medicare-approved facility. You pay up to $5 per prescription for outpatient symptom-control drugs and 5% of the Medicare-approved amount for inpatient respite care, per Medicare.gov. 

But Part A won't cover curative treatment, drugs intended to cure the terminal illness, services from non-hospice providers, or room and board unless your hospice team arranges inpatient or respite care.

Part A covers home health when a doctor certifies you as homebound (meaning leaving home requires considerable effort) and orders skilled care. Your doctor must complete a face-to-face visit before certifying you. Covered services cost nothing. You pay 20% co-insurance for durable medical equipment at home, per Medicare.gov. Occasional outings for appointments or adult day care don't affect your homebound status. 

Covered under this benefit: part-time skilled nursing care, physical and occupational therapy, speech-language therapy, medical social services, part-time home health aide services when provided alongside skilled nursing, injectable osteoporosis medications for women, and durable medical equipment and supplies for home use.

Part A doesn't cover services outside its four categories or items that don't meet clinical thresholds. Prescription drugs taken at home require a standalone Part D plan or a Medicare Advantage plan that bundles drug, hospital and medical coverage in one policy. 

• Dental care, dentures and routine orthodontics
• Routine vision care and prescription eyeglasses
• Hearing aids and routine hearing exams
• Long-term custodial care (help with bathing, dressing and daily activities)
• Private duty nursing or private rooms unless medically necessary
• Personal comfort items
• Prescription drugs taken at home
• Most medical care outside the United States

About 99% of enrollees pay nothing for Part A because they paid Medicare taxes for at least 40 quarters, per CMS. Those with 30 to 39 quarters pay $311 per month; those with fewer than 30 quarters pay $565 per month. Your actual costs beyond the premium depend on how long you stay in a hospital or skilled nursing facility. The $1,736 benefit-period deductible and daily co-insurance for extended stays are the gaps Medicare Supplement plans are built to cover.

Most people are automatically enrolled in Medicare Part A when they turn 65 if they already receive Social Security or Railroad Retirement Board benefits. If you aren't automatically enrolled, you must act during your Initial Enrollment Period, a seven-month window starting three months before your 65th birthday. Enrolling in those first three months starts coverage on the first day of your birthday month.

Part A provides hospital insurance that most Americans pay nothing for in retirement, covering inpatient care, skilled nursing stays, hospice services and home health at no monthly premium for the 99% of enrollees who paid Medicare taxes for at least a decade. The $1,736 per-benefit-period deductible and daily co-insurance for extended stays are real costs worth planning for before you need care.

We've answered the most frequently asked questions about Medicare Part A coverage, costs and eligibility: