Medicare Part A
Hospital insurance that covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services; premium-free for most Americans who worked 40+ quarters.
Medicare Part A is the hospital insurance component of Original Medicare. Most beneficiaries pay no monthly premium because they or a spouse paid Medicare payroll taxes (1.45% of wages, matched by employers) for at least 40 quarters (10 years) of covered employment. Those with 30–39 quarters pay $278/month (2024); fewer than 30 quarters pay $505/month.
Part A's 2024 inpatient deductible is $1,632 per benefit period (not per year — a new deductible applies each time you are admitted after a 60-day gap in care). Days 1–60 are covered with no coinsurance beyond the deductible. Days 61–90 require a $408/day coinsurance payment. Beyond 90 days, the patient uses "lifetime reserve days" (60 total, ever) at $816/day, and after those are exhausted, all costs fall to the patient.
Part A does not cover most long-term custodial care. Skilled nursing facility coverage requires a preceding 3-day inpatient hospital stay, covers only skilled care (physical therapy, wound care, IV medications), and is fully covered for only days 1–20; days 21–100 require a $204/day coinsurance; beyond 100 days, Part A pays nothing.
Real-World Example
After a hip replacement requiring a 5-day hospital stay followed by 30 days of skilled nursing rehabilitation, the patient paid the $1,632 Part A deductible plus $204/day × 10 days (days 21–30) in SNF coinsurance — a total out-of-pocket cost of $3,672.