Medicare Part A

Medicare Part A is your hospital insurance. In 2026 it covers: inpatient hospital stays (semi-private room, meals, general nursing, drugs administered during your stay); skilled nursing facility (SNF) care following a qualifying 3-day hospital stay; home health care (part-time skilled nursing, physical therapy, speech-language therapy); and hospice care for terminal illness. Part A does not cover outpatient care, prescription drugs, dental, vision, or hearing — those require Part B, Part D, or a Medicare Supplement plan.

Most people pay $0 premium for Part A if they (or their spouse) worked at least 40 quarters (10 years) and paid Medicare taxes. If you worked 30–39 quarters, your 2026 premium is $285/month. If you worked fewer than 30 quarters, it is $518/month. In addition, there is a per-benefit-period deductible of $1,676 for hospital stays, plus daily coinsurance charges for extended stays. A Medicare Supplement plan can help cover these out-of-pocket costs.

A benefit period begins the day you are admitted as an inpatient to a hospital or SNF and ends when you have been out of inpatient care for 60 consecutive days. There is no limit to the number of benefit periods you can have, but you pay a new $1,676 deductible for each one. For days 1–60 in a hospital, Part A pays all covered costs after the deductible. Days 61–90 carry a $419/day coinsurance, and days 91+ use your 60 lifetime reserve days at $838/day. Understanding benefit periods is critical to planning your coverage — Brad can walk you through how a Medicare Supplement plan can eliminate most of these costs.

For most people, enrollment is automatic. If you are already receiving Social Security or Railroad Retirement benefits, you will be automatically enrolled in Part A (and Part B) the month you turn 65 — no action needed. If you are not yet receiving benefits, you must actively enroll during your Initial Enrollment Period (IEP) — a 7-month window starting 3 months before your 65th birthday month and ending 3 months after. Delaying enrollment past your IEP without qualifying coverage can result in a late enrollment penalty and a gap in coverage.

Yes, and since Part A is premium-free for most people, many choose to enroll in Part A even while continuing to work. However, if you contribute to a Health Savings Account (HSA) through your employer, enrolling in any part of Medicare — including Part A — makes you ineligible to continue making HSA contributions. If avoiding that restriction matters to you, you may want to delay Part A until you retire. Brad can help you weigh the pros and cons based on your specific situation.

Yes, but with conditions. Part A covers SNF care only if: (1) you had a qualifying inpatient hospital stay of at least 3 days, and (2) you need skilled care such as skilled nursing or physical therapy — not just custodial or personal care. Coverage in 2026: Days 1–20 are fully covered by Part A. Days 21–100 carry a $209.50/day coinsurance. After day 100, Part A pays nothing. A Medicare Supplement plan can cover the daily coinsurance, giving you significant financial protection for extended SNF stays.

You are eligible for Medicare Part A if you are: age 65 or older and a U.S. citizen or permanent resident who has lived in the U.S. for at least 5 consecutive years; under 65 with a qualifying disability after receiving Social Security Disability Insurance (SSDI) for 24 months; or any age with End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig's Disease). Not sure if you qualify? Call Brad at (920) 251-4969 for a free eligibility review.

If you are not automatically enrolled and you miss your Initial Enrollment Period without having other qualifying coverage, you may face a late enrollment penalty. Your Part A premium will increase by 10% for twice the number of years you went without coverage. For example, if you delayed enrollment for 2 years, you pay the penalty for 4 years. This is why it is important to enroll on time or make sure you have creditable coverage in place. Brad can help you avoid this penalty entirely.