Key Takeaways
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Medicare Part A in 2025 continues to cover key hospital services, but you still face some out-of-pocket costs even if you’re enrolled.
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Understanding what is covered versus what you’ll need to pay for helps you better plan for hospital stays, skilled nursing, and hospice care.
Understanding the Scope of Medicare Part A
Medicare Part A is often called hospital insurance, and in 2025, it continues to offer coverage for a range of inpatient services. This part of Medicare is typically premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters). Even if you qualify for premium-free Part A, there are still other costs to consider, such as deductibles and coinsurance.
In 2025, Medicare Part A remains a cornerstone of your health coverage, especially if you’re hospitalized or need post-acute care in a skilled nursing facility. However, it doesn’t cover everything, and understanding the limitations is essential to avoid surprise medical bills.
What Medicare Part A Covers in 2025
Medicare Part A covers several types of inpatient care, which are grouped under specific service categories:
1. Inpatient Hospital Care
If you’re formally admitted to a hospital, Part A covers:
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Semi-private room
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Meals
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General nursing
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Medications as part of your inpatient treatment
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Other hospital services and supplies
This coverage includes care in acute care hospitals, critical access hospitals, and long-term care hospitals. However, it does not cover private-duty nursing or personal items like toothpaste or a television in your room.
2. Skilled Nursing Facility (SNF) Care
Part A covers skilled nursing care only under certain conditions. In 2025, you must:
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Have a qualifying hospital stay of at least three consecutive inpatient days (not counting the discharge day)
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Be admitted to the SNF within 30 days of your hospital discharge
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Require skilled nursing or rehabilitation services daily
When these requirements are met, Medicare Part A will cover up to 100 days in a benefit period:
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Days 1–20: No coinsurance
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Days 21–100: Daily coinsurance applies
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After day 100: You pay all costs
3. Hospice Care
Hospice care is for those with a terminal illness and a life expectancy of six months or less. In 2025, Part A covers:
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Pain relief and symptom control
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Medical and nursing services
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Counseling and support services
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Short-term inpatient respite care (to give family caregivers a break)
You must give up curative treatment to receive hospice services under Medicare Part A.
4. Home Health Care (Limited)
Though Medicare Part A primarily covers inpatient services, it also provides limited home health care if you’re recently discharged from a hospital or SNF. Services may include:
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Intermittent skilled nursing care
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Physical, occupational, or speech therapy
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Medical social services
Home health services are only covered if your doctor certifies that you’re homebound and need skilled care.
What You’ll Likely Pay Out of Pocket in 2025
Even if you qualify for premium-free Part A, you are still responsible for certain out-of-pocket expenses in 2025.
Inpatient Hospital Deductible
You must pay a deductible for each benefit period. In 2025, the Part A deductible is $1,676. This amount covers the first 60 days of inpatient care in a hospital per benefit period.
Inpatient Hospital Coinsurance
After the 60th day in a hospital, you’ll begin paying daily coinsurance:
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Days 61–90: $419 per day
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Days 91–150: $838 per day (lifetime reserve days)
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After day 150: You pay all costs
Skilled Nursing Facility Coinsurance
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Days 1–20: $0 (fully covered)
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Days 21–100: $209.50 per day
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After day 100: You are responsible for the full cost of care
Hospice and Home Health Services
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Hospice: You may need to pay a copayment of up to $5 for each prescription and 5% of the Medicare-approved amount for inpatient respite care.
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Home Health Care: Usually no cost for services, but you may pay 20% for durable medical equipment (like walkers or oxygen equipment).
How Benefit Periods Work
A benefit period begins the day you’re admitted as an inpatient and ends after you’ve gone 60 days without inpatient hospital or skilled nursing facility care. You can have multiple benefit periods in a year, and you’ll need to pay the deductible each time a new benefit period begins.
This structure means your costs could add up quickly if you’re hospitalized more than once in a calendar year.
What Medicare Part A Does Not Cover
It’s just as important to know what Medicare Part A doesn’t cover. In 2025, these services fall outside of Part A coverage:
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Doctor’s services during an inpatient stay (covered by Part B)
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Private rooms (unless medically necessary)
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Custodial care (help with bathing, dressing, or eating when not part of skilled care)
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Long-term care in a nursing home
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Prescription drugs you take at home
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Personal convenience items (telephone, TV, etc.)
To address these gaps, many people consider additional coverage like Medicare Part B, Medicare Advantage, or Medigap policies. These options come with their own rules and costs and are not included in Part A.
Enrollment Considerations in 2025
If you’re turning 65 in 2025, your Initial Enrollment Period (IEP) begins three months before your 65th birthday and ends three months after. If you’re already receiving Social Security or Railroad Retirement Board benefits, you’re typically enrolled in Part A automatically.
You can also enroll during the General Enrollment Period from January 1 to March 31 each year if you missed your IEP. However, waiting could result in a delay in coverage and potential penalties if you’re not eligible for premium-free Part A.
How Part A Works with Other Coverage
Many people don’t rely on Medicare Part A alone. It often works in coordination with:
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Medicare Part B for doctor visits and outpatient services
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Medicare Part D for prescription drugs
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Medigap (Medicare Supplement Insurance) to help cover deductibles and coinsurance
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Employer or retiree coverage if you or your spouse is still working
Understanding how these work together can help you decide if you need additional coverage to avoid major out-of-pocket costs.
Planning for Costs Beyond Part A
To avoid high medical expenses, it’s a good idea to budget for:
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Multiple hospital stays in a year
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Skilled nursing beyond 20 days
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Long-term care needs
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Medical equipment or home modifications
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Outpatient follow-up treatments not covered by Part A
It may also be worth evaluating whether you’ll need additional insurance or financial planning support as you age.
Reviewing Your Medicare Coverage Annually
Medicare plans and rules can change every year. Even though Part A benefits are relatively stable, reviewing your overall Medicare coverage annually ensures it continues to meet your needs.
The Annual Enrollment Period (October 15 to December 7) allows you to make changes to Medicare Advantage or drug coverage. Even if you don’t make changes, it’s worth verifying how all parts of your Medicare work together to keep your healthcare costs manageable.
Staying Informed in 2025
Understanding what Medicare Part A covers and what it doesn’t can prevent costly surprises. While it takes care of many big-ticket items like hospital stays and skilled nursing, it doesn’t offer complete coverage. Being informed is your best protection.
You may also benefit from speaking with a licensed agent who can walk you through your Medicare options. They can help you identify any gaps and provide guidance on what coverage aligns with your health and financial situation.
Make Sense of What Medicare Part A Covers This Year
Medicare Part A in 2025 provides solid coverage for hospital-related care, but it doesn’t eliminate out-of-pocket costs. Being aware of what’s included, how benefit periods work, and what services you’ll need to pay for can help you avoid financial surprises. Don’t assume everything is covered just because you have Medicare.
If you’re unsure how Medicare Part A fits into your overall healthcare needs, speak with a licensed agent listed on this website for professional guidance tailored to your situation.
