Your Medicare Coverage
Is my test, item, or service covered?
Inpatient hospital care
How often is it covered?
Medicare Part A (Hospital Insurance) covers hospital services, including semi-private rooms, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies. This includes the care you get in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals, inpatient care as part of a qualifying clinical research study, and mental health care.
What's not covered
- Private-duty nursing
- Private room (unless medically necessary )
- Television and phone in your room (if there's a separate charge for these items)
- Personal care items, like razors or slipper socks
All people with Medicare are covered when all of these are true:
- A doctor makes an official order which says you need inpatient hospital care to treat your illness or injury.
- You need the kind of care that can be given only in a hospital.
- The hospital accepts Medicare.
- The Utilization Review Committee of the hospital approves your stay while you're in the hospital.
Your costs in Original Medicare
- $1,184 deductible for each benefit period in 2013. ($1,216 in 2014)
- Days 1–60: $0 coinsurance for each benefit period in 2013. ($0 in 2014)
- Days 61–90: $296 coinsurance per day of each benefit period in 2013. ($304 in 2014)
- Days 91 and beyond: $592 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) in 2013. ($608 in 2014)
- Beyond lifetime reserve days : all costs.
You pay for private-duty nursing, a television, or a phone in your room. You pay for a private room unless it's medically necessary.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs.
- Find hospitals
- Steps to Choosing a Hospital Checklist [PDF, 222KB]
- Find out if you're an inpatient or an outpatient—it affects what you pay
- Skilled nursing facility coverage
- Long-term care hospital coverage
- Surgery (estimating costs)
- Your rights in the hospital
- Hospital Discharge Planning Checklist [PDF, 182KB]