Everything You Need to Know About Medicare Part A

A Guide to Medicare Part A Coverage, Costs, and Enrollment

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In 2020, over 54.5 million Original Medicare enrollees were 65 years old or older.1 Each year, as more seniors age into eligibility, that number grows. If you're approaching Medicare enrollment eligibility age, or you qualify for Medicare for reasons unrelated to age, you're probably curious about what exactly this government insurance plan is all about, including Part A of Original Medicare. To help, the guide below will cover the signup process, how much you can expect to spend, and what Medicare Part A covers — and what it doesn't.

What Is Medicare Part A, and What Does it Cover?

Medicare Part A is your hospital insurance. It makes up one part of Original Medicare, which also includes Part B medical insurance. If you need to stay in the hospital or receive hospice care, Medicare Part A provides coverage.2

Part A also covers the following:

Part A doesn't cover the following:

  • Room and board during hospice care
  • Private-duty nursing during inpatient hospital stay
  • A TV or phone in your hospital room
  • A private hospital room, unless medically necessary

Did You Know? Some older adults qualify for Medicare and Medicaid. To see if you qualify for one or both of these government programs, check out our Medicare and Medicaid guide.

How Much Does Part A Cost?

Did you know that many beneficiaries don't pay a premium for Medicare Part A?3 You are eligible for premium-free Part A if you or your spouse paid Medicare taxes for at least 40 quarters while working.

If you're 65, you also need to meet one of the following eligibility criteria:

  • You get retirement benefits from Social Security or the Railroad Retirement Board.
  • You're eligible for Social Security or Railroad benefits but just haven't filed yet.
  • You or your spouse had Medicare-covered government employment.

If you're under 65, you need to meet different eligibility criteria to qualify for premium-free Part A:

  • You received Social Security or Railroad disability benefits for 24 months.
  • You have end-stage renal disease and meet other requirements.

The chart below explains the costs of Part A in 2022.4

Expense Out-of-pocket cost Other details
Part A premium
  • $0 if you or your spouse paid taxes for 40+ quarters
  • $274 per month if you paid taxes for fewer than 30 quarters
  • $499 per month if you paid taxes for 30 to 39 quarters
To buy Part A, you must also have Medicare Part B
Part A hospital inpatient deductible $1,556 deductible for each benefit period
Hospital inpatient coinsurance: Days 1-60 $0 for each benefit period
Hospital inpatient coinsurance: Days 61-90 $389 per day of each benefit period
Hospital inpatient coinsurance: Days 91+ $778 per “lifetime reserve day” after day 90 for each benefit period Up to 60 lifetime reserve days over your lifetime
Hospital inpatient coinsurance: Beyond lifetime reserve days You pay all costs

Did You Know? Worried about Medicare costs? Medicare Savings Programs help low-income seniors afford their Part A and Part B premiums.

Medicare Part A Enrollment

Roughly 10,000 baby boomers age into Medicare every day.5 Let's take a look at when and how you can enroll in Medicare.

When Can I Enroll in Medicare Part A?

You can only enroll in Medicare at certain times during the year. Failure to enroll at the correct time could mean late enrollment penalties or gaps in coverage.

You can sign up for Medicare Part A:

During your Initial Enrollment Period (IEP): You have a seven-month window to initially enroll in Medicare. It starts three months before your 65th birthday month, includes your birthday month, and ends three months after your birthday month. For example, if you're turning 65 on March 6, 2023, your initial enrollment window begins December 1, 2022 and ends on June 30, 2023.

Helpful Hint: Medicare.gov offers an “Estimate when I'm eligible for Medicare” tool to help you understand when your Initial Enrollment Period begins.

During Medicare's Special Enrollment Period (SEP): Some individuals qualify for delayed enrollment without penalties. For example, you might delay Medicare coverage because you still have company health insurance benefits. When that coverage ends, you might qualify for an SEP that lasts for eight months from the date your employee coverage ended.

During Medicare's General Enrollment Period: If you miss your initial enrollment period or your SEP window, you may be able to apply from January 1 to March 31 for coverage that will start on July 1. Going this route could result in a late-enrollment fee.

How Do I Enroll in Medicare Part A?

Enrolling in Medicare Part A is automatic for many older adults. When you apply for disability or retirement benefits from Social Security or the Railroad Retirement Board, your application doubles as a Medicare application. If your retirement application is approved, you're automatically approved for Part A coverage as soon as you're eligible for Medicare.

FYI: Want to learn more about signing up for Medicare? Check out our Medicare annual enrollment guide.

If you're not eligible for the automatic process, you may need to sign up through Social Security or the Railroad Retirement Board. Here's how:

  • Sign up online with Social Security.  Visit Social Security's Medicare benefits page and create a my Social Security account to sign up for Medicare. This is the fastest, easiest way to sign up.
  • Call Social Security. Call (800) 772-1213 to apply over the phone. TTY users can call (800) 325-0778.
  • Contact your local Social Security office. Use this online tool to locate the office nearest you for in-person assistance.
  • Call the Railroad Retirement Board. If you or your spouse worked for a railroad, you can call (877) 772-5772 to enroll.
Written By

Sarah Goldy-Brown

Writer & Researcher

Sarah covers a range of senior lifestyle topics, from reviews of walk-in tubs and hearing aids to overviews of Medicare and Medicaid. Her close relationship with her grandparents gave her a firsthand look at the evolving life needs of older adults, and… Learn More About Sarah Goldy-Brown