Medicare Part A 2027: Hospital Costs, Benefit Periods and What Medigap Pays
Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 29, 2026
Medicare Part A is hospital insurance, and in 2027 most people will pay no premium for it but face a deductible projected at $1,788 for each benefit period, plus daily charges for long hospital and skilled nursing stays. Every Medicare Supplement plan except Plan A pays that hospital deductible at least in part, and all of them pay the hospital coinsurance.
2027 by the Numbers
$1,788
projected 2027 Part A deductible per benefit period, up from $1,736 in 2026 (Medicare Trustees)
40 quarters
of Medicare-taxed work (about 10 years) for premium-free Part A, by you or your spouse
$17,360
your share of a 100-day skilled nursing stay at 2026 rates with no Medigap plan (our math)
60 days
out of the hospital and nursing facility before a new benefit period and a new deductible starts
Part A is the hospital half of Original Medicare. It pays when you are formally admitted to a hospital, when you need skilled nursing care after that stay, and for hospice and some home health care.
Part A costs work differently from almost any other insurance you have had. There is no yearly deductible. Instead you pay per benefit period, and the daily charges grow the longer you stay. This page explains each piece for 2027. For the big picture of all four parts, start with our Medicare basics 2027 guide.
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What Part A Covers and What It Does Not
Inpatient hospital care. A semi-private room, meals, nursing, drugs given in the hospital and other hospital services when you are formally admitted.
Skilled nursing facility care. Short-term rehab or skilled care after a qualifying hospital stay of at least 3 days in a row as an inpatient. It does not pay for long-term custodial care.
Hospice and home health. Hospice care for a terminal illness and some part-time skilled home health care.
Watch for observation status: If the hospital keeps you under observation, you are an outpatient even if you stay overnight. Those days fall under Part B, not Part A, and they do not count toward the 3-day stay you need before Part A will cover skilled nursing care. Ask the staff whether you have been admitted.
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Premium-Free Part A and What It Costs If You Have to Buy It
You get Part A without a premium if you or your spouse earned 40 credits, also called quarters, by working and paying Medicare taxes. That is about 10 years of work. If you have fewer credits, you can still buy Part A, but you must also enroll in Part B.
| Your work record | 2026 monthly premium | 2027 monthly premium (projected) |
|---|---|---|
| 40 or more quarters | $0 | $0 |
| 30 to 39 quarters | $311 | $330 |
| Fewer than 30 quarters | $565 | $600 |
2026: CMS. 2027: Medicare Trustees Report projection, final figures expected in the fall.
If you have to pay for Part A and sign up late, your premium can go up 10%, and you pay that higher amount for twice the number of years you waited.
How the Part A Benefit Period Works
A benefit period starts the day you are admitted as an inpatient. It ends once you have gone 60 days in a row without inpatient hospital or skilled nursing care. If you go back in after that, a new benefit period starts and you owe the deductible again. There is no limit on the number of benefit periods.
March: hospital stay for pneumonia. Benefit period 1 starts. You owe the Part A deductible.
April: home and recovering. The 60-day count starts the day you leave care.
August: hip surgery. More than 60 days have passed, so benefit period 2 starts and you owe a second deductible.
Our math: two benefit periods in 2027 at the projected $1,788 deductible means $3,576 in deductibles alone, in the same calendar year. This is the cost that catches many new Medicare members off guard.
Part A Hospital and Skilled Nursing Costs: 2026 and 2027
| What you owe per benefit period | 2026 (final) | 2027 (projected) |
|---|---|---|
| Hospital days 1-60 | $1,736 deductible | $1,788 deductible |
| Hospital days 61-90 | $434 a day | $447 a day |
| Lifetime reserve days (60 total, used after day 90) | $868 a day | $894 a day |
| After lifetime reserve days are used up | All costs | All costs |
| Skilled nursing days 1-20 | $0 | $0 |
| Skilled nursing days 21-100 | $217 a day | $223.50 a day |
| Skilled nursing after day 100 | All costs | All costs |
2026: CMS fact sheet. 2027: 2026 Medicare Trustees Report projections, not final.
Our math on a long stay without a Medicare Supplement plan, at 2026 rates: a 120-day hospital stay costs you the $1,736 deductible, plus 30 days at $434 ($13,020), plus 30 lifetime reserve days at $868 ($26,040), for a total of $40,796. A 100-day skilled nursing stay costs 80 days at $217, or $17,360.
Which Medicare Supplement Plans Pay Part A Costs
| Part A cost | Paid in full by | Paid in part by |
|---|---|---|
| Hospital coinsurance plus 365 extra days | Every plan letter | None |
| Part A deductible | B, C, D, F, G, N | K (50%), L (75%), M (50%) |
| Skilled nursing coinsurance | C, D, F, G, M, N | K (50%), L (75%) |
| Hospice coinsurance | A, B, C, D, F, G, M, N | K (50%), L (75%) |
Standard plan benefits in all states except Massachusetts, Minnesota and Wisconsin. Plans C and F are only for people eligible for Medicare before 2020.
Plan G and Plan N both pay the full Part A deductible and skilled nursing coinsurance. Compare them on our Medicare Supplement Plan G 2027 page or see every letter in the 2027 comparison chart.
How to Get Part A and Protect Yourself From Hospital Bills
Check your work credits. Your Social Security statement shows whether you or your spouse have 40 quarters for premium-free Part A.
Sign up during your 7-month window. If you already get Social Security at least 4 months before 65, Part A starts automatically.
Decide on Part B. A Medicare Supplement requires both Part A and Part B, so time Part B with your job coverage in mind.
Buy a Medicare Supplement in your 6-month Medigap window. That window starts when you are 65 and have Part B, and no health questions are allowed during it.
Broker tip: If you are still working and covered by an employer plan, taking free Part A at 65 usually costs nothing. But if you contribute to a Health Savings Account, enrolling in Part A ends your ability to contribute, so plan the timing with your HSA in mind.
Bottom Line
Part A is free for most people in 2027, but the hospital side of Medicare is far from free when you use it. You pay a deductible projected at $1,788 every benefit period, plus daily charges that climb past day 60 in the hospital and day 20 in skilled nursing. A Medicare Supplement plan such as Plan G or Plan N pays those Part A costs, so a long stay does not become a five-figure bill.
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Medicare Part A 2027 — Frequently Asked Questions
➤ Is Medicare Part A free in 2027?
For most people, yes. If you or your spouse have 40 quarters of Medicare-taxed work, Part A has no monthly premium, but you still pay the deductible and coinsurance when you use it.
➤ What is the Medicare Part A deductible for 2027?
It is projected at $1,788 per benefit period, up from $1,736 in 2026. CMS usually announces the final 2027 figure in the fall.
➤ Can I pay the Part A deductible more than once a year?
Yes. The deductible applies to each benefit period, not each calendar year, so two hospital stays more than 60 days apart mean two deductibles.
➤ How many days in the hospital does Part A cover?
Part A covers up to 90 days per benefit period, plus 60 lifetime reserve days you can use only once. Every Medicare Supplement plan adds 365 more hospital days over your lifetime.
➤ Does Part A pay for a nursing home?
Only short-term skilled nursing or rehab after a qualifying 3-day inpatient hospital stay, for up to 100 days per benefit period. It does not pay for long-term custodial care, and neither do Medicare Supplement plans.
➤ Can my spouse’s work record get me premium-free Part A?
Yes. You can qualify for premium-free Part A based on a current, former or deceased spouse’s work record if the marriage meets Social Security’s rules.
➤ Does Medigap Plan N pay the Part A deductible?
Yes. Plan N pays the full Part A deductible and the skilled nursing coinsurance. Its copays apply to Part B doctor and emergency room visits, not to Part A hospital care.
➤ Should I take Part A at 65 if I have job coverage?
Most people do because it is free and can act as backup coverage. The main exception is if you or your employer put money into a Health Savings Account, because Part A enrollment ends HSA contributions.
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