What Does Medicare Part A Cover? Benefits, Costs & Limits

Medicare Part A is often called "Hospital Insurance," but that label doesn't capture the full picture. Understanding what does Medicare Part A cover requires looking beyond hospital stays to include skilled nursing facility care, hospice services, and certain home health benefits. If you're turning 65 or qualifying through a disability, knowing exactly what Part A pays for, and what it doesn't, can protect you from surprise medical expenses.

At Golden Health and Life Agency, we specialize in Medicare consultations and help clients sort through these details every day. We've seen how confusing the rules around coverage limits, deductibles, and benefit periods can be. This guide explains what Medicare Part A covers, outlines the costs you should expect, and identifies common coverage gaps so you can plan your healthcare with confidence.

What Medicare Part A covers

When people ask what does Medicare Part A cover, they typically think of hospital stays. That's accurate but incomplete. Part A includes four main categories of care: inpatient hospital services, skilled nursing facility stays, hospice care, and home health services under specific conditions. Each benefit type has its own rules about duration, eligibility, and what specific services qualify.

Inpatient Hospital Care

Part A covers your hospital room, meals, nursing care, and most medically necessary services when you're admitted as an inpatient. This includes semi-private rooms, intensive care units, operating and recovery rooms, medications given during your stay, lab tests, imaging services like X-rays and MRIs, and medical supplies. You also get coverage for blood transfusions after the first three pints, which you must either pay for or replace through donation.

Medicare Part A begins coverage the day you're formally admitted as an inpatient, not when you first arrive at the hospital.

Skilled Nursing Facility Care

After a qualifying three-day hospital stay, Part A covers up to 100 days in a skilled nursing facility per benefit period. The care must be medically necessary and ordered by a doctor. Coverage includes your semi-private room, meals, skilled nursing and rehabilitative services, and necessary medications. Days 1 through 20 have no coinsurance. Days 21 through 100 require a daily coinsurance payment ($204.00 in 2026).

Hospice and Home Health Care

Part A covers hospice services for terminally ill patients with a life expectancy of six months or less. This includes medical care, counseling, medications for symptom control, and short-term respite care. Home health care falls under Part A when you need intermittent skilled nursing, physical therapy, or speech therapy following a hospital or skilled nursing stay. You must be homebound and under a doctor-approved care plan.

What Part A does not cover

Understanding what does Medicare Part A cover becomes clearer when you know what it excludes. Part A focuses on acute, medically necessary care in specific settings, which means everyday medical expenses and long-term custodial care fall outside its scope. You'll need additional coverage through Medicare Parts B and D, or supplemental insurance, to fill these gaps.

Common Medical Expenses Not Covered

Part A does not pay for outpatient services like doctor visits, preventive screenings, or diagnostic tests performed outside a hospital admission. Prescription drugs you take at home are excluded, even if you needed them after a hospital discharge. Part A also won't cover private nursing or a private room in a hospital unless medically necessary, and you'll pay the difference if you request one for personal preference.

Long-term care in a nursing home is not covered by Medicare Part A when you only need help with daily activities like bathing or eating.

Everyday Health Needs Excluded

Most dental, vision, and hearing services remain outside Part A's coverage. This includes routine checkups, dentures, eyeglasses, and hearing aids. You also won't receive coverage for cosmetic procedures, acupuncture, or chiropractic care beyond limited exceptions. Custodial care that provides assistance with daily living activities, whether at home or in a facility, requires separate long-term care insurance or private payment.

What Medicare Part A costs in 2026

Most people pay no monthly premium for Medicare Part A because they or their spouse paid Medicare taxes for at least 10 years (40 quarters) during their working life. However, you still face out-of-pocket expenses through deductibles and coinsurance when you actually use Part A services. These costs reset each benefit period, which begins when you enter a hospital or skilled nursing facility and ends when you've gone 60 consecutive days without receiving inpatient care.

Premium-Free Part A

You qualify for premium-free Part A if you or your spouse worked and paid Medicare taxes for the required duration. If you have fewer than 40 quarters of coverage, you'll pay a monthly premium of either $285 or $518 in 2026, depending on your work history. Anyone receiving Social Security or Railroad Retirement benefits for at least four months automatically enrolls in Part A at age 65.

Deductibles and Coinsurance

Your Part A deductible stands at $1,676 per benefit period in 2026. You pay this amount once before Part A coverage begins for that hospital stay. Hospital stays lasting more than 60 days trigger daily coinsurance charges: $419 for days 61 through 90, and $838 for each lifetime reserve day beyond 90. Skilled nursing facility care requires $204 daily coinsurance for days 21 through 100.

Each benefit period resets your deductible, which means multiple hospitalizations in one year can result in paying the $1,676 deductible several times.

How Part A works with other Medicare parts

Medicare Part A functions as one piece of a larger coverage system that includes Parts B, C, and D. You need to understand how these parts interact because what does Medicare Part A cover represents only hospital-related services, while the other parts handle outpatient care, prescriptions, and alternative coverage options. Most people combine multiple parts to create complete health insurance protection.

Part B fills outpatient gaps

Medicare Part B covers services that Part A excludes, including doctor visits, outpatient procedures, preventive screenings, and durable medical equipment like wheelchairs or walkers. You pay a monthly premium for Part B (starting at $185 in 2026), plus an annual deductible and 20% coinsurance for most services. When you have both Part A and Part B, Medicare refers to this as Original Medicare.

Part A and Part B work together to cover the full spectrum of medically necessary care, from hospital stays to routine checkups.

Parts C and D expand coverage

Medicare Advantage (Part C) replaces Original Medicare by bundling Part A, Part B, and usually prescription drug coverage into one private insurance plan. You must have both Parts A and B to join a Part C plan. Medicare Part D adds standalone prescription drug coverage when you stick with Original Medicare. Most people need Part D because Part A only covers medications administered during inpatient stays.

How to use Part A without surprise bills

You can avoid unexpected costs by confirming your admission status before receiving care and verifying that facilities participate in Medicare. Knowing what does Medicare Part A cover helps you ask the right questions when you enter a hospital or skilled nursing facility, but you also need to understand your specific situation during each benefit period to prevent billing surprises.

Confirm Your Admission Status

Hospitals sometimes place you under observation status instead of admitting you as an inpatient, which means Part A won't cover your stay. You should ask your doctor to clarify your status within the first 24 hours and request written confirmation of inpatient admission. Observation stays fall under Part B, which has different cost-sharing rules and won't count toward the three-day requirement for skilled nursing facility coverage.

Always verify you've been formally admitted as an inpatient, not placed under observation, to ensure Part A coverage applies.

Choose Medicare-Participating Facilities

You reduce billing complications when you use Medicare-certified hospitals and skilled nursing facilities. Non-participating providers can charge you more than Medicare's approved amounts or refuse to accept Medicare assignment. Before scheduling any non-emergency procedure, confirm the facility accepts Medicare and ask about estimated out-of-pocket costs based on your current benefit period status.

What to do next

You now understand what does Medicare Part A cover and how it fits into your overall Medicare plan. Part A handles hospital stays, skilled nursing care, hospice services, and limited home health benefits, but leaves significant gaps in outpatient care, prescriptions, and long-term custodial needs. Your next step involves reviewing your current coverage to identify where you might face exposure to unexpected costs or service denials during the coming year.

Start by checking whether you need to enroll in Part B for doctor visits and outpatient services, or Part D for prescription drug coverage. Compare your out-of-pocket costs under Original Medicare versus Medicare Advantage plans to find the option that matches your health needs and budget. Consider whether a Medigap policy would help cover deductibles and coinsurance. If you have questions about benefit periods, coinsurance amounts, or which supplemental coverage makes sense for your situation, professional guidance can save you money and prevent coverage surprises.

Contact Golden Health and Life Agency for personalized Medicare consultation. We help clients navigate Medicare's complexities and find coverage that protects both their health and financial security.