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Medicare Part A: what it actually covers.

Most people know Part A as “hospital insurance” and stop there — but the details of benefit periods, coinsurance, and what happens after day 100 are exactly where costly surprises show up.

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Published July 27, 2026 · By Erik Roti, Options.Health

Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice, inpatient rehabilitation, and some home health services. About 99% of beneficiaries get it premium-free, since it’s funded by payroll taxes paid over a working career. But “free” premium doesn’t mean free care — the cost-sharing structure has real teeth, and it works differently than most other insurance you’ve had.

The benefit period, not the calendar year, is what resets your deductible

Unlike Part B, which has one deductible per calendar year, Part A works in benefit periods. A benefit period starts the day you’re admitted as an inpatient and ends once you’ve been out of inpatient care for 60 consecutive days. If you’re hospitalized twice in the same year with more than 60 days between stays, you could owe the deductible — $1,736 for 2026 — more than once. There’s no limit on how many benefit periods you can have in a year.

What happens as a hospital stay stretches longer

After the deductible, Part A covers the first 60 days of an inpatient stay in full. Days 61–90 carry a daily coinsurance of $434 in 2026. Beyond day 90, you draw from a lifetime bank of 60 “lifetime reserve days,” at $868 per day — and once those are used up, for good, Part A pays nothing further for that benefit period. Past day 150 with no reserve days left, the full cost is yours.

Skilled nursing coverage is more limited than most people expect

Part A covers skilled nursing facility (SNF) care only after a qualifying inpatient hospital stay, and only for skilled care — things like physical therapy or wound care that require licensed staff, not long-term custodial care. The first 20 days are covered in full; days 21–100 carry a $217 daily coinsurance in 2026; after day 100, Medicare stops paying entirely. This is one of the most common places people assume Medicare will cover an extended nursing home stay and are surprised when it doesn’t.

Hospice and home health are covered differently

Hospice care under Part A is covered with little to no cost-sharing once a doctor certifies a terminal prognosis, and it’s one of the more generous benefits in the program. Home health services — skilled nursing or therapy provided at home — are also covered under Part A (sometimes jointly with Part B), but only when ordered by a doctor and tied to a specific medical need, not for ongoing personal care or homemaking help.

This is exactly the gap Medicare Supplement plans are built to close. The Part A deductible, the day 61–90 coinsurance, and the SNF daily coinsurance are all costs a Medigap plan can cover, depending on which plan you choose. A licensed broker can walk through which plan actually closes the gaps you’re most likely to hit.

Medicare Part A, answered

About 99% of people don’t, because they or a spouse have at least 40 quarters of Medicare-covered work history. Those with fewer quarters can buy into Part A for a monthly premium, which is $565 in 2026 (or $311 for those with 30–39 quarters).
No — Part A only covers skilled nursing care following a qualifying hospital stay, and only up to 100 days per benefit period. Long-term custodial care in a nursing home isn’t covered by Medicare at all; that’s typically a Medicaid or private-pay situation.
Generally, at least three consecutive days as an admitted inpatient, not counting the discharge day, immediately before you’re transferred to the skilled nursing facility. Being in the hospital under “observation status” rather than as a formal inpatient doesn’t count toward this requirement.
Yes — most Medigap plans cover the Part A deductible in full, along with the day 61–90 and SNF coinsurance amounts, which is exactly the kind of exposure these plans are designed to eliminate.

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Last updated: July 27, 2026