Medicare Part A is your hospital insurance — the foundation of Medicare that pays for inpatient care when you are admitted to a hospital, skilled nursing facility, or hospice program. While most Floridians qualify for premium-free Part A, the cost-sharing structure is more complex than it first appears. The per-benefit-period deductible, the SNF coinsurance cliff after day 20, and the lifetime reserve day limit all represent real financial exposure that can add up quickly during a serious illness or extended recovery. This guide explains every element of Part A coverage in plain language so you can plan ahead — and understand exactly how a Medigap supplement fills each gap.
In This Guide
Part A covers four main categories of inpatient and institutional care. Understanding what falls inside — and outside — each bucket prevents surprise bills.
When you are formally admitted to a hospital, Part A pays for your semi-private room, meals, general nursing, and most hospital services and supplies. The key word is "admitted" — observation status is different and billed under Part B, which is a common source of confusion for Florida patients who spend days in the hospital but are never formally admitted.
After a qualifying inpatient hospital stay of at least three days, Part A covers a stay in a Medicare-certified skilled nursing facility if you need skilled nursing or rehabilitation services — not just custodial care. Coverage runs up to 100 days per benefit period with the cost-sharing structure described below.
For beneficiaries with a terminal illness and a life expectancy of six months or less, Part A covers hospice services including physician care, nursing, counseling, and comfort medications. There is a small coinsurance for outpatient drugs (5% or $5 per prescription, whichever is less) and for inpatient respite care.
Part A (and Part B) covers medically necessary skilled nursing care, physical therapy, speech-language pathology, and home health aide services through a Medicare-certified home health agency when you are homebound. This is strictly skilled care — not long-term home health aide services for daily living assistance.
The Medicare Part A premium depends on your work history under Social Security. Most Florida beneficiaries owe nothing.
| Work Quarters (SSA-Covered) | 2026 Monthly Part A Premium |
|---|---|
| 40 or more quarters (10+ years) | $0 — premium-free |
| 30–39 quarters | ~$284/month |
| Fewer than 30 quarters | $518/month |
If you have fewer than 40 quarters, you may still enroll in Part A by paying the monthly premium. This is called "voluntary enrollment." You must also enroll in Part B (and pay that premium) to be eligible for Part A voluntary enrollment.
Unlike most insurance deductibles that reset on January 1, the Part A deductible resets based on benefit periods — not the calendar year. This catches many Florida beneficiaries off guard.
There is no limit on how many benefit periods you can have in a lifetime. If you are hospitalized in January, discharged, readmitted in March (more than 60 days later), and readmitted again in August, you owe three separate Part A deductibles in the same calendar year — potentially $5,028. This is one of the most important financial risks that Medigap coverage is designed to eliminate.
Once you meet the $1,676 benefit-period deductible, coinsurance applies for extended hospital stays.
| Hospital Days (per benefit period) | Your Cost in 2026 |
|---|---|
| Days 1–60 | $0 (deductible already covers this) |
| Days 61–90 | $419/day |
| Days 91–150 (Lifetime Reserve Days) | $838/day |
| Beyond 150 days (LRDs exhausted) | You pay 100% of all costs |
You have exactly 60 lifetime reserve days — used once and gone. Once you exhaust them, Medicare Part A pays nothing for any day beyond day 90 of a benefit period. Extended ICU stays or complex surgeries with complications can push patients into this territory.
A Medicare SNF stay after a qualifying three-day hospital admission follows its own cost-sharing schedule that is separate from the hospital tiers above.
| SNF Days (per benefit period) | Your Cost in 2026 |
|---|---|
| Days 1–20 | $0 — fully covered by Part A |
| Days 21–100 | $209.50/day |
| After day 100 | $0 from Medicare — you pay 100% |
Part A is narrowly focused on inpatient and institutional care. The following services are not covered under Part A:
For outpatient and Part B coverage details, visit our Florida Medicare Guide. For drug coverage, compare plans at Sun State Coverage.
Medigap (Medicare Supplement) Plan G is the most comprehensive plan available to new Medicare enrollees in Florida and covers every Part A cost-sharing gap except one — the Part B deductible ($257 in 2026, which you pay once per year out of pocket).
| Part A Cost-Sharing Item | Your Cost Without Supplement | Your Cost With Plan G |
|---|---|---|
| Part A deductible (per benefit period) | $1,676 | $0 — Plan G pays it |
| Hospital coinsurance days 61–90 | $419/day | $0 — Plan G pays it |
| Lifetime reserve day coinsurance | $838/day | $0 — Plan G pays it |
| SNF coinsurance days 21–100 | $209.50/day | $0 — Plan G pays it |
| Part A hospice coinsurance/copays | 5% or $5 | $0 — Plan G pays it |
Understanding Part A is the first step. Here is how to act on what you have learned:
For personalized guidance, explore our full Florida Medicare Guide or speak with a licensed agent at Sun State Coverage.
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How much is the Medicare Part A deductible in 2026?
The Medicare Part A deductible in 2026 is $1,676 per benefit period. This is not a calendar-year deductible — you can owe it more than once per year if you are admitted, discharged, and readmitted after a 60-day gap.
Do I pay a premium for Medicare Part A?
Most people pay $0 for Part A if they or their spouse worked at least 40 quarters (10 years) under Social Security. Those with 30–39 quarters pay about $284/month; fewer than 30 quarters pay $518/month in 2026.
What is a Medicare benefit period?
A benefit period begins the day you are admitted to a hospital or skilled nursing facility and ends when you have been out of inpatient care for 60 consecutive days. There is no limit on the number of benefit periods you can have, but you owe a new Part A deductible at the start of each one.
What does Medicare Part A NOT cover?
Part A does not cover outpatient care, prescription drugs, routine dental, vision, or hearing. It also does not cover most custodial care (long-term nursing home stays for assistance with daily activities). You need Part B, Part D, and possibly a Medigap or Medicare Advantage plan for those services.
How does Medigap Plan G cover Part A gaps in Florida?
Medigap Plan G pays the $1,676 Part A deductible, all hospital coinsurance for days 61–90 and lifetime reserve days, SNF coinsurance for days 21–100, and Part A hospice coinsurance. In practice, once you meet the Part B deductible ($257), Plan G covers virtually all remaining Medicare-approved costs.