Key Takeaways

• Medicare Part A forms the foundation of hospital coverage in 2026, and when you are enrolled in PSHB, it usually pays first for inpatient hospital services, reducing how often your PSHB plan needs to step in.

• Understanding what Medicare Part A does and does not cover helps you better predict remaining costs under PSHB, especially for deductibles, coinsurance, and extended hospital stays.

Understanding The Role Of Medicare Part A In 2026

As a Postal Service employee or retiree enrolled in the Postal Service Health Benefits (PSHB) program, Medicare Part A plays a central role once you become eligible for Medicare. In 2026, Part A is often described as hospital insurance, but its impact goes beyond just hospital bills. It sets the first layer of coverage for certain types of care and determines how PSHB coordinates benefits with Medicare.

When you have both Medicare Part A and PSHB, Medicare generally becomes the primary payer for services it covers. Your PSHB plan then acts as secondary coverage. This coordination can lower your out-of-pocket responsibility, but only for services that Part A actually includes.

What Does Medicare Part A Cover In 2026?

Medicare Part A focuses on care that is medically necessary and tied to inpatient treatment or recovery from serious illness. In 2026, coverage under Part A includes several distinct categories.

Inpatient Hospital Care

Medicare Part A covers inpatient hospital stays when you are formally admitted to a hospital. Coverage applies to:

• Semi-private hospital rooms

• Meals and general nursing services

• Drugs administered as part of inpatient treatment

• Other hospital services and supplies during your stay

For 2026, Part A has a deductible of $1,736 per benefit period. A benefit period begins the day you are admitted as an inpatient and ends after you have been out of the hospital or skilled nursing facility for 60 consecutive days.

Once the deductible is met:

• Days 1–60 of an inpatient stay have $0 coinsurance

• Days 61–90 require daily coinsurance

• Days 91–150 use lifetime reserve days, also with daily coinsurance

After lifetime reserve days are exhausted, Medicare Part A no longer pays for inpatient hospital costs, which is where PSHB coverage becomes especially important.

Skilled Nursing Facility Care

Part A also covers care in a skilled nursing facility, but only after you meet specific conditions. In 2026, this includes:

• A qualifying inpatient hospital stay of at least three consecutive days

• Admission to a Medicare-certified skilled nursing facility

• Skilled care related to the condition treated during the hospital stay

Coverage rules are structured as follows:

• Days 1–20: $0 coinsurance

• Days 21–100: daily coinsurance

• After day 100: Medicare Part A stops paying

PSHB may help cover remaining costs once Medicare coverage limits are reached, depending on your plan design.

Hospice Care

Medicare Part A covers hospice care when you are certified as terminally ill and choose comfort-focused care rather than curative treatment. Covered services include:

• Pain and symptom management

• Medical and nursing services

• Counseling and support services

• Limited respite care

Hospice care under Part A generally involves minimal cost-sharing in 2026, with only small copayments for certain medications or respite care.

Limited Home Health Services

Part A can also cover limited home health services when they are tied to a hospital or skilled nursing facility stay. These services must be medically necessary and provided by a Medicare-certified home health agency.

What Medicare Part A Does Not Cover

Knowing what Part A excludes is just as important as knowing what it includes. In 2026, Medicare Part A does not cover:

• Routine doctor visits

• Outpatient hospital services

• Prescription drugs taken at home

• Custodial or long-term care

• Most dental, vision, and hearing services

These gaps are where PSHB continues to play a major role in your overall health coverage.

How Medicare Part A Coordinates With PSHB

When you are enrolled in both Medicare Part A and PSHB, coordination of benefits follows clear rules.

Which Coverage Pays First?

For services covered by Medicare Part A:

• Medicare pays first

• PSHB pays second

PSHB may cover some or all of the remaining deductible, coinsurance, or copayment amounts after Medicare processes the claim. This coordination often results in lower out-of-pocket costs for inpatient care.

For services not covered by Medicare Part A, PSHB becomes the primary payer according to its plan rules.

How Claims Are Typically Processed

In most cases, claims are sent to Medicare first. After Medicare pays its share, the claim information is automatically forwarded to your PSHB plan. You usually do not need to file separate paperwork.

Why Medicare Part A Is Especially Important For PSHB Enrollees

Medicare Part A provides predictable coverage for high-cost hospital services. In 2026, inpatient care can represent one of the largest medical expenses you may face. Having Part A in place reduces how much of that cost flows directly to your PSHB plan.

For PSHB enrollees, this coordination helps:

• Limit exposure to large hospital bills

• Reduce reliance on annual PSHB deductibles for inpatient care

• Preserve PSHB benefits for services Medicare does not cover

How Benefit Periods Affect Your Costs

One unique feature of Medicare Part A is the benefit period structure. Unlike calendar-year deductibles, Part A deductibles can apply more than once in a year if you have multiple hospital admissions separated by enough time.

In 2026, each new benefit period triggers a new Part A deductible. PSHB may help with some of these costs, but understanding how benefit periods reset helps you anticipate potential expenses.

What Happens When Medicare Part A Coverage Ends?

Medicare Part A has limits, especially for long hospital or skilled nursing stays. Once these limits are reached:

• Medicare stops paying for those services

• PSHB may continue coverage under its own rules

At this stage, PSHB often becomes the primary source of coverage, subject to plan deductibles, coinsurance, and annual limits.

Enrollment Timing And Automatic Coverage

Most people become eligible for Medicare Part A at age 65. In many cases, Part A enrollment is automatic if you are already receiving Social Security benefits. In 2026, failing to enroll when eligible can affect how PSHB coordinates benefits.

For most PSHB enrollees, enrolling in Medicare Part A on time ensures smoother claims processing and avoids unexpected coverage gaps.

How Medicare Part A Fits Into Overall PSHB Planning

Medicare Part A is not designed to replace PSHB. Instead, it works alongside it. Part A focuses on inpatient and facility-based care, while PSHB fills in many of the gaps related to outpatient services, preventive care, and ongoing treatment.

Understanding this division of responsibility helps you make informed decisions about enrollment and long-term health cost planning in 2026.

Bringing Your Coverage Pieces Together

When Medicare Part A and PSHB work together, your coverage becomes more layered and predictable. Part A absorbs much of the cost associated with serious hospital care, while PSHB provides additional protection before and after Medicare limits are reached.

If you want help understanding how Medicare Part A fits into your specific PSHB situation, consider reaching out to one of the licensed agents listed on this website. A personalized review can help you better understand coordination rules, timelines, and potential out-of-pocket costs.