Your Medicare Coverage

Is my test, item, or service covered?

Long-term care hospitals

How often is it covered?

Medicare Part A (Hospital Insurance) covers care in a long-term care hospital (LTCH).  LTCHs specialize in treating patients when both of these apply:

  • They may have more than one serious condition.
  • They may improve with time and care, and return home.  

Your costs in Original Medicare

Generally, you won't pay more for care in a long-term care hospital than in an acute care hospital. Under Medicare, you're only responsible for one deductible for any benefit period. This applies whether you're in an acute care hospital or a long-term care hospital (LTCH).

You don't have to pay a second deductible for your care in a LTCH if:

  • You're transferred to a LTCH directly from an acute care hospital
  • You're admitted to a LTCH within 60 days of being discharged from an inpatient hospital stay

If you're admitted to the LTCH more than 60 days after any previous hospital stay:

  • A new benefit period begins.
  • You'll have to pay a deductible and coinsurance because you're in a new benefit period. These charges are the same as if you were being admitted to an acute care hospital.
Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service
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.

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