The Medicare program is made up of several parts. Medicare Part A together with Medicare Part B make up what’s referred to as original Medicare.

Most people who have Part A won’t have to pay a premium. However, there are other costs, such as deductibles, copays, and coinsurance you may have to pay if you need hospital care.

Here is what you need to know about the premiums and other costs related to Medicare Part A.

Medicare Part A is considered hospital insurance. It helps to cover some of your costs at various medical and healthcare facilities when you’re admitted as an inpatient.

Some people will be automatically enrolled in Part A when they become eligible. Others will have to sign up for it through the Social Security Administration (SSA).

Most people who enroll in Part A will not pay a monthly premium. This is called premium-free Medicare Part A.

Medicare Part A premiums are based on the number of quarters an individual has paid Medicare taxes prior to enrolling in Medicare. Medicare taxes are part of the withholding taxes collected from every paycheck you receive.

If you haven’t worked a total of 40 quarters (or 10 years), here is how much the Part A premium will cost in 2021:

Total quarters you paid Medicare taxes2021 Part A monthly premium
40 or more$0
30–39$259
< 30$471

When you enroll in Part A, you’ll receive a Medicare card in the mail. If you have Part A coverage, your Medicare card will say “HOSPITAL” and have a date when your coverage is effective. You can use this card to receive any services that are covered by Part A.

FAQ: Do you need to enroll in Medicare Part B if you enroll in Part A?

When you enroll in Part A, you will also need to enroll in Part B. Medicare Part B covers outpatient healthcare services like doctor’s appointments.

You will pay a separate monthly premium for this coverage. The standard Part B premium amount in 2021 is $148.50, and most people who have Part B will pay this amount.

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Whether you pay a monthly premium for your Medicare Part A or not, there are other costs associated with Part A as well. These costs will vary depending on things like the type of facility you’re admitted to and the length of your stay.

These additional out-of-pocket costs may include:

  • Deductibles: the amount you need to pay before Part A starts covering the costs of your care
  • Copays: a fixed amount that you have to pay for a service
  • Coinsurance: The percentage that you pay for services after you’ve met your deductible

FAQ: What is the Part A benefit period?

Benefit periods apply for inpatient stays at a hospital, mental health facility, or skilled nursing facility.

For each benefit period, Part A will cover the entirety of your first 60 days (or first 20 days for a skilled nursing facility) after you’ve met your deductible. After this initial period, you’ll need to pay a daily coinsurance.

Benefit periods begin the day that you’re admitted as an inpatient and end 60 days after you leave the facility. You will not begin a new benefit period until you’ve been out of inpatient care for at least 60 consecutive days.

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Inpatient hospital care

Here’s how each of these costs factor into a hospital stay in 2021:

Length of stayYour cost
deductible to meet for each benefit period$1,484
days 1–60 $0 daily coinsurance
days 61–90 $371 daily coinsurance
day 91 and beyond
(you can use up to 60 lifetime reserve days)
$742 daily coinsurance
after all lifetime reserve days have been usedall costs

Skilled nursing facility care

Skilled nursing facilities provide rehabilitation care such as skilled nursing, occupational therapy, physical therapy, and other services to help patients recover from injury and illness.

Medicare Part A covers the cost of care in a skilled nursing facility; however, there are costs you will have to pay as well. Here is what you’ll pay for a stay in a skilled nursing facility during each benefit period in 2021:

Length of stayYour cost
days 1–20$0
days 21–100$185.50 daily coinsurance
day 101 and beyondall costs

Home healthcare

Medicare Part A covers short-term home healthcare services in certain qualifying situations. Medicare must approve your home health services. If approved, you may pay nothing for home health care services.

If you need any durable medical equipment during this time, such as physical therapy supplies, wound care supplies, and assistive devices, you may be responsible for 20 percent of the Medicare-approved cost of these items.

Hospice care

As long as the provider(s) you choose is Medicare-approved, Medicare Part A will cover hospice care. Although the services themselves are often free of cost, there may be some fees you’ll be required to pay such as:

  • a copayment of no more than $5 for each prescription drug for pain relief and symptom control if you are receiving hospice care at home
  • 5 percent of the Medicare-approved amount for inpatient respite care
  • the full cost of nursing home care, as Medicare does not pay for nursing home care during hospice or at any other time

Inpatient mental health care

Medicare Part A covers inpatient mental health care; however, there are costs you may be required to pay.

For example, you must pay 20 percent of the Medicare-approved costs for mental health services from doctors and licensed therapists when you’re admitted to a facility as an inpatient.

Here’s how an inpatient mental health facility stay will cost in 2021:

Length of stayYour cost
deductible to meet for each benefit period$1,484
days 1–60 $0 daily coinsurance
days 61–90$371 daily coinsurance
days 91 and beyond, during which you’ll use your lifetime reserve days$742 daily coinsurance
after all 60 lifetime reserve days have been usedall costs

FAQ: Will I pay a penalty if I don’t enroll in Part A as soon as I’m eligible?

If you aren’t eligible for premium-free Part A and choose not to buy it when you are first able to enroll in Medicare, you may be subject to a late enrollment penalty. This can cause your monthly premium to increase by up to 10 percent for each year you do not enroll in Medicare Part A after you are eligible.

You’ll pay this increased premium for twice the amount of years that you were eligible for Part A, but didn’t sign up for it. For example, if you enroll 3 years after you were eligible, you’ll pay an increased premium for 6 years.

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Part A usually covers the following types of care:

You’re only covered under Part A if you’re admitted to a facility as an inpatient (unless it’s home healthcare). Therefore, it’s important to ask your care providers if you’re considered an inpatient or an outpatient on each day of your stay. Whether you’re considered an inpatient or an outpatient can affect your coverage and how much you have to pay.

Generally, Part A doesn’t cover long-term care. Long-term care refers to nonmedical care for daily living for people with a disability or a long-term illness. An example would be the type of care provided at an assisted living facility.

Additionally, Part A won’t pay for inpatient hospital or mental health facility stays beyond your lifetime reserve days. You have a total of 60 reserve days that you can use if you’re an inpatient in one of these facilities after you’ve been there for 90 days.

Lifetime reserve days aren’t replenished. Once you’ve used all of them, you’re responsible for all costs. For example, if you used all of your reserve days during previous inpatient hospital stays lasting over 90 days, you’re responsible for all costs if your next inpatient stay exceeds 90 days.

Medicare Part A covers inpatient stays, such as those at a hospital or skilled nursing facility. Together with Part B, these parts make up original Medicare.

Most people don’t pay a monthly premium for Part A, but there are other costs associated with Part A that you may be required to pay like deductibles, copays, and coinsurance.

This article was updated on November 20, 2020, to reflect 2021 Medicare information.

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