Medicare/Part A
Medicare Part A · Hospital Insurance
Hospital coverage — usually at no premium.
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most NJ residents receive Part A at no monthly premium.
$0
premium for most NJ residents
2025 costs
What Part A costs when you use it
Part A has no monthly premium for most people, but it does have deductibles and coinsurance when you're hospitalized.
| Cost type | 2025 amount |
|---|---|
| Monthly premium (40+ work quarters) | $0 |
| Monthly premium (30–39 quarters) | $278 |
| Monthly premium (< 30 quarters) | $505 |
| Inpatient deductible (per benefit period) | $1,676 |
| Hospital coinsurance — days 1–60 | $0 |
| Hospital coinsurance — days 61–90 | ~$419/day |
| Lifetime reserve days (up to 60) | ~$838/day |
| SNF — days 1–20 (after 3-day qualifying inpatient stay) | $0 |
| SNF — days 21–100 | ~$209.50/day |
| SNF beyond 100 days | All costs |
Figures are 2025 Medicare standard amounts. Medigap plans G, N, and F cover the inpatient deductible and most coinsurance.
What's covered
Four areas Part A covers
Part A is broader than most people realize — hospital stays are just the start.
Inpatient hospital
Hospital stays — covered from day one
Part A covers semiprivate rooms, meals, general nursing, and hospital services and supplies. Your deductible resets with each new benefit period.
- Inpatient hospital stays of any length
- Semiprivate room, meals, and nursing care
- $1,676 deductible per benefit period in 2025
- Days 1–60 at $0 after the deductible
SNF and home health
Skilled nursing and home health
Following a qualifying hospital stay, Part A covers short-term skilled nursing facility care and medically necessary home health visits — not custodial care.
- SNF days 1–20 at $0 (requires 3-day inpatient stay first)
- SNF days 21–100: ~$209.50/day coinsurance
- Home health: skilled nursing, physical therapy, speech therapy
- Custodial care (bathing, dressing) is NOT covered
Most NJ residents pay $0 for Part A
If you (or your spouse) worked and paid Medicare taxes for at least 40 quarters — 10 years — Part A is premium-free. Fewer quarters mean a monthly premium up to $505. Even if you pay a premium, Part A is almost always worth having: a single hospital stay can cost tens of thousands of dollars without it.
Part A covers hospice care
If a doctor certifies a terminal illness with a life expectancy of 6 months or less, Part A covers hospice care — including palliative drugs, nursing visits, grief counseling, and short-term inpatient respite. Hospice is fully covered with $0 coinsurance for most services.
FAQ
Part A questions
Is Part A really premium-free?+
Yes — if you or your spouse worked and paid Medicare taxes for at least 40 quarters (10 years). If you have 30–39 quarters, the 2025 premium is $278/month. Fewer than 30 quarters: $505/month.
What is a benefit period?+
A benefit period starts the day you are admitted as an inpatient and ends when you have been out of the hospital (or skilled nursing facility) for 60 consecutive days. There is no limit on how many benefit periods you can have — but each one starts a new inpatient deductible.
Does Part A cover skilled nursing facility care?+
Yes, for up to 100 days per benefit period following a qualifying 3-day inpatient hospital stay. Days 1–20 are fully covered. Days 21–100 carry a ~$209.50/day coinsurance in 2025. Custodial (long-term) care is not covered.
Does Medigap cover the Part A deductible?+
Plans G, N, and F all cover the Part A hospital inpatient deductible. This is one of the main reasons NJ enrollees pair Part A with a Medigap plan.
What is the difference between inpatient and observation status?+
Observation status is considered outpatient care — even if you sleep in a hospital bed. This matters because Part A's skilled nursing benefit requires a 3-day inpatient stay. Always ask the hospital whether you are admitted inpatient or under observation.
What does Medicare Part A cover in New Jersey?+
Medicare Part A is hospital insurance. In NJ it covers inpatient hospital care, up to 100 days of skilled nursing facility care per benefit period (after a 3-day qualifying hospital stay), hospice for terminal illness, and medically necessary home health services. It does not cover doctor visits, outpatient care, or routine SNF stays — those require Part B and/or Part C.
What is the Part A late enrollment penalty?+
If you have to pay a Part A premium and you delay enrollment past your Initial Enrollment Period without creditable coverage, your premium goes up 10% and you pay that penalty for twice the number of years you delayed. The penalty only applies if you have to pay a Part A premium — most NJ residents with 10+ years of work history are exempt.
Questions about Part A?
A licensed NJ Medicare advisor can explain your costs and help you choose the right supplemental coverage — no cost.