The short version

Medicare Part A is the "hospital" half of Original Medicare. Where Part B handles doctor visits and outpatient care, Part A steps in when you are formally admitted to a hospital or need care in certain institutional settings. It covers four main things: inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. For most people approaching 65 here in Charlotte and across North Carolina, Part A comes with no monthly premium because you already paid for it through years of working.

What Part A covers

Inpatient hospital care

Once a doctor formally admits you as an inpatient, Part A covers your room, general nursing, meals, the drugs given during your stay, and other hospital services and supplies. There is one trap worth knowing: if the hospital keeps you "under observation" rather than admitting you, that time is billed as outpatient under Part B, not Part A. It is always worth asking your care team, "Am I an inpatient or under observation?" because the answer changes how your stay is covered.

Skilled nursing facility (SNF) care

Part A can cover skilled nursing facility care, but only after a qualifying inpatient hospital stay of at least 3 days in a row (counting your admission day but not your discharge day). It also has to be genuinely skilled care, like IV therapy, wound care, or physical rehabilitation, rather than help with daily living. When you stay eligible, Medicare covers up to 100 days of SNF care per benefit period.

Hospice care

If a doctor certifies that someone is terminally ill, generally with a life expectancy of 6 months or less, and that person chooses comfort care instead of curative treatment, Part A covers hospice. That includes pain relief, symptom management, and support services, usually provided at home or wherever the person lives.

Some home health care

Part A also helps cover skilled, part-time or intermittent home health care, such as skilled nursing or physical, occupational, and speech therapy, when a doctor certifies that you are homebound and orders it. Part A and Part B share this home health benefit, so you may see both parts involved.

What Part A costs in 2026

Here is where the "you already earned it" point matters. In 2026, most people pay a $0 monthly premium for Part A because they (or a spouse) worked and paid Medicare payroll taxes for at least 40 quarters, which is roughly 10 years. Those quarters do not have to be consecutive.

  • In 2026, if you have 30 to 39 quarters, the Part A premium is $311 per month.
  • In 2026, if you have fewer than 30 quarters, it is $565 per month.

Premium-free does not mean cost-free. In 2026, Part A has an inpatient hospital deductible of $1,736 per benefit period. If a stay runs long, coinsurance applies: $434 per day for days 61 through 90, and $868 per day for lifetime reserve days (day 91 and beyond) in 2026. A "benefit period" starts when you are admitted and ends after you have gone a set stretch of time without inpatient hospital or skilled nursing care — check Medicare.gov for the exact rule — so it is possible to face more than one deductible in a single year.

How North Carolina residents qualify for Part A

You generally qualify for Medicare at 65 if you are a U.S. citizen or a lawful permanent resident who has lived here continuously for at least 5 years. Even if you never worked enough on your own record, you may still get premium-free Part A on a current, former, or deceased spouse's 40-quarter record, depending on the length of the marriage. Your spouse does not have to be collecting Social Security yet for you to use their record.

Timing matters too. If you are already receiving Social Security at least 4 months before you turn 65, you are enrolled in Part A (and Part B) automatically, and your Medicare card arrives in the mail. If you are not yet drawing Social Security, perhaps because you are still working or delaying benefits, you sign up yourself during your Initial Enrollment Period. That window runs 7 months around your 65th birthday: the 3 months before your birthday month, the birthday month itself, and the 3 months after.

What Part A does NOT cover

It is just as important to know the gaps. Original Medicare, which is Part A and Part B together, generally does not cover long-term custodial care, meaning ongoing help with daily activities like bathing, dressing, or eating when that is the only care needed. That includes most nursing-home stays and assisted living. Remember, Part A covers skilled nursing short-term after a qualifying hospital stay, but not long-term custodial care. For that kind of care, people often look to Medicaid or a separate long-term care plan.

Part A also does not cover the outpatient and everyday care that falls under Part B (doctor visits, lab tests, durable medical equipment) or your prescription drugs, which are covered under Part D. And because Original Medicare has no annual out-of-pocket cap on Parts A and B, many people in North Carolina pair it with a Medicare Supplement (Medigap) policy or choose a Medicare Advantage plan, which does include an out-of-pocket maximum. Which route fits best genuinely depends on your health, budget, doctors, and how much cost predictability you want, so this is a decision worth talking through rather than guessing at.

A note on getting the details right

Part A rules have real fine print: the 3-day inpatient requirement before skilled nursing, the observation-versus-admitted distinction, benefit periods that can trigger more than one deductible, and figures that change every year. Medicare.gov and 1-800-MEDICARE are always the controlling source for your exact situation and current figures. That said, sorting out how Part A works alongside Part B, Part D, Medigap, and Medicare Advantage is exactly the kind of thing where a knowledgeable second set of eyes pays off.

How The Jordan Insurance Agency helps

The Jordan Insurance Agency is an independent, full-time, licensed insurance agency based in Charlotte, North Carolina, serving people across the state as they approach 65 and beyond. Because we are independent and represent multiple carriers, we are not steering you toward one company's product. We start with what Part A does and does not cover in your specific case, then help you build the pieces around it, whether that is Original Medicare with a Medigap policy and a Part D drug plan, or a Medicare Advantage plan with a built-in out-of-pocket cap.

An experienced, full-time agent who completes annual AHIP and carrier certifications, carries E&O coverage, and reviews your plan every year at renewal is genuinely better positioned to catch coverage gaps than a new or part-time agent. Just as important, our help costs you nothing extra: the carrier pays the agent, and your premium is the same whether you enroll on your own or work with us. If you are 3 to 6 months out from your Initial Enrollment Period, that is the ideal time to reach out to The Jordan Insurance Agency so you can make an unrushed, well-informed decision, and you always keep Medicare.gov and 1-800-MEDICARE as your official reference for current figures.

Plan availability & disclaimer

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. The Jordan Insurance Agency is not connected with or endorsed by the United States government or the federal Medicare program.