Is Medicare Part A Free?

Medicare is a government healthcare program that covers healthcare costs for people ages 65 and over or those with certain disabilities. The Medicare program is split into several sections or parts. These include:

• Medicare Part A. Medicare Part A covers hospitalization and inpatient care, including hospice and skilled nursing care. This also includes medications you receive while you’re in the hospital.
• Medicare Part B. Medicare Part B covers outpatient costs, such as doctor’s visits and outpatient therapy.
• Medicare Part C. Medicare Part C, also known as Medicare Advantage, is a private insurance plan that includes the same services as Part A and Part B, as well as optional coverage for things like prescription medications and dental coverage.
• Medicare Part D. Medicare Part D is an optional prescription drug plan offered by Medicare through private insurance companies.
• Medigap. Medigap plans, also known as Medicare supplement insurance, are optional private insurance plans offered through Medicare that help you pay for your share of Medicare services.

Most people don’t have to pay a monthly premium for their Medicare Part A coverage. If you’ve worked for a total of 40 quarters or more during your lifetime, you’ve already paid for your Medicare Part A coverage through those income taxes.

Outside of qualifying for premium-free Part A based on your work history, there are a few other situations when you may receive coverage without a monthly premium:

• You’re 65 years old and receive retirement benefits from Social Security or the Railroad Retirement Board (RRB).
• You’re 65 years old and you or your spouse had Medicare-covered health benefits from a government job.
• You’re under age 65 and have received Social Security or RRB disability benefits for 24 months.
• You have end stage renal disease.

There are several different costs to consider when you’re signing up for Medicare Part A.

Let’s go over each of the costs for Part A and how much you might pay based on your individual situation.

Premiums

If you don’t meet the criteria listed above for premium-free Part A, here’s a breakdown of what your 2022 costs will be:

• If you or your spouse worked for 30 to 39 quarters, the standard monthly Part A premium cost is $274 in 2022.
• If you or your spouse for worked fewer than 30 quarters, the standard monthly Part A premium cost is $499 in 2022.

Deductibles and hospital coinsurance

With Medicare Part A, you’ll also pay a deductible and coinsurance costs for each benefit period. In 2022, these costs are:

• $1,556 deductible for each benefit period
• $0 coinsurance for days 1 through 60 in each benefit period
• $389 daily coinsurance for days 61 through 90 in each benefit period
• $778 daily coinsurance for days 91 and beyond in each benefit period

Each day beyond day 90 is considered a lifetime reserve day. You have up to 60 of these days to use in your lifetime. Once you’ve used all of your lifetime reserve days, you must pay all the costs for the rest of your stay.

Benefit periods reset once you’ve been out of inpatient care for 60 days or when you begin inpatient care for a new condition.

If you have trouble paying for these costs, you can apply for a Medicare savings program. These state programs help cover the costs of your Medicare deductibles and coinsurance.

Skilled nursing and hospice care

Medicare Part A covers the full cost of hospice care, but there are specific coinsurance costs for skilled nursing care services.

In 2022, these costs are:

• $0 coinsurance for days 1 through 20 for each benefit period
• $194.50 daily coinsurance for days 21 through 100 for each benefit period
• all costs for days 101 and beyond in each benefit period

Again, a benefit period resets after you’ve been discharged for 60 days or you begin inpatient care for a new diagnosis or condition.

In most cases, you’ll be automatically enrolled in Medicare Part A. You’re automatically enrolled in original Medicare — which is made up of parts A and B — starting on the first day of the month you turn 65 years old.

If you’re under age 65 and receiving Social Security or RRB disability benefits, you’ll automatically be enrolled in Medicare Part A when you’ve been receiving the disability benefits for 24 months.

If you’re not automatically enrolled, you can sign up manually through the Social Security Administration.

• Most people receive Medicare Part A automatically when they turn age 65 and pay no monthly premiums.
• If you or your spouse haven’t worked at least 40 quarters, you’ll pay a monthly premium for Part A.
• You pay a deductible and coinsurance costs for Medicare Part A services when you receive inpatient or skilled nursing care.
• There are state programs, called Medicare savings programs, that can help you cover the costs of your coinsurance and deductibles for Medicare Part A, if you’re eligible.