Do You Pay a Premium for Part A?
Most people do not pay a monthly premium for Part A. According to Medicare & You 2026, you qualify for premium-free Part A if you or your spouse worked and paid Medicare taxes for at least 40 quarters — that's 10 years of qualifying work. Most people who turn 65 have already earned this.
If you do have to buy Part A, the 2026 premium is either $311 or $565 per month, depending on how long you or your spouse worked and paid Medicare taxes.
Inpatient Hospital Costs — 2026
Even if you pay no premium, you will owe these amounts when you're admitted to the hospital. All figures are per benefit period, not per calendar year.
| Hospital Stay | Your Cost in 2026 |
|---|---|
| Deductible (per benefit period) | $1,736 |
| Days 1–60 (after deductible) | $0 per day |
| Days 61–90 | $434 per day |
| Lifetime Reserve Days (days 91+) | $868 per day (60 lifetime days total) |
| Beyond 150 days | You pay all costs |
Skilled Nursing Facility Costs — 2026
| SNF Stay | Your Cost in 2026 |
|---|---|
| Days 1–20 | $0 — fully covered |
| Days 21–100 | $217 per day |
| Day 101 and beyond | You pay all costs |
Understanding the Benefit Period
The benefit period is the single most misunderstood concept in Part A — and the one that catches people off guard the most. A benefit period begins the day you're admitted to a hospital or skilled nursing facility. It ends when you've been out of both for 60 consecutive days in a row.
Unlike Part B, which has one deductible per calendar year, Part A's $1,736 deductible resets with each new benefit period. If you're hospitalized in January, recover, go home, and then are hospitalized again in September — more than 60 days later — that's a new benefit period and a new $1,736 deductible. There is no limit to how many benefit periods you can have in a year.
The Part A Late Enrollment Penalty
Most people don't face a late enrollment penalty for Part A because most people qualify for premium-free coverage. But if you're one of the people who has to pay a Part A premium and you don't sign up when you're first eligible, your monthly premium may go up 10%. You'll pay that higher amount for twice the number of years you could have had Part A but didn't sign up.
If you were eligible for Part A for 2 years but didn't sign up, you'll pay a 10% higher premium for 4 years. This penalty applies only to people who have to buy Part A — the vast majority of people pay $0 and face no penalty at all.
How Medigap Can Reduce These Costs
A Medigap (Medicare Supplement Insurance) plan can help cover Part A costs that Medicare doesn't pay — including the deductible, daily hospital coinsurance, and skilled nursing facility coinsurance. Different Medigap plan types cover different costs. Some cover the full Part A deductible; others cover SNF coinsurance; some cover both. Medigap plans are standardized by letter (Plan G, Plan N, etc.) but premiums vary by insurer and location.
Betsy can compare Medigap options available in Massachusetts, Kentucky, and Florida without any bias toward a particular carrier.
"The benefit period reset is something I walk through with every client. People assume Medicare works like their old employer insurance — one deductible per year, and that's it. Part A doesn't work that way. If you get hospitalized twice with more than 60 days between stays, you're paying that deductible twice. That's one of the main reasons a Medigap plan makes sense for a lot of people — it takes that uncertainty off the table."
Talk to Betsy — Free ConsultationHelp Paying Part A Costs
If you have limited income and resources, you may qualify for a Medicare Savings Program through your state, which can help pay Part A premiums (if you pay them), deductibles, coinsurance, and copayments. Visit Medicare.gov or call 1-800-MEDICARE to learn more.