Medicare Part A is hospital insurance. It helps pay for inpatient care in a hospital, short-term skilled nursing facility care after a qualifying hospital stay, hospice, and some home health care. Most people pay no monthly premium for it, but in 2026 there is a $1,736 deductible each time a new benefit period starts. Part A does not pay for long-term custodial care, and it does not cover doctor visits or emergency room visits, which fall under Part B.
What does Medicare Part A cover?
According to Medicare.gov, Part A helps cover inpatient care in hospitals, critical access hospitals and skilled nursing facilities, plus hospice care and some home health care. The table below sums up the five main areas.
| Part A service | What it includes | The main condition or limit |
|---|---|---|
| Inpatient hospital care | Semi-private room, meals, general nursing, certain drugs and supplies | You must be formally admitted with a doctor’s order, at a hospital that accepts Medicare |
| Inpatient mental health care | Psychiatric care you get as a hospital inpatient | 190-day lifetime limit in a freestanding psychiatric hospital (not in a general hospital’s psychiatric unit) |
| Skilled nursing facility (SNF) | Semi-private room, meals, skilled nursing, therapy, medications | Prior inpatient stay of at least 3 days in a row, and a need for daily skilled care |
| Hospice | Comfort care for a terminal illness | Your hospice doctor and regular doctor certify a life expectancy of 6 months or less, and you accept comfort care instead of care to cure the illness |
| Home health care | Part-time skilled nursing, therapy and an aide alongside them | Paid under Part A and/or Part B; a provider must order it |
Details are on Medicare.gov’s page for inpatient hospital care. Our guides to skilled nursing facility coverage, hospice at home and the Medicare home health benefit go further into each one.
Does Medicare Part A cover emergency room visits?
Usually not directly. Medicare.gov lists emergency department services under Part B, and you pay a copayment for the visit plus a copayment for each hospital service. After the Part B deductible, you also pay 20% of the approved amount for the doctor’s services.
The picture changes if you are admitted. If the same hospital admits you for a related condition within 3 days of the emergency visit, you do not pay the emergency copayments, because Medicare treats the visit as part of your inpatient stay. Part A then pays for the inpatient stay.
What does Part A not cover?
Four things come up most often:
- Long-term care. Medicare does not pay for custodial care, such as help with dressing, bathing and using the bathroom, or home-delivered meals and adult day health care.
- Doctors’ fees. Part B generally covers 80% of the approved amount for doctors’ services in the hospital.
- Hospital extras. Private-duty nursing, a private room unless medically necessary, and personal items such as razors.
- 24-hour care at home. Medicare.gov says home health does not include 24-hour-a-day care at home, or custodial care when it is the only care you need.
Our page on what Medicare covers for home care explains how families plan for these gaps.
Inpatient or observation: why your hospital status matters
Part A pays for inpatient care, so whether you were formally admitted decides a lot. Per Medicare.gov, you are an inpatient only from the moment a doctor orders your admission and the hospital formally admits you. You are an outpatient if you get emergency department or observation services without that order, even if you spend the night in a regular hospital bed.
Medicare says admission is generally appropriate when you are expected to need 2 or more midnights of hospital care, but the doctor must order it. After more than 24 hours in observation, the hospital must give you a Medicare Outpatient Observation Notice (MOON).
Time in observation or the emergency room does not count toward the 3-day inpatient stay needed for skilled nursing facility coverage. You or a family member can ask the hospital team each day which you are. If your status was changed, see our guide on skilled nursing after a hospital stay and appeals.
What does Medicare Part A cost in 2026?
For most people the monthly premium is $0, because they or a spouse paid Medicare taxes long enough while working. The CMS 2026 fact sheet says about 99% of beneficiaries have no Part A premium because they have at least 40 quarters of Medicare-covered employment. Medicare.gov says generally at least 10 years of work.
| Type of care | Days | What you pay in 2026 |
|---|---|---|
| Inpatient hospital | 1 to 60 | $1,736 deductible per benefit period, then $0 a day |
| Inpatient hospital | 61 to 90 | $434 a day |
| Inpatient hospital | 91 to 150 | $868 a day, using your 60 lifetime reserve days |
| Inpatient hospital | After day 150 | All costs |
| Skilled nursing facility | 1 to 20 | $0 a day (no new deductible if already paid in the same benefit period) |
| Skilled nursing facility | 21 to 100 | $217 a day |
| Skilled nursing facility | After day 100 | All costs |
| Home health care | Covered services | $0 (20% of the approved amount for durable medical equipment) |
| Hospice | Covered services | $0, plus up to $5 per drug for symptom control at home and 5% for inpatient respite care |
Source: Medicare.gov costs page. Original Medicare has no yearly out-of-pocket limit unless you add Medigap or join a Medicare Advantage plan.
What is a benefit period?
A benefit period is how Original Medicare counts your hospital and skilled nursing facility use. It begins the day you are admitted as an inpatient and ends when you have gone 60 days in a row without inpatient hospital care or skilled care in a facility. If you are admitted again after it ends, a new one starts and you pay the deductible again. There is no limit on benefit periods in a year, so you can pay the deductible more than once.
Who is eligible for Part A, and who gets it automatically?
Medicare.gov says Medicare is for people 65 or older who meet citizenship or residency requirements (for example, U.S. citizens and lawful permanent residents). You may qualify earlier with a disability, End-Stage Renal Disease (ESRD) or ALS.
Whether you must sign up depends on Social Security, as Medicare.gov explains:
- Getting Social Security benefits at least 4 months before 65: you get Parts A and B automatically when you turn 65.
- Already getting Social Security after 65: you get Part A automatically and chose Part B when you applied for benefits.
- Disability benefits: you get Parts A and B automatically after 24 months of disability benefits.
- Not getting Social Security yet: you must contact Social Security to sign up.
How do you sign up for Medicare Part A?
If you are not enrolled automatically, you sign up through Social Security. Medicare.gov calls signing up online the easiest and fastest way with a secure my Social Security account. By phone, Social Security is at 1-800-772-1213 (TTY 1-800-325-0778).
- Check your window. The Initial Enrollment Period lasts 7 months: 3 months before the month you turn 65, that month, and the 3 months after.
- Decide about Part B at the same time. It has its own premium and rules, in our Part B guide. To buy Part A, you must also sign up for Part B.
- Apply with Social Security. Do it online, by phone or at a local office. About 2 weeks after you sign up, Medicare mails a welcome package with your Medicare card.
- Read the start date. Coverage always starts on the first of a month. Premium-free Part A starts the month you turn 65 (the month before, if your birthday is on the 1st).
If you sign up for premium-free Part A after turning 65, coverage starts 6 months back, but not earlier than the month you turned 65.
What if you miss the deadline?
For premium-free Part A, there is no penalty for signing up late. For people who must buy Part A, there is one. According to Medicare.gov’s page on late enrollment penalties, the monthly premium may rise 10%, and you pay the higher amount for twice the number of years you could have signed up but did not. Two years late means four years of the higher premium.
| Situation | When you can sign up |
|---|---|
| Turning 65 | Initial Enrollment Period: 7 months around your 65th birthday month |
| Missed it, and you must buy Part A | General Enrollment Period, January 1 to March 31 each year; coverage starts the month after you sign up |
| Coverage from your or your spouse’s job | Special Enrollment Period ending 8 months after the job or coverage ends, whichever is first (COBRA does not count) |
| Lost Medicaid on or after 1/1/2023 | Special Enrollment Period ending 6 months after Medicaid ends |
Source: Medicare.gov, When does Medicare coverage start?
Medicare Part A and B together: what is Original Medicare?
Original Medicare is Part A plus Part B. Part B covers doctors and other providers, outpatient care, some home health care, durable medical equipment and many preventive services. You can use any doctor or hospital that takes Medicare, and add a separate Part D drug plan. Part A alone leaves out doctors and outpatient care. For how Medicare differs from Medicaid, see our Medicare vs Medicaid guide for New York.
Does Medicare Advantage replace Part A?
Not exactly. Medicare Advantage plans, run by private insurers, bundle Part A, Part B and usually Part D. You must keep Part B and pay its premium, and the plan sets its own copayments, network and yearly out-of-pocket limit. The Part A amounts above are for Original Medicare; plan members may pay copayments in the first 60 hospital days or first 20 skilled nursing days. If you choose hospice in a plan, Original Medicare covers what you need for the terminal illness. Our Medicare Advantage vs Original Medicare guide lays out the differences.
Where can New Yorkers get help with Part A and its costs?
- HIICAP. New York’s health insurance counseling program is part of the national SHIP network. Its number is 1-800-701-0501. 1-800-MEDICARE (1-800-633-4227) answers benefit questions.
- Medicare Savings Programs. The New York State Department of Health describes the Qualified Medicare Beneficiary (QMB) program as one that can pay the Part A and/or Part B premium and the Parts A and B coinsurance and deductibles. The 2026 income limit is $1,836 a month for a single person and $2,489 for a couple, plus a $20 deduction. The Medicaid Helpline is 1-800-541-2831.
Medicare Part A advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
Families often haven’t heard of the Medicare Savings Programs, or of Extra Help with prescription costs, SNAP or HEAP. Many never check Medicaid or home care eligibility because they assume their income is too high. If you don’t know what you qualify for, start with what is on the table: insurance, income, benefits already received and the person’s care needs. You don’t have to fill out a dozen applications this week. First find out which programs fit. NYC Aging, NY Connects (1-800-342-9871) and Medicaid specialists are good places to ask, and hospital Medical Social Services can help in tricky situations.
We help families understand their home care options in Brooklyn and Queens and send them to the right specialist for the rest. Please don’t wait for a hospital stay or a fall to start looking. It is far easier to arrange safe care before things reach a crisis. Our guide to financial help for seniors in NYC lists more programs.
ProLife Home Care is a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. If you are planning for a discharge, our guide to hospital discharge and home care may help, or call (718) 232-2777 or use our contact page.
Medicare amounts and rules change every year, and the figures here are for 2026. Everything above was checked on 16 October 2026 against medicare.gov, cms.gov, health.ny.gov and shiphelp.org. Confirm your own situation with Social Security, 1-800-MEDICARE or HIICAP. This page is general information, not insurance, medical or legal advice.
Frequently asked questions
What is the difference between Medicare Part A and B?
Part A is hospital insurance: inpatient hospital stays, skilled nursing facility care after a qualifying stay, hospice and some home health care. Part B is medical insurance: doctors, outpatient care, preventive services, some home health care and durable medical equipment. Together they make up Original Medicare.
What does Medicare Part A cover?
It covers inpatient hospital care, inpatient mental health care in a hospital, short-term skilled nursing facility care, hospice and some home health care. It does not cover long-term custodial care, private-duty nursing or a private room unless medically necessary.
Is Medicare Part A free?
For most people the monthly premium is $0, because they or a spouse paid Medicare taxes long enough, generally at least 10 years or 40 quarters. In 2026 you still pay a $1,736 deductible for each benefit period. People with fewer quarters can buy Part A for $311 or $565 a month.
How much is the Part A deductible in 2026?
$1,736 for each inpatient hospital benefit period. Days 61 to 90 cost $434 a day, lifetime reserve days cost $868 a day, and skilled nursing facility days 21 to 100 cost $217 a day.
How do I sign up for Medicare Part A?
If you already get Social Security benefits, you are enrolled automatically at 65 or when you start getting them after 65. Otherwise sign up with Social Security online, at 1-800-772-1213 or at a local office, ideally within the 7-month Initial Enrollment Period around your 65th birthday.
Does Medicare Part A cover emergency room visits?
Not by itself. Emergency department visits are billed under Part B. If you are admitted to the same hospital for a related condition within 3 days, the visit becomes part of your inpatient stay and Part A pays for the stay.
Is there a penalty for signing up for Part A late?
Only if you have to buy it. Then the monthly premium may rise 10% for twice the number of years you could have signed up but did not. People who qualify for premium-free Part A can sign up later without that penalty, and coverage can go back up to 6 months.
