Most people with Part A won’t have to pay a premium. But you may have to pay other costs, like deductibles and copayments, if you need inpatient care.

The Medicare program has several parts. Part A and Part B make up Original Medicare.

Part A is inpatient hospital insurance. It helps cover some of your costs at various medical and healthcare facilities when you’re admitted as an inpatient.

Some people will be automatically enrolled in Part A when they become eligible, while others must sign up for it through the Social Security Administration (SSA).

Part A premiums are based on the number of quarters you paid Medicare taxes before enrollment. Medicare taxes are part of the withholding taxes collected from every paycheck you receive.

Most people do not have to pay a monthly premium for Part A. You’re eligible for premium-free Part A if you:

  • have paid Medicare taxes for 40 or more quarters during your life (equal to around 10 years)
  • are age 65 years or older and eligible for or currently collecting Social Security or Railroad Retirement Board (RRB) retirement benefits
  • are under age 65 years and eligible to collect Social Security or RRB disability benefits
  • have received a diagnosis of end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) at any age

If you don’t meet the criteria for premium-free Part A in 2025, you’ll pay $285 or $518 each month.

Deductibles are the amount you need to pay before Part A starts covering the costs of your care.

Copayments, or copays, are a fixed amount you must pay for a medical item or service.

Coinsurance is a percentage amount you must pay for eligible services.

All of these costs apply to Part A. Here’s how each factors into a hospital stay in 2025:

  • $1,676 deductible for each benefit period
  • $0 copayment for days 1 to 60 of treatment after you pay your deductible
  • $419 copayment per day for days 61 to 90 of treatment
  • $838 copayment per day for days 91 to 150 of treatment while using your 60 lifetime reserve days
  • 100% of the treatment costs for days 151+
  • $0 copayment for days 1 to 20
  • $209.50 copayment per day for days 21 to 100 of treatment
  • 100% of the treatment costs for days 101+
  • $0 for covered services
  • 20% coinsurance for all Medicare-approved durable medical equipment

For hospice:

  • $0 for covered services
  • $5 copayment for prescription drugs and similar products for pain relief or symptom management
  • 5% coinsurance of all Medicare-approved costs for inpatient respite care

If you aren’t eligible for premium-free Part A and choose not to buy it when you can first enroll in Medicare, you may be subject to a late enrollment penalty.

This can cause your monthly premium to increase by up to 10% for each year you do not enroll in Part A after you are eligible.

You’ll pay this increased premium for twice the number of years you were eligible for Part A but didn’t sign up for it. For example, if you enroll 3 years after you were first eligible, you’ll pay an increased premium for 6 years.

Most people don’t pay a monthly Part A premium, but you may be required to pay other costs, such as deductibles, copayments, and coinsurance.