In 2016, 16.7 percent of Americans with health insurance were using Medicare. The Medicare program is made up of several parts. Medicare Part A, along with Medicare Part B, makes 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 fees, such as deductibles, copays, and co-insurance you may have to pay if you have hospital care.

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

Medicare Part A is hospital insurance. It helps to cover some of the costs of stays at various medical and healthcare facilities, should you need inpatient care.

Some people will be automatically enrolled in Part A. 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.

eligibility for premium-free part a

You are eligible for premium-free Part A if you:

  • have paid Medicare taxes for 40 or more quarters in your life
  • are age 65 or older and eligible for, or currently collecting, Social Security or Railroad Retirement Board (RRB) retirement benefits
  • are under the age of 65 and eligible to collect Social Security or RRB disability benefits
  • are receiving regular dialysis or have had a kidney transplant and have submitted a Medicare application through the SSA

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.

Number of quarters you paid Medicare taxes2020 monthly Part A premium
40 or more$0

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 that your coverage is effective. You can use this card to receive any services that are covered by 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 2020 is $144.60, and most people who have Part B will pay this amount.

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.
  • Co-insurance: The percentage that you pay for services after you’ve met your deductible.

Other Medicare Part A hospitalization costs

Period of hospitalizationYour cost
every benefit period (hospitalization)$1,408 (deductible)
days 1-60 $0 (coinsurance)
days 61-90 $352 per day
days 91 and beyond
(called lifetime reserve days – up to 60 days in your lifetime)
$704 per day
after all lifetime reserve days have been usedall costs

Fees for other services covered by Medicare Part A

Medicare Part A covers services at other facilities, and there are unique fees you may be required to pay for these services and facilities.

According to, additional fees for services covered by Medicare Part A include the following.

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.

Other skilled nursing facility costs

Days in skilled nursing facilityYour cost
Days 1–20$0
Days 21–100$176 per day
Days 101 and beyondall costs

Home health care

Medicare Part A does not cover home health care services. However, Part A will pay 20 percent of the Medicare-approved fee for durable medical equipment (DME). This includes items such as wheelchairs, walkers, or hospital beds if ordered by your doctor for use in home healthcare.

The Medicare-approved fee may be less than the DME provider charges. If this is the case, you will have to pay any remaining amount due.

Hospice care

As long as the hospice provider you choose is Medicare-approved, Medicare does cover hospice. There may be additional fees you are 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 cost of nursing home care (Medicare does not pay for nursing home care for hospice)

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 mental health professionals such as doctors and licensed therapists that you receive as an inpatient.

Other mental health service costs

Period of mental health inpatient careYour cost
every benefit period (hospitalization)$1,408 (deductible)
days 1-60 $0 (coinsurance)
days 61–90$352 per day
days 91 and beyond
(called lifetime reserve days – up to 60 days in your lifetime)
$704 per day
after all lifetime reserve days have been usedall costs

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 three years after you were eligible, you’ll pay an increased premium for six years.

Part A can cover care in the following types of facilities:

You’re only covered under Part A if you’re admitted as an inpatient to the above facilities. Because of this, 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.

Depending on the facility, Part A may not cover the entirety of your stay. Some facilities have benefit periods. These 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 co-insurance.

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

Part A doesn’t cover long-term care. Long-term care refers to non-medical care that’s provided to 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 for over 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.

65th birthdayInitial Enrollment is a seven-month period that includes the month of your 65th birthday as well as the 3 months before and after your 65th birthday.
Jan.1 – March 3, 2020This period is known as General Enrollment. You can sign up for Parts A and B if you didn’t sign up during Initial Enrollment AND are unable to sign up using Special Enrollment. You can also switch from a Part C plan back to Original Medicare during General Enrollment.
April 1 – June 30, 2020If you enrolled in Parts A and B during the General Enrollment period, you can choose to add a Part D plan during this timeframe.
Oct. 15 – Dec. 7, 2020This is Open Enrollment. During this time period, anyone with parts A and B can change over to a Part C plan. You may also add, change, or remove a Part D plan during this time.
Special enrollmentIf you have coverage with an employer-provided group health plan, you can sign up for parts A and B during Special Enrollment. You can do this while you’re covered by the group plan OR in an eight-month period after ending employment or group plan coverage.

Medicare Part A covers inpatient stays, such as those at a hospital or skilled nursing facility. Together with Part B, it comprises 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 co-insurance.

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