Hospital Coverage Under Part A Ends Sooner Than Most People Expect

Key Takeaways

• Medicare Part A does not provide unlimited hospital coverage. In 2025, your coverage runs out faster than many expect, especially after 60 days of inpatient care in a benefit period.

• Once your coverage limits are reached, you face daily coinsurance costs or full out-of-pocket expenses unless you qualify for additional benefit periods under strict conditions.

What Part A Really Covers—and for How Long

Medicare Part A is often referred to as “hospital insurance.” In 2025, it continues to cover inpatient hospital care, skilled nursing facility (SNF) care, hospice care, and limited home health care services. But what you may not realize is that this coverage comes with strict timeframes and caps.

Understanding the Benefit Period

Coverage under Part A operates on a benefit period basis. This period begins the day you’re admitted as an inpatient and ends once you haven’t received any inpatient care for 60 consecutive days.

That means if you are hospitalized, your benefit period starts. Even if you go to a skilled nursing facility afterward, the same benefit period continues. Only after 60 days of no inpatient or skilled nursing care does a new benefit period begin.

Here’s why this matters: each benefit period resets your coverage limits but also resets your deductible. So while a new benefit period allows you to access a fresh set of covered days, it also brings new costs.

How Long Will Part A Pay for Hospital Stays in 2025?

You might assume Medicare covers an extended hospital stay without interruption, but it doesn’t. Here are the limits:

• Days 1–60: Medicare covers all approved hospital costs after the deductible is met.

• Days 61–90: You pay a daily coinsurance amount.

• Days 91–150: You use your 60 lifetime reserve days. Each day requires a higher coinsurance payment.

• After day 150: Medicare stops paying. You are responsible for 100% of the cost.

This structure means that once you exceed 90 days in a hospital during a single benefit period, you begin using a limited bank of 60 lifetime reserve days. Once those are gone, they are gone for good.

Skilled Nursing Facility Coverage Also Ends Quickly

Part A covers care in a skilled nursing facility, but only under very specific conditions:

• You must have had a qualifying three-day inpatient hospital stay.

• You must enter the SNF within 30 days of that hospital stay.

• The care must be medically necessary and follow your hospital treatment.

Here’s how long Part A covers SNF care:

• Days 1–20: Fully covered by Medicare.

• Days 21–100: You owe a daily coinsurance.

• After day 100: You pay all costs.

Again, this is per benefit period. So unless you qualify for a new benefit period by staying out of inpatient or SNF care for 60 consecutive days, you may face high out-of-pocket costs quickly.

Hospice and Home Health Coverage Have Their Own Limits

While Part A also includes hospice care and some home health services, these too have eligibility rules and limitations:

• Hospice care is available if your doctor certifies that you are terminally ill with a life expectancy of six months or less. You must agree to forgo curative treatment.

• Home health care is covered only if you are homebound and require skilled nursing or therapy. There is no set number of covered days, but care must be intermittent and reasonable.

These services are valuable but not unlimited, and they are not a substitute for long-term custodial care.

What Happens When Your Coverage Runs Out?

When you reach the end of your covered days in a hospital or SNF, Medicare stops paying entirely. That can lead to substantial bills:

• Hospital stays beyond 150 days in a benefit period

• Skilled nursing care after day 100

• Using up your 60 lifetime reserve days

At that point, you are responsible for the full cost of care unless you have other coverage like Medigap or qualify for Medicaid. Medicare Advantage plans may offer different coverage durations, but you must verify details before enrolling.

You Can Restart a Benefit Period—But It Comes with a Cost

To restart your Part A hospital or SNF coverage, you must stay out of inpatient or SNF care for 60 consecutive days. Only then will a new benefit period begin.

While that gives you access to another 60 fully covered hospital days, you’ll need to pay the inpatient deductible again, which in 2025 is $1,676 per benefit period.

This is one reason people are surprised by their bills: you can have multiple benefit periods in one year, each with its own deductible and cost-sharing responsibilities.

Lifetime Reserve Days: Use Them Wisely

Your 60 lifetime reserve days are a one-time extension of hospital coverage under Part A. Once you use them up, they are permanently gone. They do not reset with new benefit periods, and you cannot buy more.

In 2025, if you exceed 90 days in the hospital within one benefit period, Medicare automatically starts using these days unless you tell the provider not to.

• They carry higher coinsurance costs.

• They are not available for skilled nursing facility stays.

You may want to delay using these days unless absolutely necessary, especially if you expect future long hospitalizations.

Understanding the Gaps in Part A Protection

Part A offers essential benefits, but many gaps can expose you to high costs:

• Hospital stays beyond 150 days per benefit period

• No coverage for long-term custodial care or assisted living

• Limited SNF coverage, and only after a qualifying hospital stay

• No outpatient care (that’s under Part B)

This is where many Medicare beneficiaries discover the value of additional protection, such as Medigap policies or Medicaid for those who qualify. However, these are separate programs with their own rules and limitations.

Why the 2025 Structure Still Catches People Off Guard

Despite being decades old, Medicare Part A’s benefit design still causes confusion. In 2025, most people associate hospital coverage with continuous protection, but:

• Coverage is based on benefit periods, not calendar years.

• The reset clock only starts when you’ve been out of care for 60 straight days.

• You might pay the inpatient deductible multiple times in a year.

• You have only 60 lifetime reserve days, ever.

Understanding these timelines is key to avoiding surprises during an extended illness or recovery period.

When Should You Worry About Part A Limits?

You should start thinking seriously about Part A limits if:

• You or a loved one requires frequent hospitalizations.

• You are in a skilled nursing facility following surgery or a major illness.

• Your health condition may result in long-term inpatient care.

This is especially important in 2025, as hospital stays continue to rise in cost. Having a plan to handle what Medicare Part A doesn’t cover is a crucial part of protecting your finances and care options.

What You Can Do Right Now

To prepare for the limits of Part A coverage, consider the following actions:

• Review your Medicare Summary Notice (MSN) regularly to track how many inpatient days you’ve used.

• Understand benefit periods and how they affect your deductible and coverage.

• Explore supplemental options like Medigap or Medicaid if eligible.

• Consult a licensed agent listed on this website to go over your hospital coverage and out-of-pocket exposure.

Protecting Your Hospital Coverage in 2025 and Beyond

Medicare Part A provides a solid foundation for inpatient care, but it doesn’t cover everything. Many people are surprised to learn how quickly hospital and skilled nursing coverage ends under the benefit period model. In 2025, being informed is more important than ever.

Make sure you understand your benefit periods, keep track of your hospital days, and know when coinsurance and full-cost responsibilities begin. If you haven’t already, speak to a licensed agent listed on this website to help evaluate your options and minimize your exposure to surprise costs.