Medicare Part A: Hospital Insurance
Medicare Part A is known as "Hospital Insurance" and covers inpatient care in hospitals, skilled nursing facilities, hospice care, and some home health services. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working.
Part A Coverage
Inpatient Hospital Care
| Coverage | What's Included |
|---|
| Semi-private room | Room and board |
| Meals | All meals during stay |
| General nursing | Nursing care |
| Drugs | Medications as inpatient |
| Lab tests | Blood work, urinalysis, etc. |
| X-rays | Diagnostic imaging |
| Operating room | Surgical suite and supplies |
| Medical supplies | Bandages, casts, equipment |
Other Part A Covered Services
| Service | Description |
|---|
| Skilled Nursing Facility (SNF) | Up to 100 days following 3-day hospital stay |
| Home Health Care | Intermittent skilled nursing, therapy at home |
| Hospice Care | End-of-life care for terminal illness (6-month prognosis) |
| Inpatient Psychiatric | Limited to 190 lifetime days in psychiatric hospital |
Key Point: Part A does NOT cover custodial or long-term care. SNF coverage requires a qualifying 3-day hospital stay and skilled care needs.
2025 Part A Costs
Part A Premiums
| Work History | 2025 Monthly Premium |
|---|
| 40+ quarters (10+ years) | $0 (premium-free) |
| 30-39 quarters | $285/month |
| Less than 30 quarters | $518/month |
Part A Deductibles and Coinsurance
| Cost | 2025 Amount |
|---|
| Inpatient hospital deductible | $1,676 per benefit period |
| Days 1-60 | $0 coinsurance after deductible |
| Days 61-90 | $419/day coinsurance |
| Days 91-150 (Lifetime Reserve) | $838/day coinsurance |
| Beyond 150 days | All costs (no coverage) |
Skilled Nursing Facility Costs
| Days | 2025 Cost |
|---|
| Days 1-20 | $0 coinsurance |
| Days 21-100 | $209.50/day coinsurance |
| Beyond 100 days | All costs (no coverage) |
Benefit Periods Explained
What is a Benefit Period?
| Component | Definition |
|---|
| Starts | Day you're admitted as inpatient |
| Ends | 60 consecutive days after discharge |
| Resets | Deductible applies again with new benefit period |
| No limit | Unlimited number of benefit periods |
Benefit Period Example
| Timeline | What Happens |
|---|
| January 1 | Admitted to hospital (benefit period begins) |
| January 10 | Discharged after 10 days |
| Days 1-60 after discharge | Still in same benefit period |
| Day 61+ after discharge | Benefit period ends |
| Next admission | New benefit period, new deductible |
Exam Tip: The Part A deductible is per BENEFIT PERIOD, not per year. Someone hospitalized multiple times in a year could pay the deductible multiple times if 60+ days pass between stays.
Lifetime Reserve Days
What Are Lifetime Reserve Days?
| Feature | Details |
|---|
| Total available | 60 days lifetime |
| When used | Hospital stays exceeding 90 days |
| 2025 coinsurance | $838/day |
| Renewable | Never—once used, they're gone |
| Election | Can choose not to use (preserve for future) |
Using Reserve Days
| Scenario | Days Used |
|---|
| 100-day hospital stay | 10 lifetime reserve days used |
| Future 95-day hospital stay | 5 more lifetime reserve days used |
| Remaining reserve | 45 days left for lifetime |
What Part A Does NOT Cover
Excluded Services
| Service | Why Not Covered |
|---|
| Private rooms | Unless medically necessary |
| Private-duty nursing | Beyond general nursing needs |
| Television/telephone | Personal convenience items |
| Personal items | Toothbrush, razor, slippers |
| Custodial care | Non-skilled personal care |
| Long-term care | Extended nursing home stays |
Custodial vs. Skilled Care
| Type | Description | Covered? |
|---|
| Skilled care | Requires licensed medical professionals | Yes |
| Custodial care | Help with daily activities (bathing, dressing) | No |
| Rehabilitation | Physical, occupational, speech therapy | Yes |
| Maintenance care | Keeping condition stable (not improving) | Limited |
Key Point: Medicare Part A covers SKILLED care, not CUSTODIAL care. If someone only needs help with daily activities without medical treatment, Part A will not cover their stay.