What Does Medicare Part A Cover? Hospital, Nursing Facility, and Hospice Rules

What does Medicare Part A cover? It is Medicare’s hospital insurance. It pays for inpatient care in hospitals, short stays in a skilled nursing facility after a hospital admission, hospice care, and some home health care. It also covers blood you get as an inpatient and inpatient psychiatric care.

The catch is the fine print. Each of those benefits has its own entry rules, day limits and daily charges, and a night in a hospital bed does not always count as an inpatient stay. Many families learn this from a bill.

This guide walks through each benefit the way it plays out in real life, using the 2026 amounts from Medicare.gov and the CMS 2026 cost-sharing fact sheet. If you want the premium side of the story instead, our Part A premium guide covers who pays and how much.

Key Takeaways

• Part A covers inpatient hospital care, skilled nursing facility care after a qualifying hospital stay, hospice, some home health care, inpatient blood and inpatient mental health care.
• You must be formally admitted with a doctor’s order. Time under observation or in the emergency room is outpatient care, even overnight, and it does not count toward the 3-day stay a nursing facility needs.
• In 2026 you pay a $1,736 deductible per benefit period, then $0 for hospital days 1 to 60, $434 a day for days 61 to 90 and $868 a day on lifetime reserve days.
• Skilled nursing care is $0 for days 1 to 20 and $217 a day for days 21 to 100. Part A does not pay for long-term custodial care in a nursing home.
• Hospice is close to free: up to $5 per prescription for symptom drugs and 5% for respite stays, but room and board at home or in a nursing home is not covered.

What does Medicare Part A cover, in plain terms?

Medicare Part A covers care you get as an admitted inpatient: hospital stays, skilled nursing facility care after a hospital stay, hospice and some home health care. Medicare.gov says it helps pay for “inpatient care you get in hospitals, critical access hospitals, and skilled nursing facilities.”

Think of it as the “facility” half of Original Medicare. In the hospital, Part A pays for your room, meals, nursing and drugs, while Part B pays the doctors who treat you.

Here is the full list of what falls under Part A, with the main condition for each:

Benefit	Main condition	Your 2026 share
Inpatient hospital care	Formal admission with a doctor’s order	$1,736 deductible, then daily coinsurance after day 60
Skilled nursing facility (SNF)	3-day inpatient stay first, daily skilled care	$0 days 1 to 20, $217 a day days 21 to 100
Home health care	Homebound, needs part-time skilled care	$0 for services
Hospice	Life expectancy of 6 months or less, comfort care chosen	Up to $5 per drug, 5% for respite
Inpatient mental health	Same as hospital care; 190-day lifetime cap in psychiatric hospitals	Same as hospital care
Blood (inpatient)	Given while admitted	First 3 units a year if the hospital buys the blood
Religious nonmedical health care institution	You would otherwise qualify for hospital or SNF care	Same as hospital care

CMS says about 99% of people with Medicare pay no Part A premium. The deductible and daily charges above still apply to everyone in Original Medicare.

Not on Medicare yet? Timing matters as much as coverage. Our guide to when you can enroll in Medicare covers your 7-month first window and the later ones.

When does a hospital stay count as inpatient care?

A hospital stay counts as Part A inpatient care only when a doctor orders your admission and the hospital formally admits you. Medicare.gov says admission is generally right when you are expected to need “2 or more midnights of medically necessary hospital care.” A night in a bed is not enough.

Your inpatient status starts on the day you are formally admitted. The day before you are discharged is your last inpatient day, which matters when you count days for a nursing facility later.

What the hospital bill includes

Once you are admitted, Medicare.gov lists these as covered inpatient services:

• A semi-private room (a room you share)
• Meals
• General nursing
• Certain drugs, including methadone to treat opioid use disorder
• Other hospital services and supplies that are part of your inpatient treatment

Part A also reaches back a little. For most hospitals, it pays for related outpatient services you got during the 3 days before your admission date, such as the emergency room workup that led to the admission.

What it leaves out inside the hospital

Four items stay on you even during a covered stay: private-duty nursing, a private room unless it is medically necessary, a phone or television if the hospital charges for it separately, and personal care items like razors or slipper socks.

Your doctors’ bills are also separate. If you have Part B, it generally pays 80% of the Medicare-approved amount for doctors’ services in the hospital, and you pay the rest after the yearly Part B deductible. Our Part B premium guide explains what that half of Medicare costs each month.

Which facilities count

Inpatient care is not limited to a general hospital. Medicare.gov includes acute care hospitals, critical access hospitals (small rural hospitals with 25 or fewer beds), inpatient rehabilitation facilities, inpatient psychiatric facilities and long-term care hospitals.

It also includes inpatient care in a qualifying clinical research study. In every case, the facility must accept Medicare.

How do benefit periods and lifetime reserve days work?

A benefit period starts the day you are admitted as an inpatient and ends after you have gone 60 days in a row without inpatient hospital or skilled nursing care. You pay the $1,736 deductible once per benefit period, not once per year, and there is no limit on how many benefit periods you can have.

This is the rule that surprises people most. Part A does not run on the calendar year. If you are hospitalized in February and again in October, with months at home in between, you pay the deductible twice in the same year.

Within one benefit period, your share of the hospital bill rises the longer you stay. These are the 2026 amounts from CMS, released on November 14, 2025:

Days in the hospital (one benefit period)	You pay in 2026	2025 for comparison
Deductible	$1,736	$1,676
Days 1 to 60	$0 a day	$0 a day
Days 61 to 90	$434 a day	$419 a day
Days 91 to 150 (lifetime reserve days)	$868 a day	$838 a day
After day 150	All costs	All costs

The chart below puts the hospital and skilled nursing amounts side by side, so you can see where the daily charges climb.

Lifetime reserve days are a one-time bank

Every person on Original Medicare gets 60 lifetime reserve days. They kick in after day 90 of a single benefit period, and once you use one, it is gone for good. They do not refill when a new benefit period starts.

Here is how a long stay adds up. Say you spend 100 days in the hospital in one benefit period in 2026. You pay the $1,736 deductible, then 30 days at $434 ($13,020), then 10 reserve days at $868 ($8,680). That is $23,436, and you have 50 reserve days left for the rest of your life.

For the deductible itself, including how it compares with the Part B and Part D deductibles, see our Medicare deductibles guide.

Does Part A cover a nursing home stay?

Part A covers a short stay in a skilled nursing facility, not a long-term nursing home stay. You need a qualifying inpatient hospital stay of at least 3 days in a row first, and a doctor must decide you need daily skilled care, like IV medicine or physical therapy. Coverage stops at 100 days per benefit period.

The 3 days are counted from the day you are admitted as an inpatient. The day you leave the hospital does not count. Time in the emergency room or under observation before you are admitted does not count either, even if you were there overnight.

The conditions you must meet

The Medicare.gov skilled nursing page lists these requirements, and all of them must be true:

• You have Part A and days left in your benefit period.
• You had a qualifying inpatient hospital stay.
• You enter the facility within a short time, generally 30 days, of leaving the hospital.
• Your doctor has decided you need daily skilled care from, or supervised by, skilled nursing or therapy staff.
• The facility is Medicare-certified.
• The skilled care is for a condition treated during your hospital stay, or a new condition that started while you were in the facility for that condition.

The goal does not have to be recovery. Medicare.gov says skilled care also counts when it maintains your condition or slows it from getting worse.

What the facility stay includes

Covered services include a semi-private room, meals, skilled nursing care, physical and occupational therapy, speech-language pathology, medical social services, medications, medical supplies and equipment used in the facility, and dietary counseling.

What a rehab stay costs in 2026

Days 1 to 20 cost $0. Days 21 to 100 cost $217 a day. From day 101, you pay everything. You usually do not pay a second deductible, because Medicare.gov says you skip it if you already paid it for the hospital stay in the same benefit period.

A common example: Dad has a hip replacement, is admitted for 3 days, then goes to a rehab facility for 25 days. The family pays the $1,736 hospital deductible and 5 days at $217 ($1,085) for days 21 to 25, or $2,821 in Part A costs. Doctor and therapy bills under Part B are separate.

If you leave the facility and need to go back within 30 days, you do not need a new 3-day hospital stay. The same is true if you stop getting skilled care while in the facility and restart it within 30 days.

What if the hospital keeps you under observation?

Observation is outpatient care, so Part B pays for it, not Part A, and observation days do not count toward the 3-day stay you need for skilled nursing coverage. The hospital must give you a Medicare Outpatient Observation Notice (MOON) if you are under observation for more than 24 hours.

Observation is what a hospital provides while your doctor decides whether to admit you or send you home. You may spend a night or two in a regular bed and still be an outpatient on paper.

The MOON is the document to watch for. It tells you that you are an outpatient getting observation services, explains why you were not admitted, and explains how this may affect what you pay in the hospital and for care after you leave.

How it plays out

Medicare.gov’s hospital status page gives two cases that show the difference. You come in with chest pain, spend one night under observation, and the doctor writes an admission order on the second day. You are an outpatient until that order, then an inpatient, and Part A pays for the stay.

In the other case, you go in for outpatient surgery and stay overnight for high blood pressure, but no one writes an admission order. You go home the next day. Part A pays nothing, and Part B pays for the surgery and other outpatient services.

What you can do about it

• Ask every day. Medicare.gov says you or a caregiver should ask the doctor, a hospital social worker or a patient advocate each day whether you are an inpatient or an outpatient.
• Ask about waivers. If your doctor is in an Accountable Care Organization with a “Skilled Nursing Facility 3-Day Rule Waiver,” you may not need the 3-day stay. Medicare Advantage plans may also waive it.
• Check other help. Without a qualifying stay, ask about home health care, Medicaid or veterans’ benefits for after-hospital care.
• Appeal past status changes. If you were admitted as an inpatient on or after January 1, 2009, and the hospital later changed you to “outpatient getting observation services,” you may be able to appeal for Part A coverage of the hospital and SNF care.

Does Part A pay for home health care, or is that Part B?

Both parts cover home health care, and you pay $0 for covered services either way. Under the Social Security Act, Part A pays for up to 100 home health visits that start within 14 days after a hospital stay of at least 3 days or a covered skilled nursing stay. Part B pays for other home health care.

For most people this split happens behind the scenes, and the eligibility rules below are the same either way. If you do not have Part B, Part A covers your home health services.

Who qualifies

You must be homebound and need part-time or intermittent skilled care. Homebound means leaving home is not recommended because of your condition, or you need help like a cane, walker, wheelchair, special transport or another person to leave, and leaving takes a lot of effort.

You can still leave home for medical care and for short, infrequent outings like religious services, and you can still attend adult day care. A doctor or other provider, such as a nurse practitioner, must see you in person, confirm you need home health care and order it. A Medicare-certified agency must provide it.

What is included, and what is not

Covered home health care includes part-time skilled nursing (like wound care, IV or nutrition therapy, injections and monitoring a serious illness), physical and occupational therapy, speech-language pathology, medical social services, and medical supplies for use at home.

Home health aide help with bathing, walking or dressing is covered only while you also get skilled nursing or therapy. In most cases, aide and nursing time together is capped at 8 hours a day and 28 hours a week, with up to 35 hours a week for a short time if your provider decides it is needed.

Medicare does not pay for 24-hour care at home, home meal delivery, homemaker services like shopping and cleaning, or personal care when that is the only care you need. Medical equipment such as a walker or hospital bed is billed under Part B, where you pay 20% after the Part B deductible.

What does Part A cover in hospice?

Part A covers hospice for people with a life expectancy of 6 months or less who choose comfort care instead of treatment to cure the illness. You pay nothing for services from a Medicare-approved hospice, except up to $5 per prescription for symptom drugs and 5% of the approved amount for respite care.

To start, your hospice doctor and your regular doctor (if you have one) must certify that you are terminally ill. You then sign a hospice election statement choosing hospice instead of other Medicare-covered treatment for the terminal illness and related conditions.

How long hospice coverage lasts

Coverage runs in two 90-day periods, followed by an unlimited number of 60-day periods. After the first 6 months, the hospice medical director or hospice doctor must recertify that you are still terminally ill, after a face-to-face visit with the hospice doctor or nurse practitioner.

You can change hospice providers once in each period. You can also keep your regular doctor or nurse practitioner as the attending professional who helps supervise your hospice care.

The hospice costs families do not expect

Room and board is the big one. Medicare does not pay for it if you get hospice care at home, or if you live in a nursing home or a hospice inpatient facility. The exception is short-term inpatient or respite care that the hospice team arranges.

Respite care is a short facility stay that lets a family caregiver rest. Each respite stay can last up to 5 days, and your 5% share cannot be more than the inpatient deductible.

Once hospice starts, Medicare will not pay for treatment meant to cure the terminal illness, or for hospice care the team did not set up. ER visits, hospital stays and ambulance rides are covered only if the hospice team arranges them or they are unrelated to the illness. Call the team first.

Health problems that are not related to the terminal illness are still covered by Original Medicare, with the usual deductibles and coinsurance.

The hospice gives a written list of what it decides is unrelated and will not cover. A CMS rule finalized July 30, 2026 makes that list mandatory for everyone who elects hospice, not only those who ask.

Is inpatient mental health care covered, and what is the 190-day limit?

Yes. Part A covers mental health care when you are admitted as an inpatient, with the same deductible and daily charges as any hospital stay. If the care is in a freestanding psychiatric hospital, Part A pays for only 190 days of that care over your whole lifetime.

The 190-day limit does not apply to a Medicare-certified psychiatric unit inside a general acute care or critical access hospital, which Medicare calls a “distinct part” unit. That difference can matter for someone who needs repeated admissions over many years.

Doctors and other providers who treat you during the stay bill Part B, and you pay 20% of the Medicare-approved amount for those services. If you or someone you know is in crisis, Medicare.gov points people to the 988 Suicide and Crisis Lifeline by call, text or chat.

Does Medicare Part A pay for blood transfusions?

Part A covers blood you get as a hospital inpatient. If the hospital gets the blood from a blood bank at no charge, you pay nothing for it. If the hospital has to buy blood for you, you either pay for the first 3 units you get in a calendar year or have the blood replaced by a donation from you or someone else.

Hospitals also charge for processing and handling each unit. After you meet the Part A deductible, there is no copay for that when you are an inpatient. Blood you get as an outpatient falls under Part B instead, with a copay for each unit.

What is a religious nonmedical health care institution, and does Part A cover it?

A religious nonmedical health care institution (RNHCI) cares for people who do not accept standard medical care because of their religious beliefs. Part A covers only the nonreligious, nonmedical items and services there, like room and board, unmedicated wound dressings or a simple walker.

To qualify, you must be eligible for inpatient hospital or skilled nursing care, the institution must be Medicare-certified, and its Utilization Review Committee must agree you would need hospital or SNF care if you were not there. You also file a written election with Medicare.

The election ends if you accept standard medical care, and you may wait 1 to 5 years to qualify again. Costs match a hospital stay.

What does Medicare Part A not cover?

Part A does not cover long-term custodial care, such as help with bathing, dressing and eating in a nursing home or at home when that is the only care you need. It also excludes private-duty nursing, a private room unless medically necessary, and outpatient care, which Part B handles.

The gaps, drawn from the Medicare.gov coverage pages:

• Long-term care. Medicare and Medigap do not pay for long-term care services in a nursing home or in the community. Medicaid may pay if you qualify in your state, or you can buy private long-term care insurance.
• Extras during a stay. Private-duty nursing, a private room that is not medically necessary, a separately charged phone or TV, and personal items.
• Days past the limits. Hospital days after day 150 in a benefit period, SNF days after day 100, and psychiatric hospital days after the 190-day lifetime cap.
• Observation and ER time. These are outpatient services, so Part B pays, not Part A.
• Hospice room and board. Not covered at home or in a facility where you live.
• The religious part of RNHCI care. Only the nonmedical items are paid.

Part A is also not where routine dental, hearing or vision care lives. Part A can pay for a hospital stay tied to a covered dental procedure, as our guide on whether Medicare covers dental explains, and our hearing aids guide covers what Original Medicare does and does not pay there.

For a long nursing home stay, Medicaid is the main payer for people who qualify. Our Medicare vs Medicaid guide explains how the two programs work together.

How do Medigap and Medicare Advantage change what you pay for Part A care?

Every standard Medigap plan pays the Part A hospital coinsurance and adds up to 365 more hospital days after Medicare’s days run out. Medicare Advantage plans take the place of Original Medicare and set their own copays, and they may charge copays during the first 60 hospital days, when Original Medicare charges $0.

Medigap rows that matter for Part A include the hospital coinsurance and extra 365 days (all plans), skilled nursing coinsurance, the hospice coinsurance, the first 3 pints of blood and the Part A deductible. Plan A does not pay the deductible, and Plans K, L and M pay part of some of these.

With Medicare Advantage, check the plan’s Evidence of Coverage for daily hospital and SNF copays. Medicare.gov notes that Advantage plans may waive the 3-day hospital stay before skilled nursing care, which can help when someone was held under observation.

If you are weighing the two, our guides on Medicare Advantage vs Medigap and Medigap Plan G vs Plan N compare real costs. Open Enrollment for 2027 coverage runs October 15 to December 7, 2026, and our Open Enrollment guide covers what you can change.

When are the 2027 Part A amounts announced?

CMS sets the next year’s Part A deductible and daily coinsurance in the fall. The 2026 amounts came out on November 14, 2025. As of October 22, 2026, CMS has not released the official 2027 amounts, so the 2026 figures in this guide apply through December 31, 2026.

What Part A covers does not change much from year to year. The dollar amounts are what move. Our Medicare changes for 2027 roundup tracks the projections and will show the official numbers once CMS publishes them.

If paying the deductible or coinsurance would be hard, look at the help available. Medicaid and the Medicare Savings Programs can pay some Medicare costs for people with limited income, and our guide to Medicare help for low-income seniors compares the options.

Questions to ask before a hospital stay or discharge

Most surprise Part A bills trace back to a question nobody asked at the bedside. Keep these handy for yourself or a parent:

1. “Am I an inpatient or an outpatient today?” Ask every day of the stay. If the answer is observation, ask whether a MOON was given and why.
2. “On what date was the admission order written?” Count 3 inpatient days from that date, not from your arrival in the emergency room.
3. “Will Medicare cover rehab after I leave?” Ask whether the facility is Medicare-certified and whether you need daily skilled care.
4. “Is this a new benefit period?” If you were out of a hospital or SNF for fewer than 60 days in a row, you are still in the old one, with no new deductible but fewer days left.
5. “What will home health include?” Ask which agency serves your area and what the care plan covers, since aide help only comes with skilled care.
6. “What does hospice not pay for here?” Ask for the list of unrelated items and services, and who pays room and board.

You can also call 1-800-MEDICARE or use the Medicare.gov coverage tool to check a specific service. For a wider view of all four parts of Medicare and who qualifies, start at our Medicare program guide.