What Is Medicare Part A?

If you’ve ever asked, “What exactly is Medicare Part A, and do I need to sign up for it?” - you’re not alone.

We get this question all the time from people just like you, sitting at their kitchen table, trying to make sense of Medicare.

Here’s the simple answer: Medicare Part A is your hospital insurance. It helps cover the cost of inpatient hospital stays, skilled nursing care, hospice, and some home health services.

And here’s the good news - most people get it for free. If you or your spouse worked and paid Medicare taxes for at least 10 years, you’re likely eligible with no monthly premium.

What Is Medicare Part A?

Medicare Part A is often called your hospital insurance - and in our experience, this is the part most people think of first when they hear the word “Medicare.”

But here’s the thing: while it’s one of the core parts of Medicare, most folks aren’t exactly sure what it actually covers.

So let’s make it simple.

Medicare Part A helps pay for your care when you’re admitted to a facility - like a hospital, skilled nursing facility, or hospice.

It’s designed to cover the more serious or longer-term care situations where you’re staying overnight (or longer) for treatment, recovery, or end-of-life care.

Here’s a quick snapshot of what Medicare Part A helps cover:

• Inpatient hospital care (including semi-private rooms, meals, nursing care, and medications while you’re admitted)
• Skilled nursing facility care (after a qualifying hospital stay)
• Hospice care
• Limited home health care (if you qualify and your doctor orders it)
  

Think of Part A as your “room and board” coverage for medically necessary stays. It’s not for doctor visits or routine checkups - that’s where Part B comes in.

But if you're admitted to a hospital, this is the coverage that kicks in.

Inpatient Hospital Services

When you’re formally admitted to a hospital, Medicare Part A helps cover many of the basic services you’ll receive during your stay.

Here’s what’s typically included:

• A semi-private room (shared with one other patient)
  
• Meals during your stay
  
• General nursing care
  
• Medications you receive as part of your inpatient treatment
  
• Medical supplies and equipment used while you’re admitted
  
• Lab tests, X-rays, and other inpatient services
  

Basically, Part A covers the essentials that come with being in the hospital as a patient - your bed, your food, the nursing staff checking on you, and the medications you're given while you're there.

But here’s something that surprises almost every client we talk to: Your doctor’s services (even if they see you in the hospital) are billed under Medicare Part B, not Part A.

That means if your doctor visits you, reads test results, or consults with specialists while you’re admitted, those services will show up separately under your Part B coverage.

It’s a quirky part of how Medicare works, but it’s important to know - especially when reviewing your bills later.

Skilled Nursing Facility (SNF) / Post-Hospitalization Care

A lot of people think Medicare covers long-term nursing home care - but that’s not the case.

What Medicare Part A does cover is short-term skilled nursing care, but only under specific conditions.

Here’s when Medicare Part A will pay for care in a skilled nursing facility (SNF):

• You had a qualifying hospital stay - meaning you were admitted as an inpatient for at least 3 consecutive days
• Your SNF care is medically necessary and related to your hospital stay
• You enter the SNF within a short time (typically within 30 days) after leaving the hospital
  

This kind of care usually includes:

• Physical therapy
  
• Occupational therapy
  
• Speech therapy
  
• Skilled nursing care (like wound care or IV medications)
  

Real-world example: Let’s say you have hip replacement surgery and spend 4 days in the hospital. When you’re discharged, your doctor recommends a week or two in a skilled nursing facility for rehab.

Medicare Part A would help cover that stay - assuming all the requirements are met.

A Common Point of Confusion

Medicare does not cover long-term custodial care. So if you or a loved one needs help with daily activities like bathing, dressing, or eating - but not skilled medical care - that’s not covered by Medicare Part A.

We see families get caught off guard by this all the time. If the care is rehabilitative and follows a hospital stay, Part A may help. If it’s long-term personal care, it won’t.

What Is Not Covered by Part A?

We hear this all the time:

“I thought Medicare covered everything once I turned 65.”

The truth is, Medicare Part A only covers certain types of care - mostly related to inpatient stays. There’s a lot it doesn’t include, and it’s important to know the gaps so you’re not surprised by out-of-pocket costs.

Here’s what Part A does not cover:

• Doctor visits (including during a hospital stay) – these fall under Part B
  
• Outpatient services – like ER visits where you’re not admitted, MRIs, or minor surgeries
  
• Prescription drugs you take at home – that’s handled by Part D
  
• Long-term custodial care – help with bathing, dressing, eating, or other daily activities in a nursing home is not covered unless it’s part of short-term rehab
  
• Personal comfort items during a hospital stay – like a TV, phone, private room (unless medically necessary), or slippers
  

Part A is foundational, but it’s not full coverage. If you want more complete protection, especially for outpatient care, prescriptions, or long-term costs - that’s where Part B, Part D, and Medigap or Medicare Advantage plans come into play.

Who Is Eligible for Medicare Part A?

For most people, Medicare Part A kicks in automatically when they turn 65. If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), you’ll qualify for premium-free Part A - no monthly cost.

If you’ve worked most of your adult life or were married to someone who did, you’re probably all set.

But what if you didn’t work enough?

If you haven’t met the 10-year work requirement, you can still get Medicare Part A - but you’ll likely have to pay a monthly premium.

In 2025, that premium can range from $285-$518 per month, depending on how long you (or your spouse) worked.

Eligibility Under Age 65

You may also qualify for Medicare Part A before age 65 if:

• You’ve received Social Security Disability Insurance (SSDI) for 24 consecutive months
  
• You have End-Stage Renal Disease (ESRD) and need dialysis or a kidney transplant
  
• You have Amyotrophic Lateral Sclerosis (ALS) - in which case, Medicare begins the same month your disability benefits start
  

In these cases, Medicare enrollment is automatic - no need to apply separately for Part A.

Bottom Line: Most people qualify for premium-free Part A automatically at 65. But if you’re unsure, it’s worth checking with Social Security to confirm your eligibility and any premium you may owe.

What Does Medicare Part A Cost?

Here’s the good news: most people pay $0 per month for Medicare Part A. If you or your spouse worked and paid Medicare taxes for 10 years, you qualify for premium-free Part A.

But that doesn’t mean all your care is free. Part A still has deductibles and copays - and they can add up if you’re hospitalized or need skilled nursing care.

Here’s what you need to know regarding costs for 2025.

Inpatient Hospital Costs (Per Benefit Period):

• Deductible: $1,676 - this is what you pay upfront when admitted to the hospital
  
• Days 1–60: $0 copay after the deductible
  
• Days 61–90: $419 per day
  
• Days 91 and beyond: $838 per “lifetime reserve day” (you get 60 of these to use in your lifetime)
  
• After lifetime reserve days are used: You pay all costs
  

Skilled Nursing Facility (SNF) Costs:

• Days 1–20: $0
  
• Days 21–100: $209.50 per day
  
• After day 100: You pay all costs

Many people assume these costs reset each year - like regular insurance deductibles.
But Medicare Part A works on a benefit period, not a calendar year.

A benefit period begins the day you’re admitted as an inpatient and ends when you’ve been out of the hospital or SNF for 60 days in a row. If you’re admitted again after that, a new benefit period (and new deductible) starts.

We’ve had clients who were surprised to get hit with two deductibles in one year because of multiple hospitalizations - so it’s something to be aware of.

How Do I Enroll in Medicare Part A?

Enrolling in Medicare Part A is usually pretty straightforward - but how you get enrolled depends on whether you’re already receiving Social Security benefits.

If You're Already Getting Social Security or Railroad Retirement Benefits

You’ll be automatically enrolled in Medicare Part A (and Part B) when you turn 65.

• You don’t need to apply
  
• Your red, white, and blue Medicare card will show up about 3 months before your 65th birthday
  
• Coverage starts on the first day of your birthday month
  

No extra steps needed - just keep an eye on your mailbox.

If You’re Not Receiving Social Security Yet

You’ll need to enroll manually - and the easiest way is to do it online:

• Go to www.ssa.gov/medicare
  
• Or call the Social Security Administration at 1-800-772-1213
  
• Or visit your local Social Security office in person
  

We recommend applying as soon as your Initial Enrollment Period opens - that’s the 7-month window around your 65th birthday (3 months before, your birthday month, and 3 months after).

Avoiding Late Enrollment Penalties

Even though most people don’t pay a premium for Part A, it’s still important to enroll on time - especially if you plan to delay Part B because you’re still working.

If you delay enrolling in Medicare without having other creditable coverage, you could face late penalties or a gap in coverage down the road.

Bottom Line

Medicare Part A is your starting point - it covers hospital care, skilled nursing after a hospital stay, and hospice.

For most people, it’s premium-free and provides a vital safety net when serious health issues arise.

But it’s important to remember: Part A doesn’t cover everything. You’ll still need Part B to cover doctor visits and outpatient care, and Part D for prescription drugs.

Many people also choose a Medicare Supplement (Medigap) or Medicare Advantage plan to help with out-of-pocket costs.

We help folks every day figure out what they actually need - not just what sounds good on paper. If you’re not sure where to start, we’ll walk you through it, step by step, so you don’t miss anything or pay more than you should.

Medicare Part A FAQs

Here are some of the most common questions we get about Medicare Part A:

Does Medicare Part A cover ER visits?

Only if you’re admitted to the hospital. If you go to the ER but aren’t formally admitted, that’s billed under Part B.

Can I use Part A without Part B?

Technically yes - but most people need both for full coverage. Without Part B, you’ll be responsible for most doctor and outpatient costs.

What happens if I’m still working at 65?

You may be able to delay Part B if you have creditable coverage through your job, but it’s usually smart to take Part A right away. Talk to an agent to make sure your timing lines up.

How is a benefit period calculated?

A benefit period starts when you’re admitted to the hospital and ends when you haven’t received inpatient care for 60 days in a row. If you’re admitted again after that, a new benefit period (and deductible) begins.

Texas Medicare Resources

If you live in Texas, you’ve got access to local support that can help you make sense of Medicare - and we’re happy to point you in the right direction:

• Texas SHIP (State Health Insurance Assistance Program) – Free, unbiased counseling
  
• Medicare.gov – Official federal info and plan finder
  
• YourTexasBenefits.com – For Medicaid, Extra Help, and low-income programs