Understanding Medicare Part A Coverage
Medicare Part A, known as Hospital Insurance, covers inpatient hospital stays, skilled nursing facility (SNF) care, hospice care, and some home health care. While many receive premium-free Part A, costs like deductibles and coinsurance still apply. The Part A deductible is based on a benefit period, which starts upon inpatient admission and ends after 60 consecutive days without inpatient care. A new benefit period and deductible apply if readmitted after this 60-day window.
The Truth About "100% Coverage"
Medicare Part A covers 100% of inpatient hospital costs for the first 60 days of a benefit period after the deductible is met. The 2025 deductible is $1,676. Beyond these initial 60 days, coinsurance payments begin.
Inpatient Hospital Coinsurance
For a single benefit period in 2025:
- Days 1–60: $0 coinsurance after deductible.
- Days 61–90: Daily coinsurance of $419.
- Days 91 and beyond: Daily coinsurance of $838 for 60 lifetime reserve days.
- After exhausting lifetime reserve days: All costs are the beneficiary's responsibility.
Skilled Nursing Facility Costs
Medicare Part A also covers SNF care, but not indefinitely at 100%. For a covered stay following a qualifying hospital stay:
- Days 1–20: $0 after a qualifying hospital stay.
- Days 21–100: Daily coinsurance applies (in 2025).
- Day 101 and beyond: All costs are the beneficiary's responsibility.
Comparison: Medicare Part A Hospital vs. SNF Costs (2025)
This table highlights coinsurance differences in a single benefit period.
| Length of Stay | Inpatient Hospital Cost After Deductible | Skilled Nursing Facility Cost (Following Hospital Stay) |
|---|---|---|
| Days 1–20 | $0 coinsurance | $0 coinsurance |
| Days 21–60 | $0 coinsurance | Daily coinsurance ($209.50) |
| Days 61–90 | Daily coinsurance ($419) | Daily coinsurance ($209.50) |
| Days 91–100 | Daily coinsurance ($838 for lifetime reserve days) | Daily coinsurance ($209.50) |
| Day 101 and beyond | Daily coinsurance ($838 for lifetime reserve days), then all costs after 150 days | All costs |
How Medigap and Medicare Advantage Can Help
Options exist to help manage Part A out-of-pocket costs.
Medigap (Medicare Supplement) Plans
Medigap plans work with Original Medicare to cover costs like deductibles and coinsurance. Many plans cover the Part A deductible and coinsurance for extended hospital and SNF stays.
Medicare Advantage (Part C) Plans
These private plans offer at least the same benefits as Original Medicare but with different costs and rules. Medicare Advantage plans have a maximum out-of-pocket limit, after which the plan pays 100% for covered services for the year.
For further details on plans and options, consult the official Medicare website at {Link: medicare.gov https://www.medicare.gov/basics/costs/medicare-costs}.
The Takeaway: Avoid Assumptions
Assuming Medicare Part A pays 100% after the deductible can lead to unexpected costs. While the first 60 days of inpatient care are fully covered after the deductible, coinsurance for longer hospital and SNF stays adds up. Understanding the benefit period structure and considering supplemental coverage like Medigap or Medicare Advantage are key to managing potential expenses.
