Medicare Part A is the hospital insurance component of original Medicare, the federal health insurance program designed for adults ages 65 and older and some younger people who have qualifying disabilities. Part A coverage kicks in when you need medical care in a hospital, but does not cover outpatient services such as doctor’s visits.
Read on to learn everything you need to know about Medicare Part A.
What Does Medicare Part A Cover?
Medicare Part A, also known as hospital insurance, covers inpatient and intensive care for people enrolled in original Medicare. “But it doesn’t cover everything,” says Dr. Billy Zhang, an internal medicine physician specializing in aging adults with Providence St. Joseph Hospital in Orange County, California.
Here’s what to know about what’s covered and what’s excluded from Part A benefits.
| Covered by Part A | Excluded from Part A |
| Shared hospital room | Private hospital room |
| Meals while hospitalized | Personal care items or a TV or phone if those aren’t already included in your hospital room |
| Medications while hospitalized | Prescriptions for use at home after discharge |
| Short-term skilled nursing care post hospitalization | Long-term nursing care at home |
| Hospice care including family support services | Care and support in an assisted living facility or nursing home |
| Limited, part-time skilled nursing care or therapy at home | 24-hour at-home care |
| Limited personal assistance only while receiving skilled nursing care | Assistance with activities of daily living including grooming, meal prep and housekeeping |
| Outpatient care services including doctor’s visits |
[READ: Does Medicare Cover Home Health Care?]
Does Part A cover visits to the doctor and prescriptions?
Medicare Part A is hospital insurance, so it doesn’t cover the prescriptions you use at home and it doesn’t pay for visits to your primary care provider and most other outpatient services.
Instead, Medicare Part A is designed to work together with Medicare Part B, which covers a wide range of outpatient medical services and preventive care, such as vaccines, visits to the doctor and some medical equipment. You will have to pay a standard monthly premium for Part B, which is $202.90 for most people in 2026.
Even with original Medicare (Part A and Part B) combined, there can still be significant gaps in your coverage, according to Whitney Stidom, vice president of sales and operations with eHealth Inc., a health insurance broker and online resource provider headquartered in Austin.
“For example, it doesn’t provide coverage for prescriptions, so you will need to enroll in a separate prescription drug plan offered by a private insurance company; otherwise you could face penalties,” she says.
For prescriptions, you’ll need to purchase a Part D plan, which has a monthly premium that may vary based on your income.
And it’s important to note that if you don’t sign up for Part D when you first become eligible, you may have to pay a Part D late enrollment penalty later. That penalty also varies depending on how long you went without creditable prescription drug coverage, and it can get expensive quickly.
[READ Understanding Parts of Medicare: A Through N Explained]
How Do I Get Medicare Part A?
When you turn 65 you are, in most cases, entitled to Part A with no premium, explains Scott R. Maibor, a licensed insurance advisor and managing director of Senior Benefits Boston LLC, a Medicare advisory based in Haverhill, Massachusetts.
“It is not required to enroll, unless you work for a company of fewer than 20, but there is no harm in enrolling,” Maibor says.
But, he notes, there is one exception. “If there is a health savings account in your name being actively contributed to, you cannot have Medicare, including Part A, at the same time.”
In short, many people enroll in Medicare Part A when they turn 65 years old.
“You can enroll through the Social Security Administration online during your initial enrollment period, which starts three months before your 65th birthday and ends the third month after your birthday,” Stidom explains.
If you’re still working and have creditable coverage through your employer or a spouse’s employer, you can delay enrolling in Medicare. You can also switch to original Medicare from a Medicare Advantage plan during Medicare’s annual enrollment period, which runs from October 15 through December 7.
If you have a qualifying disability, you may be eligible for Medicare before age 65.
If you’ve received Social Security benefits or Railroad Retirement Board benefits for 24 months, you’ll automatically be enrolled in Medicare. That waiting period is waived for people with certain conditions, such as end-stage renal disease or ALS (Lou Gehrig’s disease).
You should double check that you’re enrolled on time, as late-enrollment penalties can accrue if you aren’t enrolled in Medicare at the right time.
[Read: When Can You Sign Up for Medicare?]
How Much Does Medicare Part A Cost?
Most beneficiaries don’t need to pay a monthly premium for Medicare Part A, as long as you or your spouse worked and paid Medicare taxes for at least 10 years.
However, there are other costs, including deductibles and coinsurance that the individual must pay. This means Medicare Part A is not, as many people describe it, “free,” Maibor says.
For example, the Medicare Part A deductible in 2026 is $1,736 for each time you’re admitted to the hospital per benefit period.
What’s more, if you and your spouse haven’t met the work requirement, you’ll need to pay a monthly premium. In 2026, this premium ranges from $311 to $565 depending on how long you’ve paid Medicare taxes.
How Can I Lower Out-of-Pocket Costs?
In addition to Medicare Part A, Part B and Part D, you may want to add a Medicare supplement plan, also called a Medigap plan, as these can help cover your out-of-pocket costs with original Medicare. Medigap plans can help cover costs such as coinsurance, copayments and deductibles.
Alternatively, for some people, selecting a Medicare Advantage plan may offer a better mix of coverage options for their particular needs. Many Medicare Advantage plans bundle Parts A and B and usually include an annual out-of-pocket maximum, Zhang says. These plans also typically include prescription drug benefits, and some include other health care services, such as vision and dental benefits.
If you meet low-income requirements, “you may qualify for Medicaid or Medicare Savings Programs, which can help pay premiums and cost sharing,” Zhang notes.
It can all seem very complicated, but working with a licensed insurance agent can help take the confusion out of the process and help you decide which options make the most sense for you, Stidom says.
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What Is Medicare Part A? originally appeared on usnews.com
