Most people don’t pay a monthly premium for Medicare Part A. If you do, the cost depends on your U.S. work and tax history. You’ll also need to meet a deductible and may pay coinsurance in some cases.

Medicare is a government healthcare program that covers healthcare costs for people ages 65 and over or those with certain disabilities.

The Medicare program is split into several sections or parts. Medicare Part A covers hospitalization and inpatient care, including hospice and skilled nursing care.

If you’ve worked for at least 40 quarters and paid Medicare taxes, you won’t pay a premium. Otherwise, there is a monthly premium. There may also be additional costs associated with Part A services.

Keep reading to find out how much Medicare Part A will cost you.

Most people don’t have to pay a monthly premium for their Medicare Part A coverage. If you’ve worked for a total of 40 quarters or more during your lifetime, you’ve already paid for your Medicare Part A coverage through those income taxes.

Outside of qualifying for premium-free Part A based on your work history, there are a few other situations when you may receive coverage without a monthly premium:

  • You’re 65 and receive retirement benefits from Social Security or the Railroad Retirement Board (RRB).
  • You’re 65, and you or your spouse had Medicare-covered health benefits from a government job.
  • You’re under age 65 and have received Social Security or RRB disability benefits for 24 months.
  • You have end stage renal disease (ESRD).

Is Medicare Part A deducted from your Social Security check?

In most cases, your Medicare Part A premium will be deducted from your Social Security or railroad retirement plan check (if you’re a railroad employee).

If you pay Medicare directly, however, you will receive a bill with a premium charge for Medicare Part A. This bill will include your premium charges for 3 months in advance.

However, the bill may be higher if this is the first time you are receiving a bill (retroactive coverage), if you missed a payment, or if your premium amount has changed.

There are different costs for Part A to consider. If you have to pay a premium, how much you’ll pay depends on how many quarters you or your spouse have worked and paid taxes.

If you or your spouse worked for 30-39 quarters, the standard monthly Part A premium cost is $285 in 2025. But, if you or your spouse worked fewer than 30 quarters, the standard monthly Part A premium cost will be $518 in 2025.

Deductibles and hospital coinsurance

With Medicare Part A, you’ll also pay a deductible and coinsurance costs for each benefit period. In 2025, these costs are:

  • $1,676 deductible for each benefit period
  • $0 coinsurance for days 1-60 in each benefit period
  • $419 daily coinsurance for days 61-90 in each benefit period
  • $838 daily coinsurance for days 91 and beyond in each benefit period

Each day beyond day 90 is considered a lifetime reserve day. You have up to 60 of these days to use in your lifetime. Once you’ve used all of your lifetime reserve days, you must pay all the costs for the rest of your stay.

Benefit periods reset once you’ve been out of inpatient care for 60 days or when you begin inpatient care for a new condition.

If you have trouble paying for these costs, apply for a Medicare savings program. These state programs help cover the costs of your Medicare deductibles and coinsurance.

Skilled nursing and hospice care

Medicare Part A covers the full cost of hospice care, but there are specific coinsurance costs for skilled nursing care services.

In 2025, these costs are:

  • $0 coinsurance for days 1-20 for each benefit period
  • $209.5 daily coinsurance for days 21-100 for each benefit period
  • all costs for days 101 and beyond in each benefit period

Again, the benefit period resets after 60 days of discharge or when you begin inpatient care for a new diagnosis or condition.

Home healthcare and hospice care

Once you meet the deductible, you won’t pay anything for covered home healthcare services or hospice. However, you will have a 20% coinsurance for durable medical equipment (DME).

You may also have a copayment of up to $5 for medications or products for pain relief and symptom control that you need in hospice at home. In addition, you’ll have to pay 5% of the cost of inpatient respite care.

In most cases, you’ll be automatically enrolled in Medicare Part A. You’re automatically enrolled in Original Medicare, which is made up of parts A and B, starting on the first day of the month you turn 65 years old.

If you’re under age 65 and receiving Social Security or RRB disability benefits, you’ll automatically be enrolled in Medicare Part A when you’ve been receiving the disability benefits for 24 months.

If you’re not automatically enrolled, you can sign up manually through the Social Security Administration.

Most people receive Medicare Part A automatically when they turn age 65 and pay no monthly premiums.

That said, if you or your spouse haven’t worked at least 40 quarters, you’ll pay a monthly premium for Part A.

You also pay deductibles and coinsurance costs for Medicare Part A services when you receive inpatient or skilled nursing care.

If you’re eligible, state programs called Medicare savings programs can help you cover the costs of your coinsurance and deductibles for Medicare Part A.