In 2021, Medicare Part A (Hospital Insurance) covered inpatient hospital stays, skilled nursing facility care, hospice, and limited home health services. Most individuals paid no premium for Part A if they worked 40+ quarters, though the 2021 inpatient hospital deductible was $1,484 per benefit period.
Medicare Part A, or Hospital Insurance, primarily covers inpatient care like hospital stays, skilled nursing facility (SNF) care (after a qualifying hospital stay), hospice care, and some home health services, focusing on acute or short-term needs rather than everyday medical care. It pays for inpatient hospital care, room & board, nursing, and medications in facilities, but you pay deductibles and coinsurance for extended periods, with a lifetime limit on inpatient psychiatric care days in a separate facility.
Medicare Part A doesn't help cover doctors' appointments, but Medicare parts B and C do. Instead, Medicare Part A helps cover doctors' services and other essential care if you receive inpatient care in a hospital, skilled nursing facility, or another healthcare center.
Inpatient stay
Days 1-60: $0 after you pay your Part A deductible. Days 61-90: $434 each day. Days 91-150: $868 each day while using your 60 lifetime reserve days. After day 150: You pay all costs.
With a few exceptions, Original Medicare doesn't include coverage for prescription drugs. It also does not cover health care benefits you may have been used to getting with an employer plan such as dental, vision, hearing health care or wellness items like fitness memberships.
Here are some of the biggest Medicare mistakes to avoid:
Medicare Part B covers ER visits, but you still pay a deductible and 20% of costs. Part A helps only if you're admitted to the hospital. Medigap can help cover ER costs if you have Original Medicare. Medicare Advantage plans (which replace Original Medicare) cover ER care and may offer lower copays or extra services.
Medicare Part A (Hospital Insurance)
Most people get Part A for free, but some have to pay a premium for this coverage. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child.
No, Medicare Part A does not cover 100% of hospital bills; beneficiaries pay a deductible per benefit period, followed by daily coinsurance for longer stays (days 61-90, plus lifetime reserve days), meaning you're responsible for costs beyond Medicare's approved amounts unless you have a supplemental plan like Medigap or Medicare Advantage. While Part A covers many inpatient services like semi-private rooms, meals, and general nursing after the deductible, significant out-of-pocket costs remain for extended hospitalizations.
In general, Medicare Part A helps pay for inpatient care you get in hospitals, critical access hospitals, and skilled nursing facilities. It also helps cover hospice care and some home health care.
Original Medicare (Part A and Part B) is what most people think of when they think of Medicare. But basic Medicare provides less-than-comprehensive insurance, for two reasons: It does not cover 100% of your medical costs. It does not cover prescription medications.
Medicare covers medically necessary lab work and blood tests, including some preventative screenings at set frequencies. However, it doesn't cover routine or annual blood work. Knowing the difference between routine and medically necessary can help you make more efficient use of your Medicare benefits.
Medicare Part A does not typically cover outpatient surgery. Part A is hospital insurance. It covers inpatient hospital care and services. Outpatient surgery is covered by Medicare Part B.
The Medicare "3-Day Rule" requires a beneficiary to have a qualifying 3-day inpatient hospital stay (admission day counts, discharge day doesn't) before Medicare will cover services in a Skilled Nursing Facility (SNF) for rehabilitation or skilled care, though this rule can be waived in certain Medicare Advantage plans or through specific Accountable Care Organization (ACO) initiatives. Time spent in observation or the Emergency Department doesn't count towards these 3 days, but new demonstration projects and waivers are emerging to offer more flexibility for patients needing SNF care.
Medicare Part A helps cover short-term care in a skilled nursing facility (nursing home), but it's important to understand the restrictions. Medicare pays up to 100% for the first 20 days of skilled nursing care that follows a hospital stay of three days or more.
Part A helps pay for inpatient stays in hospitals and skilled nursing facilities, some home health care, and end-of-life hospice care. Part B covers doctors' services, diagnostic screenings, lab tests, preventive services, outpatient care and some medical equipment and supplies, and transportation.
Medicare Part B premiums are automatically deducted from Social Security checks, with the standard amount for 2026 being $202.90/month, but this can increase based on your income (IRMAA). Most people pay $0 for Medicare Part A, while Part C (Advantage) and Part D (Drug) plans also have premiums that can be deducted, depending on the plan and your choices.
Some of the items and services Medicare doesn't cover include:
Once you meet your deductible, Part A will pay for days 1–60 that you are in the hospital. For days 61–90, you will pay a coinsurance for each day. If you need to stay in the hospital for longer than 90 days, you can use up to 60 lifetime reserve days.