Medicare Part A

Medicare Part A covers hospital stays and may also help with short-term home healthcare and skilled nursing care. Most people don't pay a monthly premium for Medicare Part A because they paid Medicare taxes while working—generally for at least 10 years (40 quarters).


If you don’t qualify for free Part A, your monthly premium depends on how long you paid Medicare taxes.

The monthly premiums in 2025 are as follows:

● 30-39 quarters of Medicare taxes paid: $285 per month

● Fewer than 30 quarters of Medicare taxes paid: $518 per month

Medicare Part A Benefits

Medicare Part A covers hospital stays, here's a breakdown of Medicare Part A coverage and costs:

What Part A Covers:

● Semi-private hospital rooms

● Operating and recovery rooms

● Care in specialized units (like ICU)

● Hospital meals

● Lab tests and X-rays

● Medications and medical equipment during your stay

● Rehabilitation services while inpatient

● Blood transfusions

● Hospice care

● Skilled nursing facility care

Costs in 2025:

● Deductible: Before Medicare Part A starts covering costs, you pay a deductible of $1,676 per benefit period.

● Hospital Stays:

● Days 1-60: After the deductible, Medicare covers the full cost.

● Days 61-90: You pay a daily coinsurance of $419.

● Days 91 and beyond: You can use up to 60 lifetime reserve days, with a daily coinsurance of $838. Once these are exhausted, you cover all costs.

Skilled Nursing Facility Care:

Days 1-20: Medicare covers the full cost.

Days 21-100: You pay a daily coinsurance of $209.50.

After day 100: You cover all costs.

Benefit Periods:

A benefit period starts the day you're admitted to a hospital or skilled nursing facility and ends when you haven't received inpatient care for 60 consecutive days. If you're readmitted after this period, a new benefit period begins, and you must pay the deductible again.

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Who Can Enroll in Medicare?

Most people qualify for Medicare when they turn 65—this is called “aging into” Medicare. However, some younger individuals can qualify earlier if they:

● Disability: If you’ve received disability benefits for 24 months, you’ll be automatically enrolled in Medicare starting the 25th month.

● ALS (Lou Gehrig’s Disease): You’re automatically enrolled in Medicare as soon as you're diagnosed.

● End-Stage Renal Disease (ESRD): You qualify upon diagnosis, but you must actively enroll.


To enroll, you must be a U.S. citizen or a legal permanent resident.

How to Enroll

● Automatic Enrollment: If you're already receiving Social Security or Railroad Retirement benefits at least 4 months before turning 65, you’ll be automatically enrolled in Medicare Part A and Part B. You can choose to delay Part B if you have other health coverage.

● Manual Enrollment: If you’re not receiving retirement benefits yet, we at MAC Insurance can guide you through the enrollment process. We can help you understand your options and ensure you sign up at the right time. Contact us for personalized assistance with your Medicare application.

How to Reduce the Part A Deductible

There’s no way to completely avoid the Medicare Part A deductible, but there are strategies to help manage or reduce out-of-pocket costs:

1. Medicare Supplement (Medigap) Plans – Some Medigap plans, like Plan F (if eligible) and Plan C, cover the Part A deductible. Plan G covers most other costs but does not cover the deductible.

2. Medicare Advantage (Part C) Plans – These plans often have different cost structures and may reduce or eliminate the Part A deductible.

3. Medicaid or Other Assistance Programs – If you qualify for Medicaid, it may help cover the deductible and other costs.

4. Hospital Indemnity Insurance – This is a separate insurance policy that pays you directly for hospital stays, helping offset the deductible.

5. Limiting Hospital Stays – Since the deductible applies per benefit period (not per year), avoiding hospital readmission within 60 days can prevent paying multiple deductibles.

Part A Frequently Asked Questions

Here are some of the most common questions we receive about Medicare Part A:

1. Is Medicare Part A free? If you (or your spouse) paid Medicare taxes for at least 10 years, you won’t have to pay a premium for Part A. However, there are other costs, such as a deductible and copays, when you use Part A benefits.


2. What does Part A cover? Medicare Part A covers inpatient costs at hospitals and skilled nursing facilities. It primarily includes inpatient care, skilled nursing services, hospice care, and home health care.

3. When can I enroll in Medicare Part A? Most people become eligible for Part A at age 65. Enrollment can begin three months before your birthday month.

4, Does Part A cover everything? No, Part A includes cost-sharing requirements. There is a deductible for each benefit period and copays based on the length of your inpatient stay and the type of facility you’re in.

MAC Insurance Makes Medicare Easy

Is your 65th birthday approaching? It’s never too early to begin learning about Medicare! We often start working with beneficiaries when they’re 64 or even younger. This gives you ample time to understand Medicare and select the plans that best fit your needs.

At MAC Insurance, our Medicare advisors collaborate with major insurance providers as well as smaller companies. This enables us to find the ideal Medicare plan tailored to your healthcare needs and budget. Best of all, our services are completely free, so there’s no reason not to take advantage of expert Medicare guidance!

Get assistance with

MEDICARE PART A

We’ve covered a lot, and it’s natural to have questions about your Medicare Part A coverage. Our agents are here to answer all your Medicare-related questions, explain how Medicare works, and break down your coverage options.

While we can’t apply for Medicare Parts A and B on your behalf, we can guide you through the process. We’ll ask a few questions about your situation and provide recommendations based on your answers.

You don’t have to navigate this alone! Medicare Part A is just the start of your Medicare journey. Call one of our agents—we’ll help you get started and continue supporting you even after your enrollment is complete.

ADDITIONAL QUESTIONS TO BE ADVISED ON:

Is the Part A deductible paid yearly?

No, the Part A deductible applies per benefit period, not per year. A benefit period starts when you're admitted and ends after 60 days without hospital care. If you're hospitalized again after 60 days, you must pay the deductible again.

When is the right time to apply for Medicare Part A?

You can apply for Medicare Part A 3 months before your 65th birthday. If you get it premium-free, it's smart to enroll, even if you have employer coverage. If your job has fewer than 20 employees, you must sign up for Parts A and B to avoid penalties.

Will I be automatically enrolled in Medicare at 65?

If you're receiving Social Security, you're automatically enrolled in Medicare Parts A and B. If not, you must apply through the Social Security Administration.

Can I enroll in Part A without Part B?

Yes, you can enroll in Part A only online or through the Social Security office.

Do I need to enroll in Medicare Part A if I’m still employed?

No, you don’t have to enroll in Medicare. But if you qualify for free Part A, it’s a good idea to sign up and use the benefits!

Will I get a penalty if I don’t enroll in Part A when I turn 65?

Maybe. If you don’t have qualifying health coverage and delay enrolling in Medicare, you could face a penalty. Check if your current plan is creditable to avoid extra costs.

We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options.

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