Medicare Part A covers inpatient hospital charges

Medicare Part A is the part that pays for hospital stays. When you are admitted to a hospital as an inpatient — meaning you stay overnight and occupy a hospital bed — Part A covers the room, meals, nursing care, lab tests, imaging, and most other costs tied to your stay. You do not choose Part A; it is automatic when you turn 65 and enroll in Medicare.

Part A does not cover everything in a hospital. It does not pay for a private room unless medically necessary, television or phone charges, or personal care items you bring from home. Outpatient services — like emergency room visits where you are treated and released the same day, or imaging done in the hospital's outpatient department — are covered by Medicare Part B instead, not Part A.

The distinction between inpatient and outpatient matters because it determines your out-of-pocket cost. Part A has a deductible you pay once per benefit period, then covers most costs. Part B has a different deductible and a coinsurance structure. Understanding which applies to your situation can save you from unexpected bills.

Key Takeaways

  • Medicare Part A covers the cost of a hospital room, meals, nursing, tests, and procedures when you are admitted as an inpatient and stay overnight.
  • You pay a single deductible per benefit period (currently $1,556 for 2024, though this amount changes yearly), then Part A covers all covered hospital costs for up to 60 days.
  • If your hospital stay lasts longer than 60 days in a single benefit period, you pay coinsurance for days 61 through 90, and a higher coinsurance for days 91 and beyond.
  • Emergency room visits and outpatient hospital services are covered by Part B, not Part A, even if they happen in a hospital building.
  • A hospital admission is inpatient only if a doctor orders you admitted; observation status (even if you stay overnight) is outpatient and covered by Part B.

What Part A actually pays for during a hospital stay

Part A covers the hospital bed itself, all meals provided by the hospital, nursing care from hospital staff, and use of hospital equipment and facilities. This includes operating room time, anesthesia, lab work, X-rays, CT scans, and other diagnostic imaging done as part of your inpatient care. Medications administered in the hospital are covered. Blood transfusions and blood products are covered. Physical therapy, occupational therapy, and speech therapy ordered during your stay are covered.

Part A also covers a semi-private room (a room with one or more other patients). If your doctor orders a private room because of a medical condition — for example, because you have a contagious infection — Part A covers it. If you straightforward prefer a private room for comfort, you pay the difference between the semi-private and private room rates out of pocket.

Doctors' fees are a separate matter. The doctor who treats you in the hospital bills under Part B, not Part A. Part B covers the doctor's services; Part A covers the hospital facility. This is why you may receive two separate bills after a hospital stay.

How much you pay: deductibles and coinsurance

For 2024, you pay a deductible of $1,556 per benefit period when you are admitted to the hospital. A benefit period starts the day you are admitted and ends 60 days after you leave the hospital without being readmitted. If you are readmitted within those 60 days, you do not pay a second deductible; you are still in the same benefit period. If you are readmitted after 60 days have passed since discharge, a new benefit period begins and you owe a new deductible.

After you pay the deductible, Part A covers all covered hospital costs for days 1 through 60 of your stay. You pay nothing more during those 60 days (except for any Part B services, which have their own costs).

If your stay extends beyond 60 days, you enter a coinsurance phase. For days 61 through 90, you pay $389 per day (for 2024). For days 91 and beyond, you pay $778 per day. These amounts change each year. If your stay is very long, these daily costs add up quickly, which is why some people buy Medigap coverage (supplemental insurance) to cover these gaps.

The difference between inpatient admission and observation status

A hospital stay is only covered by Part A if you are formally admitted as an inpatient. The key is the doctor's order, not how long you stay or whether you occupy a hospital bed. Some hospitals place patients in observation status — a category that looks like admission but is technically outpatient care. You may stay overnight, sleep in a hospital bed, and receive hospital meals, but if the paperwork says "observation" rather than "inpatient admission," Part A does not explore.

Observation stays are covered by Part B instead, which means you pay Part B coinsurance (usually 20 percent of the Medicare-approved amount) rather than the Part A deductible. This can cost you more out of pocket, especially for a longer observation stay. Before you leave the hospital, ask the hospital staff or your doctor whether you were admitted as an inpatient or placed in observation. If you are unsure, call Medicare at 1-800-MEDICARE and provide your hospital record number; they can tell you which status applies.

What happens after you leave the hospital

If you go directly home after discharge, Part A coverage ends. Any care you receive at home — nursing visits, physical therapy, medical equipment — is covered under different rules (home health is covered by Part A under certain conditions, but skilled nursing facility care is a separate benefit with its own limits).

If you are discharged to a skilled nursing facility (a nursing home where you receive skilled care like wound care or physical therapy), Part A covers up to 100 days per benefit period, but only if you were admitted to the hospital first and stayed at least three days. The first 20 days are fully covered by Part A. Days 21 through 100 require you to pay coinsurance ($194.50 per day for 2024). After 100 days in a single benefit period, Part A coverage ends and you pay all costs out of pocket.

When Part B covers hospital services instead

Part B covers hospital services that are outpatient. This includes emergency room visits where you are treated and released the same day, even if you are in the hospital for eight hours. It includes outpatient surgery, where you go to the hospital's surgical center, have a procedure, and leave the same day. It includes diagnostic tests like imaging or lab work ordered by your doctor and done in the hospital's outpatient department.

Part B also covers observation stays, as mentioned above. And Part B covers doctor services in the hospital — the surgeon, anesthesiologist, radiologist, or other physician who treats you — regardless of whether you are an inpatient or outpatient.

For Part B services, you typically pay 20 percent coinsurance after you meet your Part B deductible (which is separate from the Part A deductible). If you have a Medigap plan, it may cover some or all of this coinsurance.

How to find out what you owe before or after a hospital stay

Before you are admitted, ask the hospital's financial counselor or billing department whether your stay will be covered by Part A or Part B, and what your out-of-pocket costs are likely to be. Bring your Medicare card. The hospital can estimate your deductible and any coinsurance based on the expected length of stay, though the actual bill may differ if your stay is longer or shorter than planned.

After discharge, you will receive an Explanation of Benefits (EOB) from Medicare, usually within two weeks. The EOB lists what Medicare paid and what you owe. Review it carefully. If you see charges you do not recognize or if the deductible or coinsurance amount seems wrong, call Medicare at 1-800-MEDICARE with your EOB in hand. Do not wait for a bill from the hospital; the EOB is your first notice of what you owe.

If you received a bill from the hospital that does not match the EOB, contact the hospital's billing department and ask them to explain the difference. Hospitals sometimes bill incorrectly, and you have the right to ask for an itemized bill and to dispute charges.

Frequently Asked Questions

Does Part A cover the cost of my doctor during a hospital stay?

No. Part A covers the hospital facility — the room, bed, meals, nursing, and equipment. Your doctor's services are billed separately under Part B. You will likely receive one bill from the hospital (Part A) and separate bills from the doctor, surgeon, anesthesiologist, or other physicians who treated you (Part B).

What if I am in the hospital for less than 24 hours?

If you are admitted as an inpatient, Part A applies even if you stay less than 24 hours. You still owe the Part A deductible. If you are in observation status, Part B applies instead. The length of stay does not determine which part covers you; the admission status does.

Do I have to pay the Part A deductible every time I go to the hospital?

No. You pay the deductible once per benefit period. A benefit period lasts from the day you are admitted until 60 days after you are discharged. If you are readmitted within those 60 days, you do not owe a second deductible. If you are readmitted after 60 days have passed, a new benefit period begins and you owe a new deductible.

What if my hospital stay is longer than 90 days?

After 90 days in a single benefit period, Part A no longer covers your hospital stay and you pay all costs out of pocket. This is rare, but it happens with very serious illnesses. Medigap plans may cover some of these costs if you have one.

Can I appeal a hospital bill if I think Part A should have covered it?

Yes. If you receive a bill and believe Medicare should have paid, you can file an appeal with Medicare. Call 1-800-MEDICARE and ask for the appeals process, or request a detailed explanation of why the claim was denied. You have 120 days from the date on your EOB to file an appeal.