Understanding Medicare Part A: Hospital Coverage, Costs, and How to Fill the Gaps

April 18th, 2025

Medicare is divided into Parts A, B, C, and D. Each plays a crucial role in covering healthcare costs for seniors. Medicare Part A covers hospital stays, skilled nursing facilities, hospice, and some home health care. However, it's essential to understand its limitations and gaps, like deductibles and coinsurance, that could lead to unexpected expenses. Being informed about Part A coverage and enrollment timelines can help avoid costly penalties and gaps in healthcare.

Below is a brief overview of Medicare Part A and its importance for hospital-related expenses.​Medicare

What Medicare Part A Covers

• Inpatient hospital stays.
• Skilled nursing facility care.
• Hospice care.
• Some home health care services.​MedicareThe Insurance People+6Medicare+6Medicare+6

Costs Associated with Part A

• Premiums: Most beneficiaries don't pay a premium if they or their spouse paid Medicare taxes for at least 10 years.
• Deductibles: In 2025, the Part A deductible is $1,676 per benefit period.
• Coinsurance: After 60 days in the hospital, daily coinsurance applies.​MedicareAP News+1Medicare+1
  
• Days 61–90: $419 per day
• Days 91–150: $838 per day (lifetime reserve days)
• Beyond 150 days: ALL COSTS

Gaps in Coverage

• Extended hospital stays beyond 90 days.
• Skilled nursing facility care beyond 100 days.
• Private-duty nursing and personal items
• No coverage for custodial long-term care.​Medicare+4Medicare+4Medicare+4

How to Fill the Gaps

• Medicare Supplement Insurance (Medigap) policies.
• Medicare Advantage Plans (Part C) that include additional coverage.
• Hospital Indemnity Insurance: Provides a fixed daily, weekly, or monthly payment during hospital stays, which can help cover additional expenses .
• Private long-term care insurance options.​Verywell Health+5AP News+5Medicare+5Medicare+1Investopedia+1
  

Enrollment Time Frames and Premiums

• Initial Enrollment Period (IEP): Begins three months before turning 65 and ends three months after.
• General Enrollment Period: January 1 – March 31 each year.
• Premiums: Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working. If not, the premium can be up to $506 per month in 2024.

Avoiding Late Enrollment Penalties

Delaying enrollment can result in a 10% increase in your monthly premium for twice the number of years you could have had Part A but didn't sign up .

Need Assistance?

Navigating Medicare can be complex. Reach out to Kim & Co Agency — your trusted local Medicare advisor with 5-star Google reviews — to ensure you're making the best choices for your healthcare needs.

Conclusion

• For the sake of your retirement is it critical in understanding Part A coverage and planning for potential gaps.

Consult with experts at Kim & Co. Agency for personalized advice.​ Kim & Co. Agency and their Medicare Agents will provide a no cost consultation to help educate you on Medicare and the choices you have to make.