Inpatient hospital care

Inpatient hospital care

Medicare Part A (Hospital Insurance)

 covers inpatient hospital care when all of these are true:

  • You’re admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
  • The hospital accepts Medicare.
  • In certain cases, the Utilization Review Committee of the hospital approves your stay while you’re in the hospital.

 

Your costs in Original Medicare
  • $1,364 Deductible [glossary] for each Benefit period .
  • Days 1–60: $0 Coinsurance for each benefit period.
  • Days 61–90: $341 coinsurance per day of each benefit period.
  • Days 91 and beyond: $682 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond Lifetime reserve days : all costs.

Note

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.

Note

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. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

What it is

Medicare inpatient hospital care coverage includes:

  • Semi-private rooms
  • Meals
  • General nursing
  • Drugs as part of your inpatient treatment
  • Other hospital services and supplies
Things to know

Inpatient mental health care in a psychiatric hospital is limited to 190 days in a lifetime.

Inpatient hospital care includes 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
  • Mental health care
Medicare Part B (Medical Insurance)

covers your doctors’ services you get while you’re in a hospital.

This doesn't include:

  • 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

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