Inpatient hospital care

Medicare Part A (Hospital Insurance)

covers inpatient hospital care if you meet both of these conditions:

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, Part A also covers inpatient hospital care if the hospital's Utilization Review Committee approves your stay while you’re admitted.

Your costs in Original Medicare

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 if, or how much, Medicare will pay for them.

You pay this for each

benefit period

:

$1,556 deductible [glossary] .
Days 1–60: $0 coinsurance .
Days 61–90: $389 coinsurance per day.
Days 91 and beyond: $778 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
Each day after lifetime reserve days : All costs.

Hospitals are required to make public the standard charges for all of their items and services (including charges negotiated by Medicare Advantage Plans) to help you make more informed decisions about your care.

What it is

Medicare-covered inpatient hospital services include:

Semi-private rooms
Meals
General nursing
Drugs (including methadone to treat an opioid use disorder)
Other hospital services and supplies as part of your inpatient treatment

Medicare doesn't cover:

Private-duty nursing
Private room (unless medically necessary)
Television or phone in your room (if there's a separate charge for these items)
Personal care items (like razors or slipper socks)

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
Inpatient psychiatric facilities
Long-term care hospitals

It also includes inpatient care you get as part of a qualifying clinical research study.

If you also have Part B, it generally covers 80% of the Medicare-approved amount for doctor’s services you get while you’re in a hospital.

Inpatient hospital care

note:

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