Medicare Part A: What It Covers and What It Costs in 2026

Medicare Part A is hospital insurance. It pays for care when you are formally admitted to a hospital, for short-term skilled nursing care after a qualifying hospital stay, for hospice, and for some home health care. Most people pay no monthly premium for it. The costs show up when you use it, and they can be large.

All figures below are official 2026 amounts from CMS. The 2027 Part A deductible and coinsurance are not announced yet; CMS typically releases them in November with the Part B premium.

What does Medicare Part A cover?

Part A covers four kinds of care:

• Inpatient hospital care. Acute care hospitals, critical access hospitals (common in rural Nebraska), inpatient rehabilitation facilities, long-term care hospitals and inpatient psychiatric care. It includes a semi-private room, meals, general nursing and drugs given as part of your inpatient treatment.
• Skilled nursing facility (SNF) care. Short-term care after a qualifying inpatient stay, when you need daily skilled nursing or therapy.
• Hospice care. Comfort care for people with a terminal illness and a life expectancy of 6 months or less.
• Home health care. Part-time skilled care at home for people who are homebound (shared with Part B).

Part A does not cover private-duty nursing, a separate charge for a TV or phone, personal items like razors, or a private room unless it is medically necessary. It also does not pay your doctors while you are in the hospital. Those bills go to Part B, which generally pays 80%.

Psychiatric care in a freestanding psychiatric hospital is limited to 190 days in your lifetime.

Do you pay a premium for Part A?

Most people do not. If you or your spouse worked about 10 years (40 quarters) and paid Medicare taxes, Part A comes with no monthly premium. CMS says that is about 99% of people with Medicare.

If you have less work history, you can buy Part A:

If you have to buy Part A and do not sign up when first eligible, your premium can go up 10% for twice the number of years you waited. Example: someone who must pay the $565 premium and waits 2 years would pay $621.50 a month (in 2026 dollars) for 4 years. More examples are in our late enrollment penalties guide.

What does a hospital stay cost under Part A in 2026?

You pay one deductible, then nothing for the first 60 days, then a daily amount that climbs the longer you stay.

You get 60 lifetime reserve days total, not per stay. Once you use them, they are gone.

Worked example. A 5-day stay for pneumonia in 2026 costs you $1,736 under Part A. A 75-day stay after a serious stroke costs $1,736 plus 15 days at $434, which is $6,510, for a total of $8,246. That is before any Part B doctor bills.

What is a benefit period?

A benefit period is how Part A measures your hospital and nursing facility use. It starts the day you are admitted as an inpatient. It ends once you have gone 60 days in a row without inpatient hospital care or skilled nursing care.

That rule has a big effect on your costs:

• Two stays, far apart. Admitted in March, home for good in April, admitted again in September. That is two benefit periods and two deductibles: $3,472 in 2026.
• Two stays, close together. Admitted in March, home in April, readmitted 30 days later. You are still in the first benefit period, so no second deductible, but your day count keeps adding up toward day 61.

There is no limit on how many benefit periods you can have in a year, so the deductible can hit more than once.

Inpatient or observation: why does it matter?

You are an inpatient only when the hospital formally admits you with a doctor's order. If you are getting emergency or observation services, you are an outpatient, even if you spend the night in a hospital bed.

This matters for two reasons. First, observation is billed under Part B, so you pay the Part B deductible and 20% coinsurance instead of the Part A deductible. Second, observation days do not count toward the 3-day inpatient stay you need for skilled nursing coverage.

If you are under observation for more than 24 hours, the hospital must give you a Medicare Outpatient Observation Notice (MOON) explaining why. Medicare & You 2027 suggests you or a family member ask each day whether you are an inpatient or an outpatient. You also have appeal rights in some cases when a hospital changes your status from inpatient to outpatient.

What does Part A pay for skilled nursing care?

Part A covers up to 100 days of skilled nursing facility care per benefit period, if all of these are true:

1. You had a medically necessary inpatient stay of at least 3 days in a row (the day you leave does not count).
2. You enter the facility within a short time, generally 30 days, of leaving the hospital.
3. Your doctor certifies that you need daily skilled care, like IV medication or therapy.

Worked example. After a 4-day inpatient stay for a hip replacement, you spend 30 days in rehab at a skilled nursing facility. Days 1 to 20 cost nothing, and days 21 to 30 cost 10 x $217 = $2,170. If you needed all 100 days, your share would be 80 x $217 = $17,360.

Part A does not pay for long-term custodial care: help with bathing, dressing and eating when that is the main care you need. That gap is explained in Medicare and long-term care.

What does Part A pay for hospice and home health?

Hospice. You pay nothing for hospice care itself. You may pay up to $5 per prescription for drugs for pain and symptom management, and 5% of the Medicare-approved amount for inpatient respite care, which gives a caregiver a break of up to 5 days at a time. Medicare does not pay room and board if you live in a nursing home or other facility while on hospice, unless the hospice team arranges short-term inpatient care. Original Medicare pays for hospice even if you are in a Medicare Advantage plan.

Home health. You pay nothing for covered home health services if you are homebound and a doctor orders part-time skilled care from a Medicare-certified agency. Medical equipment through home health is usually 20% under Part B.

How do people cover Part A's gaps?

Part A has no yearly out-of-pocket limit, so most people add protection one of two ways.

• Medigap. Every standardized Medigap plan pays Part A hospital coinsurance and adds 365 extra hospital days. Most plans also pay the $1,736 deductible: Plans B, C, D, F, G and N pay it in full, Plan M pays 50%, and Plans K and L pay 50% and 75%. Plan A does not. Most also cover the $217 skilled nursing coinsurance. See Medigap Plan G and the Medicare Supplement overview.
• Medicare Advantage. The plan sets its own hospital and nursing facility copays, which count toward its yearly out-of-pocket limit. Plans vary by county and change every year. Some Medicare Advantage plans waive the 3-day hospital stay rule. Compare the two approaches in Medigap vs Medicare Advantage.

If you are still working and contributing to a Health Savings Account, signing up for Part A ends your contributions, and Part A can be backdated up to 6 months. Read HSAs and Medicare before you apply.

For questions about a specific claim, call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week (TTY 1-877-486-2048). Nebraska SHIP (1-800-234-7119) offers unbiased counseling at no cost.