Medicare Part A is your hospital insurance, and it is the first piece most people get when they turn 65, often without realizing everything it includes or how its costs are calculated. This guide walks through what Part A covers in 2026, how benefit periods work, how much you'll pay in deductible and coinsurance, and who qualifies to have it premium-free if you live in Orange, Los Angeles, San Diego, or Riverside County.
What Part A actually covers
Part A covers inpatient hospital care — meaning when a doctor formally admits you to the hospital, not when you are under observation status. This includes your semi-private room, meals, nursing care, medications given during the stay, and other hospital services and supplies related to your treatment.
It also covers care at a skilled nursing facility following a qualifying hospital stay, hospice care for terminal illness, and a limited amount of home health care when a doctor certifies you need it and you meet the homebound requirement. Part A does not cover long-term custodial care or help with daily activities by itself — that kind of personal care is generally paid for separately.
How benefit periods work
Unlike a traditional policy year, Part A measures your costs using "benefit periods." A benefit period starts the day you are admitted as an inpatient and ends once you have gone 60 days in a row without inpatient hospital or skilled nursing care.
If you return to the hospital after a benefit period ends, even within the same calendar year, a brand-new benefit period begins and a new deductible applies. This is why someone with several separate hospitalizations in the same year can end up paying the Part A deductible more than once, something that catches many families off guard.
Part A deductible and coinsurance in 2026
For each benefit period, you pay a hospital deductible before Part A begins covering your stay. Within that period, you generally pay no daily coinsurance for the first 60 days of hospitalization. From day 61 to day 90, a daily coinsurance applies, and if you need more than 90 days, you can draw on your 60 lifetime reserve days, which carry their own daily coinsurance and can only be used once over your lifetime.
In a skilled nursing facility, the first 20 days following a qualifying hospital stay typically carry no coinsurance cost, days 21 through 100 carry a daily coinsurance, and after day 100 you pay the full cost. Medicare updates these exact dollar amounts every year, so we always confirm the current figure for the year you are receiving care.
Availability, cost, benefits, and eligibility vary by person, product, contract, and insurance company, as well as by your service area. Guarantees are subject to the claims-paying ability of the issuing insurance company. Karla Arámburo is not affiliated with or endorsed by Medicare or the federal government.
Who qualifies for premium-free Part A
Most people pay no monthly premium for Part A because they already "paid" for it through Medicare taxes withheld from their paychecks. To qualify premium-free, you generally need 40 work credits, which works out to roughly 10 years of work while paying those taxes, either on your own record or through a spouse's work history.
If you have between 30 and 39 credits, you may qualify for a reduced monthly premium. With fewer than 30 credits, you typically pay the full premium, which is considerably higher. This especially affects people who worked most of their lives outside the United States and arrived later, so it is worth reviewing your specific record before assuming what you will pay.
How Part A relates to Medicare Advantage and Medigap
Having Part A active is a requirement to enroll in a Medicare Advantage plan, along with Part B. The Advantage plan administers your hospital and medical benefits under its own network rules, but eligibility is still based on having both Medicare Part A and Part B.
If you stay with Original Medicare instead, a Medigap policy can help with the deductible and coinsurance Part A leaves behind, depending on the plan letter you choose. No Medigap policy pairs with Medicare Advantage, so the decision between these two paths is worth making carefully, comparing both in full.
A bilingual, local resource in Southern California
Karla Arámburo is a bilingual, licensed insurance agent serving Southern California, and reviewing how your Part A works alongside the rest of your coverage costs nothing and comes with no pressure to enroll. You can call or text (619) 321-8733, review our guide on Medicare Advantage vs. Original Medicare, our guide on Part D or explore our Medicare services. This page is general education, not individualized advice or an enrollment recommendation.
Frequently asked questions
Does Medicare Part A cover doctor visits?
No. Doctor visits, outpatient care, and preventive services are covered by Part B, not Part A. Part A mainly covers inpatient hospital care, skilled nursing facility care, hospice, and certain home health services.
Does Part A cover my prescription drugs?
Not outside the hospital. Medications you receive during an inpatient stay are generally included in that stay's coverage, but medications you take at home are covered separately under Part D. You can read our Part D guide to understand that coverage.
How many benefit periods can I have in a year?
There is no fixed annual limit. You can have several benefit periods within the same calendar year if you go in and out of the hospital or skilled nursing facility more than once, as long as enough time passes between stays for a period to reset.
What happens if I don't have 40 work credits?
If you have between 30 and 39 credits, you may qualify for a reduced Part A premium. With fewer than 30 credits, you generally pay the full premium. In some cases, you may also qualify based on a spouse's work credits.
Do I need Part A to enroll in Medicare Advantage?
Yes. To enroll in a Medicare Advantage plan, you need to have both Part A and Part B active. The Advantage plan replaces how those benefits are administered, but you still have Medicare.
Does Medigap cover the Part A deductible?
It depends on the plan. Several Medigap policies, including Plan G and Plan N, cover the Part A deductible and coinsurance. You can compare what each plan letter covers in our Medigap guide.
Should I decline Part A if I'm still working?
Since Part A is free for most people, it almost never makes sense to decline it, even if you are still working and have employer coverage. Part B is the one that is sometimes delayed without penalty while you have group coverage.