Most people know Part A as the “free” part of Medicare. For most people the premium is $0, but the hospital bills are not. Part A has a deductible, daily charges for long stays, and one rule that surprises almost everyone: the deductible can hit you more than once in the same year.
Here is what Part A costs for 2026, and the rule you need to understand before a hospital stay.
What Part A covers
- Inpatient hospital stays
- Skilled nursing facility care after a qualifying hospital stay
- Hospice care
- Some home health care
- Inpatient care in a psychiatric hospital, with a lifetime limit
Doctor services while you are in the hospital are billed under Part B, not Part A. That is why one hospital stay can produce bills from both.
The Part A premium
You get Part A with no monthly premium if you or your spouse worked and paid Medicare taxes for at least 40 quarters, which is about 10 years.
If you have fewer quarters, you can buy Part A:
- 30 to 39 quarters: $311 a month
- Fewer than 30 quarters: $565 a month
What you pay for a hospital stay
These are the 2026 amounts with Original Medicare:
- Days 1 to 60: a $1,736 deductible, then $0 for the rest of those 60 days
- Days 61 to 90: $434 per day
- Days 91 and beyond: $868 per day, using your 60 lifetime reserve days
- After your lifetime reserve days are used up: you pay all costs
Long stays are rare. The deductible is the cost most people actually face, and that is where the key rule comes in.
The key rule: the deductible is per benefit period, not per year
The Part A deductible is not a once-a-year deductible like most health insurance. It applies to each benefit period.
A benefit period starts the day you are admitted to a hospital as an inpatient. It ends when you have gone 60 days in a row without inpatient hospital care or skilled nursing care.
Here is how that plays out. You are admitted in March and pay the $1,736 deductible. You go home and stay well through the summer. In October you are admitted again. Because more than 60 days passed, a new benefit period starts, and you owe the deductible again.
Two hospital stays in one year can mean two deductibles. Three stays can mean three. There is no yearly cap on this in Original Medicare.
Inpatient vs. observation: the other surprise
You can spend nights in a hospital bed and still not be an inpatient. If the hospital keeps you under observation status, you are an outpatient. Your care is billed under Part B, with its deductible and 20% coinsurance, instead of Part A.
Observation status also matters if you need rehab afterward. Original Medicare only covers skilled nursing care after a hospital stay of at least 3 days as an admitted inpatient. Days under observation do not count. Ask the hospital directly: “Am I admitted as an inpatient, or here under observation?” Our guide to observation vs. inpatient status covers what to do.
Skilled nursing facility costs
After a qualifying inpatient stay, Part A covers skilled nursing care:
- Days 1 to 20: $0
- Days 21 to 100: a daily coinsurance amount
- After day 100: you pay all costs
That daily coinsurance adds up fast. See Medicare skilled nursing coverage limits for the current amount and how to protect yourself.
How people cover these costs
Medicare Supplement plans. Most Supplement plans, including Plan G and Plan N, pay the Part A deductible every benefit period, the hospital coinsurance, and the skilled nursing coinsurance. With Plan G, a second or third hospital stay in a year does not mean a second or third deductible from your pocket. See Plan G or Plan N for how they compare.
Medicare Advantage plans. Advantage plans do not use the Part A deductible. Instead, you pay the plan’s copays, often a daily copay for the first several days of each hospital stay. Those copays count toward the plan’s yearly out-of-pocket maximum.
Hospital indemnity plans. These pay you cash for each day you are in the hospital. People with Advantage plans often use them to cover the daily hospital copays. See our hospital indemnity insurance page.
Common questions
Do I have to sign up for Part A if I am still working?
If you get premium-free Part A, most people sign up at 65 even while working. One exception: if you contribute to a Health Savings Account, Part A enrollment ends your ability to contribute. See HSAs and Medicare before you enroll.
Does Part A cover long-term care?
No. Part A covers short-term skilled care after a hospital stay. It does not pay for custodial care, such as help with bathing and dressing in a nursing home or assisted living.
Is there a penalty for signing up late?
Only if you have to buy Part A. If you pay a Part A premium and sign up late, the premium can go up 10% for twice the number of years you could have had Part A and did not sign up.
See where your coverage leaves you exposed
The Medicare Clarity Score takes about three minutes and shows whether your current coverage leaves gaps on hospital costs. You can also call Scott at 512-844-3983. There is no cost and no pressure.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not affiliated with or endorsed by the federal government or the federal Medicare program.