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 inpatient care.

The Medicare program has several parts. Part A and Part B make up what’s called Original Medicare.

Part A is 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, while others will have to sign up for it through the Social Security Administration.

Part A premiums are based on the number of quarters you paid Medicare taxes before enrollment. Medicare taxes are part of the withholding taxes collected from every paycheck you receive.

Most people do not have to pay a monthly premium for Part A. You’re eligible for premium-free Part A if you:

  • have paid Medicare taxes for 40 or more quarters during your life
  • are age 65 or older and eligible for or currently collecting Social Security or Railroad Retirement Board (RRB) retirement benefits
  • are under age 65 and eligible to collect Social Security or RRB disability benefits
  • are any age and have received a diagnosis of end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)

If you don’t meet the criteria for premium-free Part A, you’ll pay $278 or $505 each month.

Deductibles are the amount you need to pay before Part A starts covering the costs of your care.

Copayments, or copays, are a fixed amount you must pay for a medical item or service. Coinsurance fees are the percentage that you pay for services after you’ve met your deductible.

Here’s how each of these costs factor into a hospital stay in 2024:

  • $1,632 deductible for each benefit period
  • $0 coinsurance for days 1 to 60 of treatment after you pay your deductible
  • $408 coinsurance per day for days 61 to 90 of treatment
  • $816 coinsurance per day for days 91 to 150 of treatment while using your 60 lifetime reserve days
  • 100% of the treatment costs for days 151+
  • $0 coinsurance for days 1 to 20
  • $204 coinsurance per day for days 21 to 100 of treatment
  • 100% of the treatment costs for days 101+
  • $0 for covered services
  • 20% of all Medicare-approved costs for durable medical equipment

For hospice:

  • $0 for covered services
  • $5 copayment for prescription drugs and similar products for pain relief or symptom management
  • 5% of all Medicare-approved costs for inpatient respite care

If you aren’t eligible for premium-free Part A and choose not to buy it when you can enroll in Medicare, you may be subject to a late enrollment penalty.

This can cause your monthly premium to increase by up to 10% for each year you do not enroll in Part A after you are eligible.

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

Most people don’t pay a monthly premium for Part A, but you may be required to pay other costs, such as deductibles, copays, and coinsurance.