Updated on 4/17/2024

For many people who are becoming Medicare eligible, there is often a lot of confusion surrounding Medicare and what each part does and does not cover. Here we take a look at Medicare Part A, what it covers, what your associated costs are and how it works together with Medicare Part B.  For a quick overview of all the parts of Medicare, please visit our Medicare 101 page.

What is Part A?

Part A is what is referred to as your hospital insurance. It covers inpatient hospital stays including acute hospital, skilled nursing, inpatient mental health care, and hospice. Part A coverage also includes blood after the first three units and some home health care services (home health care is also covered under Part B). 

What it’s not

For the most part, think of Part A as covering room and board only if you are ever admitted to a hospital. Part A does not cover any costs pertaining to doctors, surgeries, lab work, diagnostic and preventative services or even ambulance transport. All of these types of services are covered under Medicare Part B. This is why it is so important that you have both Part A and Part B – so much so that Medicare will enforce a penalty if you do not enroll in Part B when you are first eligible (NOTE: if you are covered under an employer or union group health plan or retiree plan, you can waive Part B while you are covered under that health plan without being penalized). To find out more about Part B, tap here.

Do I have to sign up for Part A?

People who have worked for at least 10 years and have paid into Medicare via payroll taxes during that time are automatically enrolled in Part A upon turning 65. The Social Security Administration will mail you your Medicare card, along with other pertinent documents and instructions, usually about a month or two prior to your 65th birthday. If you have chosen to draw Social Security benefits prior to turning 65 you will also be automatically enrolled in Part B. Your Medicare card will reflect that you have both Part A and Part B with the effective date being the 1st of the month in which you turn 65. If you wait until age 65 or older to draw Social Security benefits, then your Medicare card may reflect that you have Part A only. At this point, unless you are still working and covered under your employer’s group health plan or are retired and covered under a retiree plan, you will have to sign up for Part B manually. Tap here for information on how to sign up for Part B. 

People who have not worked in the U.S. for at least 10 years and/or have not paid into Medicare via payroll taxes will have to manually apply for Part A. People in this situation will also have to pay a premium for Part A (see “What costs are associated with Part A?” below). 

What costs are associated with Part A?

2024 Part A Premiums

People who have paid into Medicare through payroll taxes for at least 40 quarters – which is 10 years or more - do not pay any premiums for their Part A (this is sometimes referred to as “premium free Part A”). In 2024, if a Medicare eligible person has paid into Medicare less than 30 quarters, their Part A monthly premium is $505. If a Medicare eligible person has paid into Medicare between 30 – 39 quarters, their Part A monthly premium is $278.

2024 Part A Cost Sharing (what you are responsible for)

Inpatient hospital (includes acute care hospitals, critical

access hospitals, inpatient rehabilitation facilities, long-term care

hospitals, inpatient care as part of a qualifying clinical research study, 

and mental health care):

The Part A inpatient hospital deductible is $1,632 for the first 60 days

Days 61– 90 there is a $408 per day co-pay

Days 91 and beyond there is a $816 per day co-pay

Skilled nursing:

$0 for the first 20 days

Days 21 – 100 there is a $204 per day co-pay

(Medicare covers up to 100 days of skilled nursing per benefit period)

Hospice:

You pay nothing for hospice care

Up to $5 per prescription for pain and symptom management drugs

You pay 5% for inpatient respite care

Home health care:

You pay nothing for home health services

Things to Consider

Medicare Part A does not cover 100% of expenses related to inpatient hospitalization. Out of pocket costs in regards to any kind of inpatient care - in addition to chargers associated with Medicare Part B - could quickly become very expensive. To limit your financial exposure to costly medical expenses consider enrolling in either a Medicare supplement plan or Medicare Advantage plan.