Medicare Part A will pay the full cost of inpatient hospital care for 60 days in each benefit period, once you have met your deductible.
Medicare Part A helps cover the costs associated with inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. When it comes to hospital care, the coverage structure involves different tiers after your deductible is met.
Understanding Medicare Part A Hospital Coverage
The way Medicare Part A covers hospital stays is structured in distinct periods, impacting how much you pay.
Full Coverage Period (Days 1-60)
Once your deductible for a benefit period is met, Medicare Part A covers 100% of the approved costs for the first 60 days of an inpatient hospital stay. This means you generally pay nothing for the services covered by Medicare during this period, beyond your initial deductible. This 60-day period is when Medicare Part A pays the "full cost" for your hospital care.
Coinsurance Period (Days 61-90)
Should your hospital stay extend beyond 60 days within the same benefit period, you will be responsible for a daily coinsurance payment for days 61 through 90. During these days, Medicare Part A continues to cover a significant portion of the cost, but you are required to pay a set amount each day.
Lifetime Reserve Days (Beyond Day 90)
If your inpatient hospital stay lasts longer than 90 days, Medicare provides "lifetime reserve days." You have a total of 60 lifetime reserve days that can be used once your initial 90 days of coverage are exhausted. These days are not renewable, meaning once you use them, they are gone forever. For each lifetime reserve day used, you will also pay a higher daily coinsurance amount.
Summary of Inpatient Hospital Coverage
To clarify the cost structure for inpatient hospital care under Medicare Part A, here's a breakdown:
| Days of Stay (Per Benefit Period) | Beneficiary Cost (After Deductible) | Medicare Part A Coverage |
|---|---|---|
| Days 1-60 | \$0 (Medicare pays full cost) | 100% |
| Days 61-90 | Daily Coinsurance | Covered (with coinsurance) |
| Days 91 and beyond | Higher Daily Coinsurance (Lifetime Reserve Days) | Covered (with coinsurance) |
What is a Benefit Period?
It's important to understand that these coverage days are based on a "benefit period." A Medicare benefit period begins the day you are admitted as an inpatient in a hospital or skilled nursing facility. It ends when you haven't received inpatient hospital or skilled nursing care for 60 consecutive days. If you are readmitted after a benefit period ends, a new one begins, and you would again be responsible for a new deductible and the cycle of coverage days restarts.
