What Part A covers
Medicare Part A is hospital insurance. It pays for inpatient care at any Medicare-participating hospital in Washington, from the academic medical centers in Seattle and the regional hospitals serving Spokane to community hospitals in places like Wenatchee, Yakima and Port Angeles. Part A also covers:
- Skilled nursing facility (SNF) care after a qualifying inpatient hospital stay of at least 3 days
- Hospice care for people with a terminal illness whose doctor certifies a life expectancy of 6 months or less
- Some home health care when ordered by a doctor and provided by a Medicare-certified home health agency
- Inpatient care in a religious nonmedical health care institution
Part A does not cover routine custodial care, long-term care in a nursing home, or most assisted living costs. For Washington residents thinking about long-term care, see our WA Cares Fund page.
What Part A costs in 2026
Most people get Part A with no premium because they (or a spouse) paid Medicare taxes for at least 40 quarters (about 10 years) during their working years. If you don't qualify, you can buy Part A: in 2026 the premium is $311 a month if you have 30 to 39 quarters and $565 a month if you have fewer than 30.
You still owe deductibles and coinsurance when you use Part A:
| Service | 2026 cost |
|---|---|
| Hospital deductible (per benefit period) | $1,736 |
| Hospital days 1–60 | $0 after the deductible |
| Hospital days 61–90 | $434 a day |
| Hospital days 91 and up (lifetime reserve days) | $868 a day, up to 60 days over your lifetime |
| Skilled nursing days 1–20 | $0 |
| Skilled nursing days 21–100 | $217 a day |
| Hospice (most services) | $0 |
| Hospice drugs for pain and symptom control | A small copayment per prescription |
How "benefit periods" work
Part A doesn't work on a calendar year; it works on benefit periods. A benefit period starts the day you're admitted as an inpatient to a hospital or skilled nursing facility and ends when you haven't had inpatient hospital or skilled nursing care for 60 days in a row. If you're admitted again after that, a new benefit period starts and you owe the deductible again.
That means someone with several hospital stays could pay the $1,736 deductible more than once in a single year. It's one reason many people pair Original Medicare with a Medigap policy, or choose a Medicare Advantage plan, which has a yearly out-of-pocket limit.
Hospital coverage across Washington
Part A is accepted at every Medicare-participating hospital in the state. That includes:
- Major academic and teaching hospitals in King and Pierce counties
- Regional referral hospitals in Spokane, Wenatchee, Yakima, Bellingham, the Tri-Cities and Vancouver
- Critical Access Hospitals in rural counties: small hospitals with 25 or fewer inpatient beds that Medicare pays under special rules
- Indian Health Service and tribal facilities: American Indian and Alaska Native people can use IHS or tribal care and Medicare together. More on this →
- VA hospitals (a separate system; Medicare doesn't pay for care at VA facilities, but you can have both). VA and Medicare →
Skilled nursing in Washington
To qualify for Part A skilled nursing facility (SNF) coverage, you need a qualifying inpatient hospital stay of at least 3 days in a row (not counting the day you leave), and you generally must enter a Medicare-certified SNF within 30 days of leaving the hospital. "Observation status" doesn't count, which is a frequent source of unexpected bills, so always confirm with the hospital whether you've been admitted as an inpatient if a SNF stay is likely.
Skilled nursing facilities are not spread evenly across Washington, and in rural counties the nearest one may be some distance away. Medicare's Care Compare tool lists Medicare-certified facilities near you, with inspection results.
The hospice benefit
When you choose hospice care, Part A covers nearly all costs related to your terminal illness: nursing, doctor services, medical equipment and supplies, drugs for pain and symptom control (with a small copayment per prescription), aide services, counseling, social work, spiritual care, short-term respite care (with 5% coinsurance for inpatient respite) and grief support for your family.
Washington voters approved the Death with Dignity Act in 2008, making Washington the second state, after Oregon, with such a law. Choosing hospice doesn't require using the Act, and using the Act doesn't end Medicare hospice coverage. More on end-of-life care in Washington →
Watch out: observation status
If you're in the hospital "under observation" rather than admitted as an inpatient, those days don't count toward the 3-day requirement for SNF coverage, and your care is billed under Part B instead. Hospitals must give you a Medicare Outpatient Observation Notice (MOON) if you're under observation for more than 24 hours. Ask your doctor or the hospital directly about your status.
What Part A doesn't cover
This is where gaps in Medicare tend to surprise people. Part A does not cover:
- Long-term custodial care (help with daily activities like bathing, dressing and eating)
- Most nursing home stays beyond the limited skilled-care benefit
- Assisted living facilities
- Adult family homes, a common care setting in Washington
- Private-duty nursing
- Personal items in the hospital, such as a phone or television
For long-term care planning in Washington, the main resources are the WA Cares Fund, Apple Health long-term services and supports, private long-term care insurance and personal savings. Community Living Connections can point you to local aging and long-term care services.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov — What Part A covers
- Medicare.gov — Inpatient hospital care
- Medicare.gov — Skilled nursing facility care
- Medicare.gov — Hospice care
- Medicare.gov — Care Compare
- Washington State Department of Health — Death with Dignity Act
- Indian Health Service — Portland Area
Frequently asked questions
Do most Washington residents pay a premium for Part A?
No. Most people get Part A with no premium because they or a spouse paid Medicare taxes for at least 40 quarters (about 10 years) of work. People with fewer quarters can buy Part A: in 2026 the premium is $311 a month with 30 to 39 quarters and $565 with fewer than 30.
What is the 2026 hospital deductible?
The Part A hospital deductible for 2026 is $1,736 per benefit period. You can owe it more than once in a year if you are admitted again after being out of the hospital or skilled nursing facility for 60 days in a row.
Does Part A cover long-term nursing home care?
No. Part A covers only limited skilled nursing care after a qualifying inpatient hospital stay, up to 100 days per benefit period. Long-term custodial care is not covered. In Washington, the WA Cares Fund and Apple Health long-term services and supports are the main public programs that help with it.
Can I use Part A at a tribal or IHS hospital?
Yes. American Indian and Alaska Native people can use Indian Health Service or tribal health facilities and Medicare together. IHS and tribal facilities can bill Medicare for the care they provide to people who have it.
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 haven't had inpatient hospital or skilled nursing care for 60 days in a row. The Part A deductible applies once per benefit period.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
