Medicare Hospital Coverage: What Part A Covers and What It Doesn't

Hospital stays are among the most expensive healthcare events. Understanding how Medicare Part A covers hospitalizations helps you avoid surprise bills and plan for costs.

What Medicare Part A Covers

Medicare Part A is your hospital insurance. It covers:

Inpatient Hospital Care

• Semi-private room
• Meals
• General nursing care
• Drugs administered during your stay
• Lab tests, X-rays, and other diagnostic tests
• Operating and recovery room costs
• Medical supplies and equipment

Skilled Nursing Facility (SNF) Care

After a qualifying hospital stay (at least 3 consecutive days), Part A covers:

• Semi-private room
• Meals
• Skilled nursing and rehabilitation services
• Medical supplies and equipment

Home Health Care

When medically necessary:

• Part-time skilled nursing care
• Physical therapy
• Speech-language pathology
• Occupational therapy

Hospice Care

For terminally ill patients who choose comfort care:

• Medical and support services
• Drugs for symptom control
• Respite care for caregivers

Part A Costs in 2025

Understanding Part A's cost structure is crucial for financial planning:

The Part A Deductible

• Amount: $1,676 per benefit period in 2025
• When it applies: Each time you're admitted to a hospital after 60 days without inpatient care
• Important: This isn't annual—multiple hospitalizations can trigger multiple deductibles

Hospital Coinsurance

• Days 1-60: $0 after deductible
• Days 61-90: $419 per day
• Days 91-150 (Lifetime Reserve): $838 per day
• Beyond 150 days: You pay 100%

SNF Coinsurance

• Days 1-20: $0
• Days 21-100: $209.50 per day
• Beyond 100 days: Not covered

What Part A Doesn't Cover

Important exclusions to understand:

• Long-term custodial care: Nursing home care for daily living assistance
• Private rooms: Unless medically necessary
• Private-duty nursing: Unless medically necessary
• Personal convenience items: TV, phone, private nurses
• Procedures not medically necessary: Cosmetic surgery
• Care outside the U.S.: With limited exceptions

Filling the Gaps

Original Medicare's hospital coverage has significant cost exposure. Options to cover gaps include:

Medigap (Medicare Supplement)

• Plan G and other Medigap plans cover Part A coinsurance
• Most plans cover the Part A deductible completely
• Provides predictable costs even for extended hospitalizations

Medicare Advantage

• Required annual out-of-pocket maximum caps hospital costs
• May have lower per-day costs than Original Medicare
• Network restrictions apply

The Bottom Line

Part A provides solid foundation coverage for hospital stays, but the cost-sharing for extended stays can add up quickly. Whether through Medigap or Medicare Advantage's out-of-pocket cap, having protection against these costs provides financial security.

Need help understanding your hospital coverage options? Our free Medicare review compares how different plans protect you against hospital costs.