Medicare Part A pays for hospital and hospice stays and some home health services. It is a part of Original Medicare, along with Medicare Part B, which covers services like doctor's visits and outpatient care.
Medicare Part A is free for almost everyone on Medicare.
You're enrolled in Medicare Part A automatically if you paid Social Security taxes through your job for at least 10 years. If you qualify due to a disability, you automatically get Medicare Part A after getting Social Security disability benefits for 24 months. In both cases, you don't have to pay anything for Medicare Part A.
What is Medicare Part A?
Medicare Part A is the part of Original Medicare that pays for hospital stays, skilled nursing facilities and hospice and home health care
Medicare is a federal health insurance program that covers people 65 and older. Some people younger than 65 may be eligible for Medicare if they have a qualifying disability or illness, such as Lou Gehrig's disease or kidney failure.
Medicare Part A is free if you paid federal income taxes for at least 10 years. The program is also free for anyone who has received Social Security disability benefits for 24 months.
What does Medicare Part A cover?
Medicare Part A covers inpatient hospital care, which can include surgery and lab work, room and meal charges, nursing care and other hospital services and supplies. Other covered Medicare Part A costs include:
Ask your doctor if Medicare will cover your medical costs, such as doctor visits, hospital stays or wheelchairs. You may have to sign a form called an Advance Beneficiary Notice of Noncoverage (ABN) if your doctor doesn't think Medicare will pay for a service or product.
This form states that you may be responsible for the charges if Medicare doesn't cover them.
Medicare Part A eligibility and enrollment
You must meet one of the following requirements to enroll in Medicare Part A.
- Over the age of 65
- Under the age of 65 with a disability
- Have permanent kidney failure that requires a regular course of dialysis or a kidney transplant, also called end-stage renal disease (ESRD)
- Have Lou Gehrig's disease (ALS)
You can sign up for Medicare Part A up to three months before you turn 65 (or if you have received Social Security benefits for 24 months due to a disability).
What if I don't qualify for free Medicare Part A?
If you don't qualify for free Medicare Part A by paying into Social Security, you won't be enrolled automatically. But you can buy Medicare Part A coverage through the Social Security Administration online or over the phone.
If you worked for a railroad, contact the Railroad Retirement Board (RRB) for information.
If you want to buy Medicare Part A coverage, you also must buy Part B.
To buy Part A and Part B (or just Part B), you need to sign up when you first become eligible for Medicare or during an open or special enrollment period.
- Initial enrollment period: The initial enrollment period is a seven-month time span that starts three months before you turn 65. It continues through the month you turn 65 and the three months following your 65th birthday.
- Special enrollment period: You may be able to enroll in Medicare without paying extra during a special enrollment period (SEP) based on certain qualifying life events. For example, if you waited to enroll in Medicare because you have coverage through your or a spouse's workplace.
- General enrollment period: If you have to buy Medicare Part A and you don’t qualify for a special enrollment period, you may have to wait for an open enrollment period to apply. This runs from Jan. 1 to March 31 each year. Your coverage would start the month after you sign up.
You'll get a monthly bill from Medicare if you don't get benefits from Social Security or the Railroad Retirement Board and have to pay for Medicare Part A. You pay for Part B every three months.
Medicare Part A costs in 2024
Medicare Part A is free for most people, but you can also buy it. Part A costs $505 per month if you paid Medicare taxes for less than 7 1/2 years. You'll pay $278 per month if you paid Medicare taxes for at least 7 1/2 years, but less than 10 years.
In most cases, if you choose to buy Part A, you must also have Medicare Part B (medical insurance).
If you're under age 65, you can get free Part A if you have Social Security or Railroad Retirement Board benefits, Lou Gehrig's disease, kidney failure or a qualifying disability.
Medicare Part A deductible
Even if you get Medicare Part A for free, you still have to pay $1,632 for medical services, also known as your deductible, before Part A kicks in. Unlike most health insurance deductibles, the Part A deductible does not go by calendar year. Instead it goes by a "benefit period" that begins the day you're admitted to the hospital and ends 60 days after you leave.
You pay the inpatient hospital deductible for each benefit period, but there's no limit to the number of benefit periods. If you're admitted to a hospital or skilled nursing facility within 60 days, the timer resets and you won't pay another deductible.
However, depending on how many days you've spent in the hospital you may need to pay a daily coinsurance which covers part of the cost of your stay.
For example, say you had an inpatient hospital stay and paid the full $1,632 deductible. You were discharged on March 1 and admitted again on April 15. Because your new hospital stay began within 60 days of the last visit, you would not be charged another Part A deductible. But, if you were readmitted in June, you would pay a new Part A deductible.
Medicare Part A coinsurance
After you meet your Medicare Part A deductible, you don't have to pay any costs for the first 60 days of your stay. Starting on day 61, you'll pay a daily charge, called coinsurance, for inpatient hospital and skilled nursing facility care.
All 10 Medicare Supplement plans will cover your Medicare Part A daily coinsurance.
Your inpatient hospital costs
|Unless you’ve already met your deductible in this benefit period
|$816/day coinsurance for each "lifetime reserve day"
|You have 60 of these over your lifetime.
If you paid your deductible within the past 60 days (during the same benefit period), you won't have to pay that amount again.
Your skilled nursing facility costs
|$0 coinsurance per day
|Up to $204 coinsurance per day
|You pay all costs
You must have a qualifying hospital stay (usually at least three days) before entering a skilled nursing facility.
Is there an alternative to Original Medicare?
Another Medicare option is Medicare Advantage (Part C). These plans have Medicare Part A, Part B and often Part D benefits. They're sold by private companies.
Medicare Advantage plans typically cover Part A and Part B deductibles and coinsurance, and often add benefits like prescription drug coverage, dental and vision. Medicare Advantage plans "bundle" your Original Medicare and additional benefits into one plan managed by a single insurance company.
Generally, if you are in good health with few medical costs, Medicare Advantage will save you money on your health care costs. But if you have serious medical conditions that require expensive treatment, Original Medicare with a Medigap plan may be the better choice.
When considering Medicare Advantage, it's best to compare multiple plans to get the option that best fits your health needs and budget.
Frequently asked questions
Can I get financial help for the cost of Medicare Part A?
If you must pay for Medicare Part A, and premiums or other costs are causing financial difficulty, your state may be able to help. Benefit programs include Medicaid, Medicare Savings Programs (MSPs) and the Program of All-Inclusive Care for the Elderly (PACE).
Your state Medicaid office has information on eligibility and how to apply.
Is there a fee for Medicare Part A?
You do not need to pay a monthly rate for Medicare Part A if you paid federal income taxes for at least a decade.
If you have not worked or paid taxes for this long, you can buy Medicare Part A for $505 a month if you worked less than 7 1/2 years, or $278 a month if you worked more than 7 1/2 years and less than 10 years.
Is my Medicare Part A or B?
You must have Medicare Part B if you're enrolled in Part A. However, it's possible to have Medicare Part B without Medicare Part A. If you're not sure if you have Part A or Part B, check the lower left hand corner of your red, white and blue Medicare card.
Benefit, cost and enrollment information found in this guide was sourced from Medicare.gov, CMS.gov and the Social Security website, SSA.gov.