Cost of Medicare Part A in 2023 and How It Works
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Medicare Part A is a portion of Original Medicare. Together, Medicare Part A and Part B make up the federal health insurance program for people who are age 65 and older, have a qualified disability or have a specific health condition like Lou Gehrig's disease.
Medicare Part A is free for those who meet eligibility requirements.
You're enrolled in Medicare Part A automatically if you contributed to Social Security while working and get benefits for at least four months prior to turning 65. If you qualify due to a disability, you automatically get Medicare Part A after receiving Social Security disability benefits for 24 months. In both cases, Medicare Part A is provided at no cost to you.
What is Medicare Part A?
Medicare Part A is a portion of Original Medicare, the federal health insurance program for people who are 65 and older, have a qualified disability or have a specific health condition like Lou Gehrig's disease or kidney failure, also called end-stage renal disease (ESRD). Also known as hospital insurance, Medicare Part A covers services at a hospital or skilled nursing facility as well as hospice and home health care.
Medicare Part A is free to people who contributed to Social Security while working. The program is also free for anyone who has received Social Security disability benefits for 24 months.
What does Medicare Part A cover?
Medicare Part A covers inpatient hospital care, which can include inpatient surgery and lab work, room and meal charges, nursing care and other hospital services and supplies. Other covered Medicare Part A expenses include:
- Skilled nursing facility (SNF) care
- Hospice care
- Home health care
Talk to your health care provider about whether Medicare will cover your services or supplies. If your provider thinks Medicare may not pay the cost, they may ask you to sign an Advance Beneficiary Notice of Noncoverage (ABN). This form states that you may be responsible for the charges if Medicare doesn't cover them.
Eligibility and enrollment in Medicare Part A
Medicare Part A is available to U.S. citizens and legal residents who meet one of the following conditions:
- Over the age of 65
- Under the age of 65 with a disability
- Have end-stage renal disease (ESRD)
- Have Lou Gehrig's disease (ALS)
If you contributed to Social Security while working and have been receiving benefits for at least four months prior to turning 65 (or received Social Security benefits for 24 months due to a disability), you'll be enrolled in Medicare Part A automatically at no cost.
What if I don't qualify for free Medicare Part A?
If you don't qualify for free Medicare Part A by paying into Social Security, you won't be enrolled automatically. But you can buy Medicare Part A coverage. You should call the Social Security office at 800-772-1213 at least three months before you turn 65 to enroll. If you worked for a railroad, contact the Railroad Retirement Board (RRB) for information.
If you are not eligible for free Part A, you don’t have to enroll. But if you want to buy Medicare Part A coverage, you also must buy Part B.
To purchase Part A and Part B (or just Part B), you need to sign up during one of three designated enrollment periods.
- Initial enrollment period: The initial enrollment period is a seven-month time span that starts three months before you turn 65. It continues through the month you turn 65 and the three months following your 65th birthday.
- Special enrollment period: You may be able to enroll in Medicare during a special enrollment period (SEP) based on certain qualifying life events — for example, if you postponed Medicare due to having employer-sponsored coverage, whether on your own or through your spouse. The SEP allows you to enroll in Medicare without a late penalty.
- General enrollment period: If you have to buy Medicare Part A and you don’t qualify for a special enrollment period, you may have to wait for a general enrollment period to apply, which runs from Jan. 1 to March 31 each year. Your coverage would start the month after you sign up.
If you don't get benefits from Social Security or the Railroad Retirement Board and have to pay for Medicare Part A, you'll get a monthly bill from Medicare. Part B is billed quarterly.
Extra time to enroll in Medicare: Extra time to sign up for Medicare is available for anyone who wasn’t able to contact the Social Security Administration because of problems with Social Security’s telephone system between Jan. 1, 2022, and Dec. 30, 2022.
Medicare Part A costs in 2023
Medicare Part A is free for most people, but if you don't qualify for premium-free Part A, you can buy it.
You'll pay up to $506 per month for Part A in 2023. If you paid Medicare taxes for less than 7.5 years, the standard Part A cost is $506 per month. If you paid Medicare taxes for at least 7.5 years but less than 10 years, Part A will cost you $278 per month.
In most cases, if you choose to purchase Part A, you must also:
- Have Medicare Part B (medical insurance)
- Pay monthly premiums for both Part A and Part B ?
Most Medicare enrollees get Part A for free. You can get free Part A at age 65 if you are eligible for monthly Social Security or RRB benefits.
If you're under age 65, you can get free Part A if you are eligible for Social Security or RRB benefits and have Lou Gehrig's disease, kidney failure or a qualifying disability.
Medicare Part A deductible
If you're getting Medicare Part A for free, you'll still pay other out-of-pocket costs, including your Part A deductible. The deductible is the amount you pay out of pocket for covered services before your health plan begins to pay. For 2023, the Medicare Part A deductible is $1,600.
Unlike most health insurance deductibles, the Part A deductible goes by benefit period rather than by calendar year. A benefit period begins the day you're admitted and ends 60 days after you leave the hospital. You pay the inpatient hospital deductible for each benefit period, but there's no limit to the number of benefit periods. If you're admitted to a hospital or SNF within 60 days, the timer resets and you won't pay another deductible.
For example, say you had an inpatient hospital stay and paid the full $1,600 deductible. You were discharged on Mar. 1 and admitted again on Apr. 15. Because your new hospital stay began within 60 days of the prior visit, you would not be charged another Part A deductible. However, if you were readmitted in June, you would pay a new Part A deductible.
Medicare Part A coinsurance
After you meet your Medicare Part A deductible, you'll pay a daily charge, called coinsurance, for inpatient hospital and skilled nursing facility care.
Your inpatient hospital costs
Days | How much you pay | Additional notes |
|---|---|---|
| 1-60 | $1,600 deductible | Unless you’ve already met your deductible in this benefit period |
| 61-90 | $400/day coinsurance | |
| 91+ | $800/day coinsurance for each "lifetime reserve day" | You have 60 of these over your lifetime. For each day after your 60 lifetime reserve days (beginning at day 152), you will be responsible for all costs. |
If you paid your deductible within the past 60 days (during the same benefit period), you won't have to pay that amount again.
Your skilled nursing facility costs
Days | How much you pay |
|---|---|
| 1-20 | $0 coinsurance per day |
| 21-100 | Up to $200 coinsurance per day |
| 101+ | You pay all costs |
You must have a qualifying hospital stay (usually at least three days) before entering a skilled nursing facility.
Is there an alternative to Original Medicare?
Another Medicare option is Medicare Advantage. These plans are sold through private health insurance companies and provide Medicare Part A, Part B and supplemental benefits. They typically cover Part A and Part B deductibles and coinsurance and often add benefits like prescription, dental and vision. Medicare Advantage plans "bundle" your Original Medicare and additional benefits into one plan managed by a single insurer.
Generally, if you are in good health with few medical expenses, Medicare Advantage will save you money on your health care costs. But if you have serious medical conditions that require expensive treatment, Medigap may be the better choice. When considering Medicare Advantage, it's best to compare multiple plans to get the option that suits your health needs and budget.
Frequently asked questions
Can I get financial help for the cost of Medicare Part A?
If you must pay for Medicare Part A, and premiums or other costs are causing financial difficulty, your state may be able to help. Benefit programs include Medicaid, Medicare Savings Programs (MSPs) and the Program of All-Inclusive Care for the Elderly (PACE). Your state Medicaid office can provide information on eligibility and how to apply.
How is Medicare Part A funded?
Medicare Part A is funded mostly through a payroll tax known as the Federal Insurance Contributions Act (FICA) tax. The total tax amount is 2.9% of your gross pay, with employers and employees each paying 1.45%. High-income earners pay slightly more, and self-employed people pay the full 2.9% tax.
Is my Medicare Part A or B?
Most Medicare recipients are enrolled in both Medicare Part A and Part B. If you're not sure if you have Part A or Part B, check your red, white and blue Medicare card. If you have Part A, "Hospital (Part A)" is printed on the lower-left corner of your card. If you have Part B, "Medical (Part B)" is printed on the lower-left corner of your card. Both will be listed for people enrolled in both parts of Medicare.
Sources
Benefit, cost and enrollment information found in this guide was sourced from Medicare.gov, CMS.gov and the Social Security website, SSA.gov.
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