Key Takeaways

• Medicare Part A in 2025 provides essential hospital-related coverage, but it does not cover everything, and many beneficiaries are surprised by the out-of-pocket costs.

• Understanding the limits, durations, and cost-sharing rules of Part A can help you avoid unexpected bills during hospital stays, skilled nursing care, and beyond.

What Is Medicare Part A?

Medicare Part A is one of the two core components of Original Medicare, alongside Part B. It focuses on inpatient care and is often referred to as hospital insurance. If you’re 65 or older and qualify based on your work history (typically 40 quarters or 10 years of Medicare-covered employment), you are entitled to Part A without a monthly premium. However, that does not mean you’ll never pay anything for services under Part A.

What Medicare Part A Covers in 2025

Medicare Part A primarily helps cover medically necessary inpatient care in various settings. In 2025, the following types of care fall under its coverage umbrella:

Inpatient Hospital Stays

Part A covers hospital stays when you are formally admitted by a doctor. This includes:

• Semi-private room

• Meals

• General nursing

• Drugs as part of your inpatient treatment

• Other hospital services and supplies

Covered hospital services must be medically necessary and provided in Medicare-approved facilities.

Skilled Nursing Facility (SNF) Care

Part A also covers short-term care in a skilled nursing facility following a qualifying hospital stay of at least three consecutive days. This is for recovery services like physical therapy or wound care. In 2025, the coverage includes:

• Up to 20 days: Fully covered

• Days 21–100: You pay a daily coinsurance of $209.50

• After day 100: You pay the full cost

Coverage resets with each new benefit period, which begins after you have not received inpatient care for 60 consecutive days.

Hospice Care

If you have a terminal illness and your provider certifies that you have six months or less to live, Part A covers hospice services. These include:

• Pain and symptom management

• Medical and nursing services

• Grief counseling for your family

• Certain drugs and medical equipment

Hospice care can be provided at home or in a Medicare-approved facility. You may need to pay small copayments for prescription drugs and respite care.

Home Health Services

In specific cases, Part A pays for limited home health care if you are homebound and require skilled services. These may include:

• Skilled nursing

• Physical or occupational therapy

• Speech-language pathology

While Part A pays the full cost for covered home health services, durable medical equipment such as wheelchairs or oxygen may be billed under Part B.

What Part A Does Not Cover

Understanding what isn’t covered is just as important. Medicare Part A does not include:

• Doctor’s services (even during an inpatient stay)

• Outpatient care

• Prescription drugs for ongoing use

• Long-term custodial care (e.g., help with bathing, dressing)

• Personal items during a hospital stay (TV, phone, toiletries)

These services may fall under Part B or require separate coverage.

Costs You’re Still Responsible for in 2025

While many assume Part A is free, the reality is you will likely pay out-of-pocket for several services. Here’s a breakdown of 2025 costs:

• Inpatient hospital deductible: $1,676 per benefit period

• Days 1–60 in hospital: No coinsurance after the deductible

• Days 61–90: $419 per day

• Days 91–150 (lifetime reserve days): $838 per day

• Beyond lifetime reserve days: You pay 100% of the cost

These costs can add up quickly if you face a prolonged illness or multiple hospitalizations within the same year.

What Is a Benefit Period?

Medicare uses benefit periods to track your use of hospital and SNF services. A benefit period starts the day you are admitted as an inpatient and ends when you have not received inpatient care for 60 days in a row.

There is no limit to the number of benefit periods you can have, but each new one requires you to pay the deductible again. This system can lead to repeated out-of-pocket expenses if you are hospitalized more than once in a year.

Lifetime Reserve Days Explained

Medicare gives you 60 lifetime reserve days that you can use after day 90 of a single hospital stay. You have only 60 for your entire lifetime, and once used, they do not reset. These days come with a higher daily coinsurance—$838 per day in 2025.

Once you exhaust these, you are fully responsible for the cost of hospital stays beyond 90 days per benefit period.

The Role of Medicare Part B and Other Coverage

Since Part A doesn’t cover everything, many beneficiaries also enroll in Part B, which helps cover:

• Doctor visits

• Outpatient services

• Preventive care

• Durable medical equipment

Part B requires a monthly premium and an annual deductible. It can work in tandem with Part A to offer more comprehensive coverage. Many people also explore supplemental insurance or Medicare Advantage plans to fill the gaps left by Parts A and B.

How to Enroll in Medicare Part A

You’re automatically enrolled in Part A when you turn 65 if you’re already receiving Social Security or Railroad Retirement benefits. If not, you need to sign up during your Initial Enrollment Period, which spans:

• 3 months before your 65th birthday

• Your birthday month

• 3 months after

If you miss this window, you may have to wait for the General Enrollment Period (January 1 to March 31) and face a delay in coverage and potential late penalties.

What If You’re Still Working at 65?

If you’re still working and have employer coverage, you may be able to delay enrolling in Part B without a penalty. However, most people sign up for Part A at 65 even if they’re still working, as it typically comes without a premium.

Make sure to speak with your benefits administrator to confirm whether your employer plan remains primary or becomes secondary once you’re eligible for Medicare.

Why Part A Isn’t Truly Free

Although you likely won’t pay a monthly premium, you did pay for Part A through payroll taxes during your working years. These taxes fund the Medicare Hospital Insurance Trust Fund. That’s why most people qualify for premium-free Part A—but again, it’s not free at the point of use.

In addition to the deductible and coinsurance costs, you should also account for:

• Multiple hospital stays in a year

• Unused or limited lifetime reserve days

• Non-covered services like custodial care or outpatient treatment

Common Misunderstandings About Medicare Part A

Many people are surprised to learn that:

• Observation stays in hospitals don’t count as inpatient care (and won’t qualify you for SNF coverage)

• Doctor fees during inpatient stays are billed separately under Part B

• Medicare does not cover 24/7 home care or assistance with daily activities

These misconceptions can result in unexpected bills if you assume that Part A covers more than it does.

Making the Most of Your Medicare Benefits

To make smart decisions about your healthcare in 2025, take the time to:

• Review your Medicare Summary Notices (MSNs) for billed services

• Ask whether you are being admitted as inpatient or under observation

• Understand the difference between hospital and skilled nursing care eligibility

• Consult with a licensed agent listed on this website to explore additional coverage options

What You Can Do Now to Stay Prepared

Being proactive about your Medicare coverage can help you avoid surprises later. Consider the following steps:

• Learn how benefit periods work and track your hospital visits

• Ask your provider to clarify what Medicare will and won’t cover

• Explore whether Medigap or other supplemental policies make sense for your situation

• Reassess your coverage needs annually, especially during Open Enrollment from October 15 to December 7

Understanding Part A Helps You Avoid Costly Mistakes

Even though Medicare Part A is widely available, few people fully grasp its limitations. Without this understanding, you may face substantial out-of-pocket costs during hospital stays, recovery periods, or hospice care.

If you want help reviewing your Medicare options or have questions about gaps in your Part A coverage, get in touch with a licensed agent listed on this website for personalized assistance.