What does Part A cover?
- Inpatient hospital care after a doctor formally admits you, including a semi-private room, meals, nursing, and drugs and supplies as part of your inpatient treatment. This includes inpatient care in critical access hospitals and inpatient rehabilitation facilities.
- Inpatient mental health care in a general or psychiatric hospital. Care in a freestanding psychiatric hospital is limited to 190 days in your lifetime.
- Skilled nursing facility care for a limited time after a qualifying hospital stay, when you need daily skilled nursing or therapy.
- Hospice care if you're terminally ill with a life expectancy of 6 months or less.
- Home health care such as part-time skilled nursing and therapy, if you're homebound and a doctor certifies the need (Part B also covers home health).
Part A doesn't pay for a private room or private-duty nursing unless medically necessary, or for long-term custodial care. Doctors' services during a hospital stay are billed under Part B.
What does Part A cost in 2026?
| Cost | 2026 amount |
|---|---|
| Premium with 40 or more quarters of Medicare-covered work | None |
| Premium with 30 to 39 quarters | $311 a month |
| Premium with fewer than 30 quarters | $565 a month |
| Hospital deductible, each benefit period | $1,736 |
| Hospital days 1 to 60 | Nothing after the deductible |
| Hospital days 61 to 90 | $434 a day |
| Lifetime reserve days (60 in your lifetime) | $868 a day |
| Skilled nursing days 1 to 20 | Nothing |
| Skilled nursing days 21 to 100 | $217 a day |
CMS sets the 2027 amounts in the fall; see Medicare costs in 2027. A Medigap policy can pay the Part A deductible and coinsurance, and Medicare Advantage plans set their own hospital cost sharing. If your income is limited, Ohio's QMB program pays Part A and Part B cost sharing, and the QDWI program can pay the Part A premium for some working people with disabilities; see Medicare Savings Programs in Ohio.
How do benefit periods work?
A benefit period begins the day you're admitted as an inpatient and ends after you've been out of the hospital and any skilled nursing facility for 60 days in a row. If you go back in after that, a new benefit period starts and you owe the deductible again. That means two hospital stays a few months apart can each carry a deductible, while a readmission within 60 days doesn't.
The 3-day rule and observation status
For Part A to cover skilled nursing facility care, you generally need an inpatient hospital stay of at least 3 days in a row, counting the day you're admitted but not the day you're discharged. Time in the emergency room or under observation before you're admitted doesn't count.
If you stay in an Ohio hospital overnight, ask: "Am I an inpatient or an outpatient?" If you're under observation for more than 24 hours, the hospital must give you a Medicare Outpatient Observation Notice (MOON) explaining your status and what it means for your costs.
Medicare Advantage plans can set their own rules for skilled nursing coverage; check the plan's Evidence of Coverage.
Appealing a hospital discharge in Ohio
If you think you're being discharged too soon, you can ask for a fast review by Ohio's Beneficiary and Family Centered Care Quality Improvement Organization, Commence Health (formerly Livanta), at 1-888-524-9900 (TTY 711). Call no later than your planned discharge date. The hospital must give you a notice, An Important Message from Medicare about Your Rights, that explains how. Notices that still say Livanta remain valid. More on Medicare appeals in Ohio.
How do I get Part A?
If you already get Social Security or Railroad Retirement benefits, you're enrolled in Part A automatically at 65. Otherwise, sign up through Social Security online, at 1-800-772-1213, or at an Ohio Social Security office during your Initial Enrollment Period. If you qualify for premium-free Part A, there's usually no reason to wait, but if you have a health savings account, read working past 65 first: Part A coverage can be backdated up to 6 months when you sign up after 65.
If you must pay a premium for Part A and don't sign up when first eligible, the Part A premium can go up 10% for twice the number of years you could have had it but didn't.
Ohio public retirees and Part A
Ohio public employees hired before April 1, 1986 may not have paid the Medicare tax on their public work and may not qualify for premium-free Part A. The retirement systems handle this differently:
- OPERS requires Medicare-eligible benefit recipients to enroll in Parts A and B. If you don't qualify for premium-free Part A, OPERS requires you to buy it and provides a monthly reimbursement for the premium, plus a partial reimbursement for eligible spouses. Ask OPERS for its Part A reimbursement form when you enroll; it isn't retroactive. See OPERS and Medicare.
- STRS Ohio requires medical plan enrollees to enroll in Part A if it's premium-free, and in Part B (OAC 3307:1-11-03). If you'd have to pay for Part A, STRS Ohio doesn't require it. See STRS Ohio and Medicare.
- SERS tells members to enroll in premium-free Part A if eligible; if Social Security says you aren't eligible for premium-free Part A and you're joining SERS's Medicare coverage, SERS says not to sign up for Part A, because its Medicare Advantage plan covers Part A services. See SERS and Medicare.
Check your own system's current guide before deciding. More on Ohio public retirement systems and Medicare.
Next steps
For questions about your hospital coverage, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). To review how Original Medicare, Medigap and Medicare Advantage handle hospital costs with plans from the companies they work with, you can request a call from a licensed insurance agent. See also Medicare basics and the glossary.
Sources
- Medicare.gov — What Part A covers
- Medicare.gov — Skilled nursing facility care
- Medicare.gov — Hospice care
- Medicare.gov — Inpatient hospital care
- CMS — 2026 Medicare Parts A and B premiums and deductibles
- CMS — Beneficiary notices (MOON and Important Message from Medicare)
- CMS — Beneficiary and Family Centered Care Quality Improvement Organizations
- Commence Health — BFCC-QIO for Ohio
- OPERS — 2026 Health Care Program Guide (Part A reimbursement)
- Ohio Administrative Code 3307:1-11-03 — STRS Ohio medical plan
- SERS — 2027 Member Healthcare Guide (signing up for Medicare)
Frequently asked questions
Do I have to pay for Medicare Part A?
Most people don't pay a Part A premium because they or their spouse paid Medicare taxes for at least 40 quarters. With 30 to 39 quarters the premium is $311 a month in 2026, and with fewer than 30 it's $565. Everyone owes the deductible and any coinsurance when they use hospital care.
What is a benefit period?
A benefit period starts the day you're admitted as an inpatient to a hospital or skilled nursing facility and ends when you've gone 60 days in a row without inpatient care. You pay the Part A deductible again in each new benefit period, and there's no limit on how many you can have.
Does Part A cover a nursing home?
Part A covers up to 100 days of skilled nursing facility care per benefit period, but only after a qualifying inpatient hospital stay of at least 3 days and only while you need daily skilled care. It doesn't cover long-term custodial care. Days 1 to 20 cost nothing; days 21 to 100 cost $217 a day in 2026.
What if the hospital says I'm under observation?
Observation is outpatient care under Part B, even if you stay overnight in a hospital bed, and observation days don't count toward the 3-day stay needed for skilled nursing coverage. If you're under observation for more than 24 hours, the hospital must give you a Medicare Outpatient Observation Notice (MOON). Ask whether you're an inpatient or an outpatient.
How do I appeal if I think I'm being discharged too soon from an Ohio hospital?
Call Ohio's Medicare quality improvement organization, Commence Health (formerly Livanta), at 1-888-524-9900 (TTY 711) no later than your planned discharge date. The hospital gives you a notice called An Important Message from Medicare that explains the steps. You can generally stay while the review happens without paying for the extra days.
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