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Updated 2026-05-21

Medicare coverage · A coverage answer

What does Medicare Part A cover?

Medicare Part A is hospital insurance. For 2026 it covers inpatient hospital stays after a $1,676 deductible (days 1 to 60 covered, days 61 to 90 cost $419 per day, lifetime reserve days cost $838 per day), skilled nursing facility care for up to 100 days after a qualifying 3-day inpatient stay (days 1 to 20 fully covered, days 21 to 100 cost $209.50 per day), hospice at 100%, home health with no cap, and inpatient psychiatric care up to 190 days lifetime.

The short answer

Medicare Part A covers inpatient hospital stays, skilled nursing facility care after a qualifying 3-day inpatient hospital stay, hospice care, home health care, and inpatient psychiatric care (190-day lifetime limit). In 2026 the Part A inpatient deductible is $1,676 per benefit period. Days 1 to 60 are fully covered after the deductible; days 61 to 90 have a $419 daily co-pay; lifetime reserve days are $838 each. Part A does not cover outpatient care, prescription drugs, assisted living, or ongoing custodial care.

What Medicare pays for

15 items

  • Inpatient hospital stays (days 1 to 60)

    Fully covered after the $1,676 deductible per benefit period in 2026.

    Covered

  • Inpatient hospital stays (days 61 to 90)

    Covered with a $419 daily co-pay in 2026.

    Covered

  • Lifetime reserve days (60 lifetime)

    $838 per day in 2026. Once used, gone for life.

    Covered

  • Skilled nursing facility, days 1 to 20

    Fully covered after a qualifying 3-day inpatient hospital stay.

    Covered

  • Skilled nursing facility, days 21 to 100

    Covered with a $209.50 daily co-pay in 2026.

    Covered

  • Skilled nursing facility, day 101 and beyond

    Patient pays full cost or transitions to Medi-Cal, LTC insurance, or private pay.

    Not covered

  • Hospice care

    100% covered for patients certified with a six-month-or-less life expectancy. $5 max per outpatient prescription.

    Covered

  • Home health care

    100% covered when homebound with intermittent skilled need. No 100-day cap.

    Covered

  • Inpatient psychiatric hospital care

    Up to 190 days in a lifetime in a freestanding psychiatric hospital.

    Covered

  • Inpatient rehabilitation facility (IRF)

    Same deductible and co-pay structure as inpatient hospital stays.

    Covered

  • Outpatient services, doctor visits, lab tests

    Falls under Part B, not Part A.

    Not covered

  • Prescription drugs

    Falls under Part D (or under Part A only during a covered inpatient stay).

    Not covered

  • Assisted living room and board

    Custodial residential care is not a Medicare benefit.

    Not covered

  • Ongoing custodial care (bathing, dressing, supervision)

    Not a Medicare benefit. Use Medi-Cal IHSS, LTC insurance, or private pay.

    Not covered

  • Dental, vision, hearing aids

    Not covered by Original Medicare. Some Medicare Advantage plans include limited benefits.

    Not covered

The four things Part A actually covers

Medicare Part A is the hospital insurance half of Original Medicare. It is built around four settings: inpatient hospital, skilled nursing facility, hospice, and home health. Inpatient psychiatric and inpatient rehabilitation are variants of the first two. Everything else (doctor visits, labs, outpatient procedures, durable medical equipment, ambulance) belongs to Part B.

Inside those four settings Part A is generous: hospital stays are mostly free after the deductible, hospice is essentially free, home health has no co-pay and no day cap. Outside those settings Part A pays nothing. The gap between what families assume Medicare covers and what Part A actually pays for is where most long-term care planning happens.

Inpatient hospital stays in 2026

After the patient is formally admitted as an inpatient (not observation), Part A pays as follows:

The deductible is per benefit period, not per year. A benefit period begins on admission and ends after 60 consecutive days with no inpatient or skilled nursing care. A patient hospitalized in February and again in November will pay two deductibles.

Skilled nursing facility (SNF) coverage

Part A pays for up to 100 days of SNF care in a benefit period, but only if three conditions are met:

  1. The patient had a qualifying 3-day inpatient hospital stay (observation days do not count).
  2. The patient is admitted to a Medicare-certified SNF within 30 days of discharge.
  3. The patient has a daily skilled need (skilled nursing or therapy) ordered by a physician.

When all three are met: days 1 to 20 are covered in full, days 21 to 100 cost $209.50 per day in 2026, and coverage ends on day 100 regardless of whether the skilled need continues. Most patients do not stay the full 100 days. Many are discharged earlier when the skilled need ends, even before day 20.

Hospice and home health

Hospice is the most comprehensive Medicare benefit. It covers nursing, hospice aides, medications for the terminal diagnosis, equipment, social work, chaplaincy, and bereavement support for the family. The only out-of-pocket costs are up to $5 per outpatient prescription and 5% of inpatient respite stays.

Home health under Part A pays for skilled nursing visits, therapy, medical social services, and home health aide hours when the patient is homebound and has an intermittent skilled need. Coverage is 100%. There is no 100-day cap. The benefit is structured in 60-day re-certifying episodes and continues as long as eligibility holds.

Inpatient psychiatric care

Part A covers inpatient psychiatric hospital care subject to the same deductible and day co-pays as a regular hospital stay, with one additional limit: a 190-day lifetime cap on care delivered in a freestanding psychiatric hospital. Psychiatric care in the psychiatric unit of a general hospital does not count toward the 190-day limit.

What Part A does not cover

Most of the care older adults actually need day to day is outside Part A:

What this means in practice

Part A handles the medical emergencies and the end-of-life benefit well. It does not handle the slow, daily-life care that families spend the most money and energy on. Planning for senior care in California means understanding where Part A ends and where Medi-Cal, IHSS, LTC insurance, VA Aid & Attendance, and private pay begin. The Care Checker can help map the next step.

Related coverage and next steps

This page explains coverage and eligibility, not medical advice. Talk to a licensed clinician about care decisions, and to a benefits counselor about your specific plan. California Care Compass does not place referrals on Coverage pages.

Common questions

7 entries

What is the 2026 Medicare Part A deductible?

The Part A inpatient hospital deductible for 2026 is $1,676 per benefit period. A benefit period starts when the patient is admitted as an inpatient and ends after 60 consecutive days with no inpatient or skilled nursing facility care. A patient can have more than one benefit period in a year, and each new period requires a new deductible.

What is the difference between inpatient and observation status?

Inpatient means the patient has been formally admitted to the hospital by a physician order. Observation is outpatient status, billed under Part B, even if the patient is in a hospital bed overnight. Observation days do not count toward the 3-day qualifying stay required for skilled nursing facility coverage. Always ask the hospital staff directly: is my parent inpatient or observation status?

When do lifetime reserve days kick in?

After 90 days in a single benefit period of inpatient hospital care, Medicare draws from the 60 lifetime reserve days. Each reserve day costs $838 in 2026. These are lifetime, not per-year, so once they are used they are gone permanently. Most patients never touch them; they exist for unusually long hospitalizations.

Does Part A cover the skilled nursing facility automatically?

No. Part A skilled nursing facility coverage requires a qualifying 3-day inpatient hospital stay (observation days do not count), admission to a Medicare-certified SNF within 30 days of discharge, and a daily skilled need ordered by a physician. Once those conditions are met, days 1 to 20 are covered fully, days 21 to 100 cost $209.50 per day in 2026, and coverage ends at day 100 even if the skilled need continues.

Does Part A pay for assisted living?

No. Part A does not cover assisted living. Assisted living is custodial residential care, not a medical benefit. Families pay privately, use LTC insurance, or in narrow cases use Medi-Cal Assisted Living Waiver slots.

Is hospice really fully covered under Part A?

Yes. The Medicare Hospice Benefit covers hospice services at 100% with the only out-of-pocket being up to $5 per outpatient prescription and 5% of inpatient respite stays. The patient must be certified by two physicians as having a six-month-or-less life expectancy and elect comfort care for the terminal diagnosis.

Do I have to pay a premium for Part A?

Most people pay no Part A premium because they (or a spouse) paid Medicare taxes for at least 10 years (40 quarters) while working. People with fewer quarters can buy Part A: in 2026 the premium is up to $518 per month for those with under 30 quarters, and a reduced amount for 30 to 39 quarters.

Sources

  1. 01Centers for Medicare & Medicaid Services · 2026 Medicare Parts A & B Premiums and Deductibles · accessed 2026-05-21
  2. 02Medicare.gov · What Part A covers · accessed 2026-05-21
  3. 03Centers for Medicare & Medicaid Services · Medicare Benefit Policy Manual, Chapter 3 (Inpatient Hospital) · accessed 2026-05-21
  4. 04Kaiser Family Foundation · An Overview of Medicare · accessed 2026-05-21
  5. 05Medicare Rights Center · Part A coverage rules · accessed 2026-05-21
  6. 06California Health Advocates · Medicare Part A in California · accessed 2026-05-21
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