Medicare covers the first 60 days of a hospital stay after a person has paid their deductible.

The exact amount of coverage that Medicare provides depends on how long a person stays in the hospital or other eligible healthcare facility.

A coinsurance cost applies after day 60 of the hospital stay. After day 90, the costs become at least partly the responsibility of the individual.

This article describes Medicare’s coverage of hospital stays and looks at how much a person may still need to spend out of pocket. It also explores the types of care facilities that are eligible and ways to reduce out-of-pocket costs.

Glossary of Medicare terms

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
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Medicare coverage for inpatient hospital care comes from Medicare Part A.

In order for Medicare to cover the hospital stay and the care a person receives, a doctor must order the hospital stay and confirm that the individual requires inpatient care to treat an injury or illness. The hospital must also accept Medicare.

This coverage includes:

  • general nursing care
  • a semiprivate room
  • hospital equipment and services
  • meals
  • medication that is part of inpatient hospital treatment

Learn more about Medicare Part A.

Before Medicare starts covering the cost of a hospital stay, the insured person must meet the deductible. This amount changes each year.

For 2024, the Medicare Part A deductible is $1,632 for each benefit period.

A benefit period starts on the first day of hospitalization and ends 60 consecutive days after the person’s discharge from the hospital or skilled nursing facility.

If a person needs to stay in a hospital again before the 60 consecutive days have passed, the second stay falls within the same benefit period as the first. This means they will not have to meet the deductible twice.

After the person pays their deductible, Medicare inpatient coverage begins.

However, depending on the length of their stay, a person may need to pay daily coinsurance out of pocket:

Days in the hospitalCoinsurance per day
days 1 through 60$0 after the deductible
days 61 through 90$408
days 91 and beyond (lifetime reserve)$816
after lifetime reserve daysall costs paid by the insured person

A person with Medicare Part A has 60 lifetime reserve days that begin after the 91st day of a hospital stay.

Medicare covers a hospital stay of up to 90 days, though a person may still need to pay coinsurance during this time. Plus, while Medicare does help fund longer stays, it may take the extra time from an individual’s reserve days.

Medicare provides 60 lifetime reserve days. The reserve days provide coverage after 90 days, but coinsurance costs still apply.

In 2024, individuals pay $816 per reserve day. After the individual uses their 60 lifetime reserve days, they will have to pay all costs associated with the hospital stay.

If a person also has Medicare Part B, it may cover up to 80% of the Medicare-approved amounts for doctor’s services while they are in the hospital.

Medicare Part A helps cover the costs of stays at different types of inpatient facilities. However, coverage may vary, depending on the type of facility.

General acute care hospitals

Acute care hospitals are facilities where individuals receive treatment for brief but severe episodes of illness. These hospitals may also provide treatment for:

  • injuries
  • conditions that are the result of disease or trauma
  • recovery following surgery

Stays in acute care hospitals are generally fewer than 25 days.

Medicare can help cover the costs of these facilities only if an individual receives treatment on an inpatient basis. However, Part A does not pay for treatment that doctors give on an outpatient basis at acute care hospitals.

Inpatient psychiatric facilities

Inpatient psychiatric facilities provide mental health care for individuals who require longer-term care.

Medicare covers up to 190 days of inpatient mental health care in a freestanding psychiatric hospital in a person’s lifetime. However, the 190-day limit does not apply to care that a person receives in a Medicare-certified psychiatric unit in a critical access or acute care hospital.

Rehabilitation centers

A rehabilitation facility provides care after a serious injury, illness, or medical condition. Services often include physical, occupational, and speech therapy.

Medicare covers this care if the agency deems it medically necessary for a person to receive inpatient care for these services. A doctor must certify that the individual meets the following requirements:

  • has a medical condition that requires intensive rehabilitation
  • requires continued medical supervision
  • requires coordinated care from the doctor, other healthcare professionals, and therapists

The same out-of-pocket coinsurance fees apply to inpatient rehabilitation facilities as for inpatient hospital stays. Medicare Part B may help cover the fees for doctor’s services while a person is in a rehabilitation facility.

Read about Medicare coverage for physical therapy.

Long-term care hospitals

Long-term care hospitals generally provide the same types of care as acute care hospitals. However, people typically stay in a long-term care hospital for longer than 25 days.

Many people who go to a long-term care hospital are transferred there from critical or intensive care units. Long-term care hospitals specialize in caring for people with more than one serious condition.

Medicare coverage in these facilities is the same as in other inpatient hospitals.

Skilled nursing facilities

Skilled nursing facilities are available for individuals who may require care for chronic conditions but do not require hospitalization. Services at skilled nursing facilities include:

  • skilled nursing care, which is care that can only a licensed or registered vocational nurse can give
  • rehabilitation services, such as physical or occupational therapy
  • custodial care, such as meals and assistance with personal care
  • medically related social services
  • dietary services
  • pharmaceutical services

Medicare Part A covers these services for a limited time if an individual meets the following conditions:

  • They have Part A coverage and have time left on their benefit period.
  • They have a qualifying inpatient hospital stay.
  • They receive care in a Medicare-certified skilled nursing facility.
  • Their doctor certifies that the individual requires daily skilled care.
  • The individual requires skilled services for one of the following:
    • a new condition that developed while they were receiving care at a skilled nursing facility for a different ongoing condition
    • an ongoing condition that doctors treated during an inpatient hospital stay

Medicare Part A coverage for care at a skilled nursing facility in 2024 involves out-of-pocket costs, including:

  • Day 1 through 20: $0 per benefit period after meeting the deductible
  • Days 21 through 100: $204 per day
  • Days 101 and after: all costs

Medicare Part A does not cover the costs of long-term stays at skilled nursing facilities. However, if a person is transferred from one of these facilities to an acute care hospital, Medicare coverage may resume.

Learn more about Medicare and skilled nursing facility care.

It may be possible for a person to pay less during an inpatient hospital stay. Some Medicare Advantage or Medigap policies can reduce out-of-pocket expenses for inpatient treatment.

Medicare Advantage

A person who has a Medicare Advantage (Part C) plan instead of Original Medicare (parts A and B) may have lower out-of-pocket expenses, such as daily hospital copayments.

However, Medicare Advantage plans vary in their level of coverage, and many of these plans cover services at in-network hospitals and facilities only.

Find out more about Medicare Advantage plans.

Medigap

A Medigap plan is a supplemental policy that a person can purchase through a private company. This type of plan is not available to people who have Medicare Advantage.

Medigap insurance pays for costs that Medicare Part A does not cover, including out-of-pocket expenses, such as coinsurance and copays.

Most Medigap policies also cover Part A deductibles for hospital stays. The cost of these policies depends on a few factors, including a person’s location of residence and age.

Learn about Medigap.

The extent to which Medicare covers the costs of inpatient hospital care depends on the length of the person’s stay in the healthcare facility.

Medicare begins to pay for inpatient treatment only once a person has paid a deductible. After day 60 of a hospital stay, a daily coinsurance applies.

This coverage may apply to stays in general acute care hospitals, rehab facilities, psychiatric hospitals, long-term care centers, and skilled nursing facilities.

Medigap policies or Medicare Advantage plans can help reduce out-of-pocket costs of inpatient care.