Medicare Part A Costs in 2026: Deductibles, Coinsurance, and Premiums

Medicare Part A is hospital insurance — the part of Medicare that covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. While most people pay no monthly premium for Part A, it is far from free. The deductibles and coinsurance under Part A are some of the highest costs in the entire Medicare program, and they can add up fast during a serious illness or extended hospital stay.

This guide covers every Part A cost for 2026 — including the per-benefit-period deductible, hospital coinsurance for extended stays, skilled nursing facility rates, premiums for those who must pay them, the blood deductible, and how costs changed compared to 2025. If you want a broader look at all four parts of Medicare and what they cost, see our complete Medicare costs breakdown for 2026.

What Does Medicare Part A Cover?

Before diving into costs, it helps to understand exactly what Part A covers. Medicare Part A pays for four main categories of care:

• Inpatient hospital care: Semi-private rooms, meals, nursing care, medications administered during your stay, lab tests, and surgeries performed while you are a hospital inpatient.
• Skilled nursing facility (SNF) care: Rehabilitation and skilled care in a nursing facility after a qualifying three-day inpatient hospital stay, for up to 100 days per benefit period.
• Hospice care: Comfort care for terminal illness, including pain management, counseling, and respite care. Covered if a doctor certifies a life expectancy of six months or less.
• Home health care: Part-time skilled nursing, physical therapy, and other services delivered in your home when you are homebound and need skilled care.

Part A does not cover long-term custodial care, private-duty nursing, or personal care assistance with daily living activities like bathing and dressing. Understanding what is and is not covered is essential to understanding where the costs fall.

2026 Part A Costs at a Glance

Here is a summary of every Medicare Part A cost-sharing amount for 2026, as published by the Centers for Medicare and Medicaid Services (CMS):

• Inpatient hospital deductible: $1,676 per benefit period
• Hospital coinsurance, days 61-90: $419 per day
• Lifetime reserve day coinsurance (days 91+): $838 per day (60 lifetime reserve days total)
• Skilled nursing facility coinsurance, days 21-100: $209.50 per day
• Premium (fewer than 30 work quarters): $505 per month
• Premium (30-39 work quarters): $278 per month
• Premium (40+ work quarters): $0 (premium-free)
• Blood deductible: First 3 pints per calendar year

The Part A Hospital Deductible: $1,676 Per Benefit Period

The single largest Part A cost for most beneficiaries is the inpatient hospital deductible. In 2026, this deductible is $1,676 — an increase of $44 from $1,632 in 2025. You owe this amount each time a new benefit period begins, not once per calendar year.

A benefit period starts the day you are formally admitted as an inpatient to a hospital or skilled nursing facility. It ends when you have been out of the hospital and out of any skilled nursing facility for 60 consecutive days. If you are discharged, stay home for 60 days, and then are readmitted, a new benefit period starts and you owe another $1,676. There is no annual limit on the number of benefit periods.

This per-benefit-period structure catches many beneficiaries off guard. A person with a hip replacement in January and a cardiac event in April could owe $3,352 in deductibles alone in a single year. For someone managing chronic conditions that require repeated hospitalizations, the costs compound rapidly.

Hospital Coinsurance for Extended Stays

Once you have paid the $1,676 deductible, Medicare Part A covers your inpatient hospital costs in full for the first 60 days of each benefit period. You owe $0 in coinsurance during this window. Most hospital stays fall within this range — the average Medicare inpatient stay is about five days.

However, if your hospitalization extends beyond 60 days, substantial daily coinsurance kicks in:

• Days 1-60: $0 coinsurance after the deductible. Medicare covers all costs.
• Days 61-90: $419 per day in coinsurance. A full 30-day stretch in this range would cost you $12,570 on top of the deductible.
• Days 91 and beyond (lifetime reserve days): $838 per day. You have a total of 60 lifetime reserve days. Once they are used, they never renew.
• Beyond lifetime reserve days: You pay 100% of all hospital costs. Medicare pays nothing.

To put this in perspective, a 90-day hospital stay under Part A alone would cost $1,676 (deductible) plus $12,570 (30 days at $419) for a total of $14,246 out of pocket — and that is before any lifetime reserve days are used. A 120-day stay would add another $25,140 in lifetime reserve day coinsurance, pushing the total above $39,000. These numbers illustrate why extended hospitalization is one of the greatest financial risks under Original Medicare.

Skilled Nursing Facility Coinsurance

Medicare Part A covers skilled nursing facility (SNF) care when you need rehabilitation or skilled medical care after a qualifying inpatient hospital stay of at least three consecutive days. The SNF benefit lasts up to 100 days per benefit period, but it comes with significant cost-sharing after the first 20 days.

Here is how the 2026 SNF coinsurance breaks down:

• Days 1-20: $0 coinsurance. Medicare covers the full cost.
• Days 21-100: $209.50 per day in coinsurance. If you use all 80 coinsurance days, the total is $16,760.
• After day 100: Medicare coverage ends. You pay 100% of all costs. Skilled nursing facility rates can exceed $300 per day, and costs add up rapidly.

SNF care is commonly needed after hip or knee replacement surgery, a stroke, or a fall resulting in a fracture. Recovery from these events often requires 30 to 60 days of rehabilitation. A 60-day stay would mean 40 days of coinsurance at $209.50, totaling $8,380. This cost is fully covered by most Medigap plans, making supplemental insurance particularly valuable for anyone facing rehabilitation after a major medical event.

Part A Premiums: Who Pays and How Much

About 99% of Medicare beneficiaries pay $0 per month for Part A because they or their spouse earned at least 40 quarters (10 years) of Medicare-taxed employment. These quarters do not need to be consecutive — part-time and seasonal work counts as long as Medicare taxes were withheld. In 2026, a worker earns one quarter of coverage for each $1,810 in earnings, up to four quarters per year.

If you do not qualify for premium-free Part A, you pay a monthly premium based on your work history:

• 30-39 quarters of work: $278 per month ($3,336 per year). This is the reduced premium tier.
• Fewer than 30 quarters of work: $505 per month ($6,060 per year). This is the full premium.

People who commonly face the Part A premium include immigrants who arrived later in life, individuals who worked primarily in jobs not covered by Social Security (certain government positions, for example), and those who spent most of their careers as homemakers. If you are in this situation, check whether your current or former spouse has 40 quarters — you may qualify for premium-free Part A through their work record even if you are divorced, as long as the marriage lasted at least 10 years.

How Part A Costs Changed From 2025 to 2026

CMS adjusts Part A cost-sharing amounts each year based on changes in the average cost of hospital care. Here is how every Part A cost changed from 2025 to 2026:

• Hospital deductible: $1,632 (2025) to $1,676 (2026), an increase of $44 (+2.7%)
• Days 61-90 coinsurance: $408 (2025) to $419 (2026), an increase of $11 per day
• Lifetime reserve day coinsurance: $816 (2025) to $838 (2026), an increase of $22 per day
• SNF coinsurance (days 21-100): $204 (2025) to $209.50 (2026), an increase of $5.50 per day
• Full premium (fewer than 30 quarters): $518 (2025) to $505 (2026), a decrease of $13 per month
• Reduced premium (30-39 quarters): $285 (2025) to $278 (2026), a decrease of $7 per month

While most Part A cost-sharing amounts increased, the premiums for those who must buy Part A actually decreased slightly. The premium reduction is unusual and reflects changes in the actuarial calculations used to determine the buy-in rate. However, the deductible and coinsurance increases are consistent with the ongoing rise in hospital operating costs nationwide.

The Blood Deductible Explained

One of the lesser-known Part A costs is the blood deductible. When you receive blood as part of a covered inpatient hospital stay or skilled nursing facility stay, you are responsible for the cost of the first three pints per calendar year. After you have paid for or replaced three pints, Medicare covers any additional blood needed during covered services.

The cost per pint of blood varies by facility but generally ranges from $200 to $400. At the high end, the three-pint blood deductible could cost $1,200. Most Medigap plans cover the blood deductible under Part A, eliminating this out-of-pocket cost entirely. Note that Part B has its own separate blood deductible of three pints for blood used in an outpatient setting.

Hospital Readmission Costs Under Part A

Hospital readmissions are a significant concern for Medicare beneficiaries, both medically and financially. If you are readmitted to the hospital within the same benefit period — meaning fewer than 60 days have passed since your last discharge — you do not owe a new deductible. Your day count picks up where it left off. For example, if your first stay lasted 50 days, a readmission within 60 days would start at day 51, meaning you would begin paying the $419 per day coinsurance almost immediately.

If 60 or more days have passed since your last discharge, a new benefit period begins and you owe the full $1,676 deductible again. Either scenario can be costly. CMS operates the Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals with excess readmissions for certain conditions including heart failure, pneumonia, and hip and knee replacements. While HRRP is designed to improve care quality, it does not directly reduce patient costs — your Part A cost-sharing obligations remain the same regardless of the hospital's performance score.

To minimize readmission risk and costs, follow your discharge instructions carefully, attend all follow-up appointments, fill prescribed medications before leaving the hospital, and make sure you understand the warning signs that should prompt you to seek emergency care. Ask your care team about transitional care management services, which Medicare covers and which are designed to support you during the critical period after hospital discharge.

How Medigap Covers Part A Cost-Sharing Gaps

The cost-sharing amounts under Part A — the $1,676 deductible, the $419/day and $838/day coinsurance, the $209.50/day SNF coinsurance — represent real financial exposure. A Medigap (Medicare Supplement) plan is specifically designed to fill these gaps.

All 10 standardized Medigap plan types cover the following Part A benefits:

• Part A hospital coinsurance for days 61-90 and lifetime reserve days
• 365 additional days of hospital coverage after Medicare benefits are exhausted

Most Medigap plans — including Plan G, the most popular plan for new enrollees — also cover:

• The Part A hospital deductible ($1,676 per benefit period)
• Skilled nursing facility coinsurance ($209.50/day for days 21-100)
• The blood deductible (first 3 pints)

With Medigap Plan G, a beneficiary who spends 90 days in the hospital pays $0 in Part A cost-sharing — the plan covers the deductible and all coinsurance. Even a catastrophic 150-day stay that consumes lifetime reserve days results in no Part A out-of-pocket costs beyond the Medigap premium itself. Plan G premiums typically range from $120 to $250 per month for a 65-year-old, depending on location and the insurance company.

Plan N is a lower-premium alternative that also covers the Part A deductible, hospital coinsurance, and SNF coinsurance. The savings on Plan N come from its Part B cost-sharing provisions, not from Part A — Plan N provides the same Part A protection as Plan G. Plans K and L offer partial (50% and 75%) coverage of the Part A deductible and SNF coinsurance, with correspondingly lower premiums and a built-in annual out-of-pocket limit.

Part A Cost Scenarios: What You Could Owe in 2026

Understanding the numbers in isolation is one thing. Seeing how they combine in real scenarios makes the financial risk tangible. Here are three scenarios showing Part A costs in 2026 for a beneficiary with premium-free Part A and no supplemental coverage.

Scenario 1: Routine 5-Day Hospital Stay

• Part A deductible: $1,676
• Hospital coinsurance (days 1-5): $0
• Total Part A cost: $1,676

Scenario 2: Extended 75-Day Stay Plus 40-Day SNF Rehabilitation

• Part A deductible: $1,676
• Hospital coinsurance, days 61-75 (15 days at $419): $6,285
• SNF coinsurance, days 21-40 (20 days at $209.50): $4,190
• Total Part A cost: $12,151

Scenario 3: Two Separate Hospital Admissions in One Year

• First admission (10 days): $1,676 deductible + $0 coinsurance = $1,676
• Second admission 90 days later (7 days): New benefit period, another $1,676 deductible + $0 coinsurance = $1,676
• Total Part A cost: $3,352

In every scenario above, a Medigap Plan G policyholder would owe $0 in Part A costs. The insurance absorbs the deductible, all coinsurance, and provides additional hospital coverage beyond what Medicare offers. This is the fundamental value proposition of Medigap for anyone on Original Medicare.

Part A Late Enrollment Penalty

The Part A late enrollment penalty applies only to people who must pay a premium for Part A — those with fewer than 40 quarters of work history. If you are eligible to buy Part A but do not sign up when you are first eligible and you do not have other qualifying coverage, your Part A premium increases by 10%. You pay the higher premium for twice the number of years you delayed enrollment.

For example, if you delayed Part A enrollment by two years, your premium would increase by 10% for four years. On the full 2026 premium of $505, that means paying $555.50 per month for four years — an additional $2,424 in total penalty costs. Unlike the Part B late enrollment penalty, the Part A penalty is not permanent, but it still represents a significant financial consequence of delayed enrollment.

The Bottom Line on Part A Costs in 2026

Medicare Part A is premium-free for most people, but the cost-sharing when you actually use it can be staggering. The $1,676 per-benefit-period deductible, $419/day coinsurance for extended hospital stays, $838/day for lifetime reserve days, and $209.50/day for skilled nursing care can add up to tens of thousands of dollars in a single year. There is no annual out-of-pocket maximum under Original Medicare Part A.

This is why supplemental coverage matters. A Medigap plan like Plan G eliminates virtually all Part A cost-sharing for a predictable monthly premium. Medicare Advantage plans offer an alternative with built-in annual out-of-pocket maximums. Either approach provides protection against the uncapped financial exposure of Original Medicare alone.

Review your coverage options carefully. If you are approaching 65 or already on Medicare without supplemental coverage, consider how a single extended hospital stay could affect your finances. The costs are real, the gaps are significant, and the tools to protect yourself are available. Contact your local SHIP for free, unbiased counseling or use the Medicare Plan Finder at Medicare.gov to compare your options.