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How much does Medicare Part A pay for hospital costs?

En español | Medicare Part A covers inpatient stays in hospitals and skilled nursing facilities, some home care and end-of-life hospice care

After you pay the Part A deductible, Medicare pays the full cost of covered hospital services for the first 60 days of each benefit period when you are an inpatient, which means you are admitted to the hospital and are not there for observational care. Part A also pays a portion of the costs for longer hospital stays.

First, what is a benefit period?

A benefit period begins the day you are admitted to a hospital as an inpatient or become a patient in a skilled nursing facility. It ends when you’ve been out of the hospital or skilled nursing facility for 60 consecutive days.

The designation as an inpatient is important. You can be lying in a hospital bed but be classified as under observation, or you can be occupying a bed in an outpatient surgery center; neither counts toward inpatient status.

You pay a single deductible even if you have more than one hospital stay during a benefit period. But be aware that you may pay more than one deductible in a calendar year, which may be different from private insurance plans you have had through work.

What hospital services does Part A cover?

If you’re admitted as an inpatient to a hospital that accepts Medicare, Medicare Part A covers most hospital services, such as:

  • A semiprivate room and meals
  • General nursing services
  • Drugs, supplies and other hospitals services that are part of your inpatient treatment
  • Some blood transfusions
  • Inpatient rehabilitation services

Physician services in the hospital are usually covered under Medicare Part B, rather than Part A.

How much do I pay for Part A hospital costs?

Your costs under Part A depend on the number of days you spend as an inpatient in the hospital during each benefit period. You pay a portion of the cost, called coinsurance, for each day you are in the hospital beyond 60 days in each benefit period. 

You pay:

  • Nothing additional for the first 60 days of covered inpatient care each benefit period after you pay the $1,556 Part A deductible in 2022.
  • $389 daily coinsurance for days 61 to 90 for each benefit period in 2022.
  • $778 daily coinsurance for up to 60 lifetime reserve days. Each lifetime reserve day can be used only once but can apply to different benefit periods.
  • You pay all costs beyond 90 days per benefit period if you use up your lifetime reserve days.

If you buy a Medicare supplement policy (known as Medigap) or have other coverage, such as retiree health insurance, that supplemental policy may cover the Part A deductible and hospital coinsurance and may also provide coverage for additional lifetime reserve days.

Keep in mind 

You’ll receive a Medicare summary notice every calendar quarter that you have Medicare claims, similar to an explanation of benefits for private insurance. It shows information about your claims and the amount you may be billed.

The summary notice also shows how much of the deductible you’ve paid and the date your benefit period began. You can access this information more frequently if you set up an online Medicare account, previously known as a MyMedicare account.

Updated July 18, 2022

     

        


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