Key Takeaways
-
While Medicare Part A covers inpatient hospital care, it does not eliminate all costs. You may still face deductibles, daily coinsurance, and other out-of-pocket charges.
-
The financial impact of a hospital stay can escalate quickly if your stay extends beyond 60 days, or if you require post-acute care such as skilled nursing or home health services.
Understanding What Part A Covers—and What It Doesn’t
Medicare Part A, also known as hospital insurance, provides coverage for inpatient care in hospitals, skilled nursing facilities, hospice, and some home health care. Many individuals qualify for premium-free Part A based on their work history, leading to a common belief that hospital-related costs are fully covered once you’re enrolled. But that’s not the full story.
In 2025, you’re responsible for more than just your health when you’re hospitalized—you’re also responsible for a range of out-of-pocket expenses that can add up quickly. Let’s break down what those costs look like.
The 2025 Medicare Part A Deductible
Each benefit period begins when you’re admitted to a hospital and ends after you’ve been out for 60 days in a row. For each benefit period, you’re responsible for a deductible of $1,676 before Part A pays anything.
This deductible is not annual—it applies to each new benefit period. That means if you’re hospitalized multiple times in a year with at least a 60-day gap between stays, you may have to pay the deductible more than once.
Daily Coinsurance Beyond Day 60
Once your hospital stay exceeds 60 days within the same benefit period, daily coinsurance charges begin:
-
Days 61–90: $419 per day
-
Days 91–150 (Lifetime Reserve Days): $838 per day
You only have 60 Lifetime Reserve Days to use throughout your life. Once they’re gone, you must pay all costs for days beyond 90 in any benefit period.
What Happens After 150 Days in the Hospital?
After you’ve used all 60 of your Lifetime Reserve Days, Medicare Part A will no longer cover additional days in the hospital. At that point, you’re responsible for 100% of the cost for every additional inpatient day.
This is why it’s crucial to plan for extended care or chronic conditions that may lead to prolonged hospitalizations.
Skilled Nursing Facility Costs
If you require care in a Skilled Nursing Facility (SNF) after a qualifying hospital stay of at least 3 days, Medicare Part A covers some of the cost:
-
Days 1–20: $0 coinsurance (covered in full)
-
Days 21–100: $209.50 per day
-
Beyond 100 days: You pay the full cost
SNF care is not long-term custodial care. It’s focused on rehabilitation—such as physical therapy, occupational therapy, or skilled nursing following an injury, surgery, or illness. If your recovery takes longer than 100 days, you must plan for the full cost of ongoing care.
Hospice Coverage Comes with Conditions
Medicare Part A covers hospice care if your doctor certifies that you’re terminally ill with a life expectancy of 6 months or less. While there is no cost for hospice services related to your terminal illness, there can be other expenses:
-
A copayment of up to $5 per prescription for pain relief and symptom control
-
5% of the Medicare-approved amount for inpatient respite care
Room and board are not covered unless you’re receiving inpatient respite care or hospice in a facility that has a specific arrangement with Medicare.
Home Health Care Coverage Limits
Part A also covers limited home health services if you meet eligibility criteria, such as being homebound and needing skilled nursing care or therapy. While these services are typically covered in full under Part A, you may still owe 20% of the cost of durable medical equipment (like walkers or wheelchairs) that you need at home.
Observation Status vs. Inpatient Admission
One of the more confusing—and costly—elements of hospital care is the difference between being admitted as an inpatient versus being placed under observation status.
If you are kept for observation, even if you’re in a hospital bed overnight, you’re technically classified as an outpatient. This means your stay is billed under Medicare Part B, not Part A, and can affect your eligibility for subsequent services like Skilled Nursing Facility care.
This distinction can have major financial consequences. Observation status may:
-
Result in higher out-of-pocket costs
-
Disqualify you from SNF coverage if you don’t meet the 3-day inpatient requirement
It’s always wise to ask your care team whether you’ve been officially admitted or placed under observation.
Hospital-Related Services Not Covered by Part A
Part A focuses on room, board, and medically necessary services during an inpatient stay. But it does not cover everything, such as:
-
Private-duty nursing
-
Personal comfort items (like a TV or phone)
-
Private rooms (unless medically necessary)
-
Charges from physicians or specialists (typically billed under Part B)
To cover these services, you may be responsible for additional out-of-pocket expenses, even during an inpatient hospital stay.
Multiple Hospital Stays in One Year
Because the Part A deductible applies per benefit period, not annually, several hospitalizations throughout the year can dramatically increase your overall costs. If your recovery between hospital stays exceeds 60 days, each new stay triggers another deductible.
This is particularly important for individuals managing multiple chronic illnesses, who may be hospitalized several times per year.
Medicare Advantage Plans Don’t Eliminate Part A Cost Sharing
Even if you’re enrolled in a Medicare Advantage plan, you’re still required to pay hospital-related cost-sharing. While the structure may differ—such as having daily copayments instead of a lump-sum deductible—these plans often require out-of-pocket payments for inpatient services.
In 2025, Medicare Advantage plans also come with maximum out-of-pocket limits for in-network services, which helps protect you from catastrophic expenses—but these caps can still be substantial.
Supplemental Coverage Options
You may consider adding a Medicare Supplement Insurance plan (also known as Medigap) to help with costs Part A doesn’t cover. These plans, available to those enrolled in Original Medicare, can help pay for deductibles, coinsurance, and some services not fully covered by Medicare.
However, you need to enroll during your Medigap Open Enrollment Period, which begins the month you’re both 65 and enrolled in Part B. Outside this window, acceptance and pricing are subject to medical underwriting.
Planning Ahead for Hospital-Related Costs
Understanding your potential out-of-pocket costs allows you to prepare better financially. Here’s what you can do:
-
Review your Medicare Summary Notice (MSN) and Explanation of Benefits (EOB) for each hospital stay
-
Keep track of how many days you’ve spent in the hospital in a benefit period
-
Clarify your status (inpatient vs. observation) upon hospital admission
-
Consider supplemental coverage options while you’re still eligible without medical underwriting
-
Speak with a licensed agent listed on this website to review your plan options
Hospital Coverage Isn’t Automatic Financial Protection
Hospital care under Medicare Part A provides important coverage—but it doesn’t offer total financial protection. With daily coinsurance, deductibles that reset per benefit period, and potential exposure from multiple hospitalizations, the costs you face can be significant.
Before you need hospital care, consider discussing your options with a licensed agent listed on this website. They can walk you through ways to limit your out-of-pocket exposure and make sure you understand how your current Medicare coverage works when you’re admitted to the hospital.
