Inpatient hospital care
covers hospital services, including these:
- Semi-private rooms
- General nursing
- Drugs as part of your inpatient treatment
- Other hospital services and supplies
This includes the care you get in these facilities:
- Acute care hospitals
- Critical access hospitals
- Inpatient rehabilitation facilities
- Long-term care hospitals
It also includes these:
- Inpatient care as part of a qualifying clinical research study
- Inpatient mental health care given in a psychiatric hospital or other hospital
What's not covered
- Private-duty nursing
- Private room (unless
- 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 Part A are covered when all of these are true:
- A doctor makes an official order which says you need 2 or more midnights of medically necessary
Inpatient hospital care [Glossary]to treat your illness or injury, and the hospital formally admits you.
- 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 a hospital.
Deductible [glossary]for each Benefit period.
- Days 1–60: $0
Coinsurancefor each benefit period.
- Days 61–90: $335 coinsurance per day of each benefit period.
- Days 91 and beyond: $670 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
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.
The copayment for a single outpatient hospital service can’t be more than the inpatient hospital deductible. However, your total copayment for all outpatient services may be more than the inpatient hospital deductible.
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.