(Updated for 2025)

Hospitalization insurance for people aged 65 and older and individuals of any age who receive Social Security Disability Insurance benefits for two or more years. Coverage includes inpatient hospitalization, critical access hospitalization, skilled nursing facility care (but not long-term “custodial” nursing home care), home health care, and hospice.

Most people should apply for Medicare at age 65 even if they are still working unless they are covered by their employer’s group health insurance. People who receive Social Security will automatically be enrolled in Medicare at age 65. Most people do not pay a monthly Part A premium (see “Part A premium buy-in” below for those who did not work enough to earn the required 40 quarters of work credit of Medicare coverage).

Hospital deductible– in 2025 you pay:

• $1,676 per illness for days 1-60 of each “benefit period”.
• $419 per day for days 61-90.
• $838 per day for days 91-150 (these 60 “reserve day” may only be used once in your lifetime.)
• You pay all costs for each day beyond 150 days for each “benefit period”.
• You pay all costs after you have used all 60 lifetime “reserve days” for days after day 90 in future “benefit periods”.
• A “benefit period” begins when the patient is hospitalized and ends when the patient has been discharged out of such facility for 60 consecutive days.
• There is no limit to the number of “benefit periods” that Medicare will cover in a general hospital.

Skilled Nursing Facility (SNF)– This is not the same as long-term “custodial” nursing home care. You must be hospitalized under Part A coverage for at least three consecutive days for the same illness prior to admission to the Medicare-approved SNF.

In 2025 you pay:

• No cost for days 1-20.
• $209.50 per day for days 21-100.
• You pay all costs for each day beyond 100 days.

Home Health Care– no deductible or co-pay if approved, limited to medically necessary part-time skilled care of a homebound individual.

Hospice– no deductible or co-pay, but you pay $5 for outpatient drugs and 5% of the Medicare-approved amount for inpatient respite care.

Blood– obtained while hospitalized is free after you pay for the first 3 units.

Inpatient Mental Health Care– In 2025 you pay:

• $1,676 for days 1-60 for each “benefit period”.
• $419 per day for days 61-90.
• $838 per day for days 91-150 (these 60 “reserve days” may only be used once in your lifetime.)
• You pay all costs for each day beyond 150 days for each “benefit period”.
• You pay all costs after you have used all 60 lifetime “reserve days” for days after day 90 in future “benefit periods”.
• A “benefit period” begins when the patient is hospitalized and ends when the patient has been discharged out of such facility for 60 consecutive days.
• There is no limit to the number of “benefit periods” that Medicare will cover in a general hospital. There is a lifetime maximum benefit of 190 days that Medicare will pay for stays in a specialty psychiatric hospital. After 190 days in a specialty psychiatric hospital, many patients choose to receive treatment in the psychiatric ward of a general hospital that is covered by Medicare.

Part A premium buy-in– Most retirees & their spouses (probably 99 percent) do not pay a monthly Part A premium. However, for people who did not work enough to earn 40 quarters of Medicare coverage, there is a Part A buy-in premium.

In 2025 the Part A buy-in premiums are:

• For people with 30-39 quarters of Medicare coverage, the buy-in cost is $285 per month.
• For people with less than 30 quarters of Medicare coverage, the buy-in cost is $518 per month.

These figures may change each year.