Paul Sanchez
Medicare Part A covers inpatient hospitals, skilled nursing facilities, hospice, inpatient rehabilitation, and some home health care services. Most people get Part A for free, but some have to pay a premium for this coverage. To be eligible for premium-free Part A, an individual must have worked and paid Medicare taxes for at least 10 years or be eligible based on a current or former spouse's work. Enrollees aged 65 and older who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium to voluntarily enroll in Medicare Part A.
| Characteristics | Values |
|---|---|
| Medicare Part A Coverage | Inpatient hospitals, skilled nursing facilities, hospice, inpatient rehabilitation, and some home health care services. |
| Who pays for Medicare Part A | About 99% of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment, as determined by the Social Security Administration. |
| Who has to pay a premium for Medicare Part A | Enrollees age 65 and older who have fewer than 40 quarters of coverage, and certain persons with disabilities, pay a monthly premium in order to voluntarily enroll in Medicare Part A. |
| Premium for Medicare Part A | The premium for Medicare Part A in 2025 is $285 a month for individuals who had at least 30 quarters of coverage, or were married to someone with at least 30 quarters of coverage. For uninsured individuals with fewer than 30 quarters of coverage, and certain individuals with disabilities, the premium is $518 a month. |
| Medicare Part A inpatient hospital deductible | The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,676 in 2025. |
| Late enrollment penalty | Individuals who do not enroll in Part A when first eligible will have to pay a late enrollment penalty. |
| Help with costs | If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs. |
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What You'll Learn
Medicare Part A is free for most people
Medicare Part A covers inpatient hospitals, skilled nursing facilities, hospice, inpatient rehabilitation, and some home health care services. Most people are eligible for premium-free Part A if they meet certain requirements. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. This means that the worker must have worked and paid Medicare taxes for a specified number of quarters, which is typically at least 40 quarters or 10 years, and filed an application for Social Security or Railroad Retirement Board (RRB) benefits. Individuals who receive regular dialysis treatments or a kidney transplant may also be eligible for premium-free Part A if they meet certain conditions.
Most people pay a monthly premium for Part B, which covers physicians' services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. The standard monthly premium for Medicare Part B enrollees was $174.70 in 2024 and increased to $185.00 for 2025. The annual deductible for all Medicare Part B beneficiaries was $240 in 2024 and increased to $257 in 2025. The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital was $1,632 in 2024 and increased to $1,676 in 2025. This covers beneficiaries' share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.
For individuals who do not meet the requirements for premium-free Part A, there are still options to enroll at a reduced or full monthly premium rate. Enrollees age 65 and older who have fewer than 40 quarters of coverage, and certain persons with disabilities, can voluntarily enroll in Medicare Part A by paying a monthly premium. The reduced monthly premium rate for individuals with at least 30 quarters of coverage or who were married to someone with at least 30 quarters of coverage was $278 in 2024 and increased to $285 in 2025. The full premium rate for certain uninsured aged individuals with fewer than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlements was $505 in 2024 and increased to $518 in 2025.
It is important to note that there is no yearly limit on out-of-pocket costs for Medicare Part A and Part B unless individuals have supplemental coverage, such as a Medicare Supplement Insurance (Medigap) policy or a Medicare Advantage Plan. Individuals with limited income and resources may be able to receive financial assistance from their state to help pay for premiums, deductibles, coinsurance, and copays. Additionally, Medicare Advantage Plans, also known as Part C, are offered by private companies and approved by the federal government. These plans bundle several coverage types, including Parts A, B, and usually D, and may include additional benefits.
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Eligibility for premium-free Part A
Medicare Part A, also known as hospital insurance, covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health services. Most people get Part A for free, but some have to pay a premium for this coverage.
To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. The worker must have worked a specified number of quarters (at least 40 quarters or 10 years) and paid Medicare taxes. They must also file an application for Social Security or Railroad Retirement Board (RRB) benefits.
Individuals who are already receiving Social Security or RRB benefits at least four months before being eligible for Medicare and residing in the United States (except Puerto Rico) are automatically enrolled in premium-free Part A. Those receiving benefits at least four months before turning 65 will get Part A automatically at age 65. People who are automatically enrolled can choose whether they want to keep or refuse Part B coverage.
Individuals who are not receiving Social Security or RRB benefits must file an application for Medicare by contacting the Social Security Administration. If your income is low, you may be eligible for the Qualified Medicare Beneficiary (QMB) program, which pays for your Medicare Part A and B premiums and other costs. You can also contact your local county office to see if you're eligible for income-based Medicare Savings Programs that can lower your costs.
Additionally, certain government employees may be eligible for premium-free Part A. Federal employees anytime after December 31, 1982, and state or local employees anytime after March 31, 1986, can qualify for premium-free Part A.
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Part A inpatient hospital deductible
Medicare Part A generally helps cover services you receive in a hospital or long-term care setting. Inpatient hospital care is covered under Medicare Part A. However, there is a deductible that beneficiaries must pay if admitted to the hospital. The Medicare Part A inpatient hospital deductible was $1,556 in 2022, an increase of $72 from $1,484 in 2021. The Part A inpatient hospital deductible covers beneficiaries' share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. For 2025, the Part A deductible is $1,676 for each inpatient hospital benefit period before Original Medicare starts to pay.
A benefit period begins the day you are admitted to a hospital or skilled nursing facility and ends when you have not spent the night in one for 60 consecutive days. If you are admitted to a hospital or skilled nursing facility after one benefit period has ended, a new one begins, and you will have to pay another deductible. There is no yearly limit on what you pay out-of-pocket unless you have supplemental coverage, like a Medicare Supplement Insurance (Medigap) policy or you join a Medicare Advantage Plan.
If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs, like deductibles, coinsurance, and copays. Medicare Part B covers most doctor services, including those received while hospitalized, as well as outpatient therapy and the rental or purchase of durable medical equipment. The 2025 Part B deductible is $257 for the year, and there are no benefit periods that apply to Part B coverage.
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Monthly premium for Part A for those not eligible for premium-free
Medicare Part A covers hospital stays, care in a skilled nursing facility, and some home health care services. For those who have worked and paid Medicare taxes for at least 10 years, Part A is typically provided at no cost. Similarly, individuals who have received regular dialysis treatments or a kidney transplant and meet certain other conditions may also be eligible for premium-free Part A. These conditions include having worked the required amount of time under Social Security, the Railroad Retirement Board (RRB), or as a government employee, or being the spouse or dependent child of someone who meets these criteria.
However, for those who do not meet the eligibility criteria for premium-free Part A, there is a monthly premium associated with this coverage. The monthly premium amount for Part A can vary based on factors such as income level and the number of quarters of coverage (QCs) earned. QCs are earned through the payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during an individual's working years. While most individuals pay the full FICA tax, certain federal, state, and local government employees only pay the Part A portion of the tax.
It is important to note that Medicare Part A has no yearly limit on out-of-pocket expenses unless individuals have supplemental coverage, such as a Medicare Supplement Insurance (Medigap) policy or a Medicare Advantage Plan. Additionally, individuals with limited income and resources may be able to receive assistance from their state in paying premiums and other costs associated with Part A. This assistance can include help with drug costs and waiving the Part D late enrollment penalty.
In summary, while Medicare Part A is provided at no cost for those who meet certain eligibility criteria, there is a monthly premium for those who do not qualify for premium-free coverage. This premium amount can vary based on factors such as income and the number of QCs earned. Individuals with limited financial resources may be able to receive assistance from their state or through supplemental coverage options to help manage the costs associated with Part A.
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Late enrollment penalty for Part A
Medicare Part A covers hospital insurance and is free if you or your spouse worked and paid Medicare taxes for at least 10 years. However, if you don't qualify for premium-free Part A, you can still purchase it during your Initial Enrollment Period (IEP). The IEP is a seven-month window that begins three months before the month you turn 65, includes your birthday month, and ends three months after the month you turn 65.
If you miss your IEP and don't sign up for Medicare Part A, you will be considered a late enrollee and may have to pay a late enrollment penalty. The penalty for Part A is 10% of the cost of your monthly premium for twice the number of years you were eligible but didn't enrol. For example, if you were eligible for Part A for one year but didn't sign up, you'll pay a 10% premium penalty every month for two years. It's important to note that this penalty is not a one-time fee and is usually charged for as long as you have that type of coverage.
You can delay enrolling in Part A without incurring a penalty if you have creditable coverage. Creditable coverage is health insurance that is as good as or better than what Medicare covers, such as through your or your spouse's employer. If you have creditable coverage and then lose it, you have up to two months before you will be charged a late enrollment penalty.
To avoid late enrollment penalties altogether, it's important to sign up for Medicare coverage during your Initial Enrollment Period. If you have other coverage that is similar in value to Medicare, such as from an employer, you may not need to sign up for Part A during your IEP without incurring a penalty.
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Frequently asked questions
Most people get Part A for free, but some have to pay a premium for this coverage.
To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child.
In most cases, if someone does not enroll in Part A when first eligible, they will have to pay a late enrollment penalty.
The premium for Part A depends on the number of quarters of coverage (QCs) you have. For 2025, the premium for those with 30-39 quarters of coverage is $285/month, and for those with fewer than 30 quarters, it is $518/month.
Medicare Part A covers inpatient hospitals, skilled nursing facilities, hospice, inpatient rehabilitation, and some home health care services.
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