Medicare covers most hospital costs, but not all of them, and the amount you pay depends on which part of Medicare you have and how long you stay
If you have Original Medicare (Part A and Part B), Medicare pays for most of your hospital bill after you meet your deductible. For 2024, that deductible is $1,676 per benefit period — a span that starts when you enter the hospital and ends 60 days after you leave. Once you pay that, Medicare covers all hospital room and board charges, meals, nursing care, and most tests and procedures done during your stay.
The catch is that you also pay a daily coinsurance amount if you stay longer than 60 days in a single benefit period. Days 61 through 90 cost you $419 per day. Days 91 and beyond cost you $838 per day, though you only have 60 of these "lifetime reserve days" available across your entire life with Medicare. After that, you pay the full cost yourself.
If you have a Medicare Advantage plan (Part C), your hospital coverage works differently. These plans must cover at least as much as Original Medicare, but they set their own deductibles, copays, and coinsurance amounts. Some plans have no deductible for hospital stays; others charge a copay per day. You need to check your specific plan's documents to know what you will owe.
Key Takeaways
- Original Medicare Part A covers hospital stays after you pay a one-time deductible of $1,676 per benefit period, but you pay coinsurance for stays longer than 60 days.
- Medicare does not cover private rooms, phone calls, television, or personal care items — only medically necessary hospital services.
- If you receive care at an out-of-network hospital with Original Medicare, you still pay the same deductible and coinsurance, but the hospital may bill you for the difference between what Medicare allows and what they charge.
- Medicare Advantage plans cover hospital stays under their own rules, which vary by plan, so you must review your plan documents to know your exact costs.
- Supplemental insurance (Medigap) can cover some or all of the coinsurance and deductible amounts that Original Medicare does not pay.
What Original Medicare Part A Actually Pays for in the Hospital
Part A covers a defined list of hospital services. This includes your room (semiprivate, unless medically necessary), all meals, nursing care, blood transfusions, operating room use, anesthesia, lab tests, X-rays, imaging, and medications given to you during your stay. It also covers rehabilitation services if you need them after hospitalization — for example, physical therapy in a hospital-based rehab unit.
What Part A does not cover: a private room (unless medically necessary and approved), a television or telephone in your room, personal grooming items, or a guest meal. These are comfort items, not medical care. If a doctor orders something specific — say, a special diet or a particular medication — Part A covers it. If you choose it for comfort, you pay.
Part A also does not cover the doctor's fees. Those fall under Part B, which has its own rules. Your hospital doctor, surgeon, anesthesiologist, and radiologist will bill separately, and you will owe 20 percent of what Medicare allows after you meet your Part B deductible ($240 for 2024).
How the Deductible and Coinsurance Work Together
When you are admitted to the hospital, you owe the Part A deductible ($1,676 in 2024) before Medicare pays anything. This is a one-time cost per benefit period, not per day or per stay. If you are admitted twice in the same benefit period, you do not pay the deductible twice.
A benefit period runs from the day you enter the hospital and ends 60 days after you are discharged. If you go home and then return to the hospital more than 60 days later, a new benefit period begins and you owe a new deductible.
After you pay the deductible, Medicare covers 100 percent of your hospital costs for days 1 through 60. On day 61, you start paying coinsurance: $419 per day for days 61 through 90. If you stay past day 90, you can use your lifetime reserve days, which cost $838 per day. You have only 60 lifetime reserve days total across your entire life with Medicare — once you use them, they are gone.
| Days in Hospital | What You Pay (2024) | What Medicare Pays |
|---|---|---|
| Days 1–60 | $1,676 deductible (one-time per benefit period) | 100% of covered costs |
| Days 61–90 | $419 per day coinsurance | Remaining costs |
| Days 91+ (lifetime reserve) | $838 per day coinsurance | Remaining costs |
| After lifetime reserve exhausted | 100% of all costs | $0 |
Out-of-Network Hospitals and Balance Billing
Original Medicare does not have a network. You can go to any hospital in the United States that accepts Medicare, and Medicare will pay its share the same way. However, some hospitals are out-of-network for your supplemental insurance (Medigap) or Medicare Advantage plan, which can affect what you owe.
With Original Medicare alone, an out-of-network hospital cannot charge you more than Medicare allows. But the hospital can ask you to sign a form before admission saying you understand they do not accept Medicare assignment. If you sign, the hospital can charge you the difference between what they charge and what Medicare allows — this is called balance billing. Before you sign any form, ask the hospital what their charges are and what Medicare allows, so you know what you might owe.
If you have a Medigap plan, check whether the hospital is in-network for your supplemental coverage. If it is not, your Medigap plan may not cover the coinsurance and deductible amounts, leaving you to pay more.
Medicare Advantage Plans and Hospital Coverage
Medicare Advantage plans (Part C) are required to cover at least as much as Original Medicare, but they structure costs differently. Some plans charge a copay per hospital day — say, $250 per day for the first three days, then $0. Others charge a flat copay per admission. Some have no copay for hospital stays at all but charge higher premiums or copays for doctor visits.
The key difference is that Medicare Advantage plans have networks. If you go to an in-network hospital, you pay what the plan specifies. If you go to an out-of-network hospital, you typically pay more — sometimes significantly more. Emergency care is usually covered at in-network rates even if the hospital is out-of-network, but non-emergency care at an out-of-network facility may not be covered at all.
You must read your plan's Summary of Benefits or call the plan to know your exact hospital costs. These details change year to year, and they vary widely between plans.
Supplemental Insurance and What It Covers
If you have Original Medicare and a Medigap (supplemental) policy, that policy can pay some or all of the deductible and coinsurance amounts Medicare does not cover. Different Medigap plans (labeled A through N) cover different amounts. Plan G, for example, covers the Part A deductible and all coinsurance for days 61 and beyond. Plan N covers the coinsurance but not the deductible.
Medigap policies are sold by private insurance companies, not by Medicare. You pay a monthly premium on top of your Medicare premium. The trade-off is that Medigap covers gaps in Original Medicare, so you have more predictable costs and no network restrictions.
If you have a Medicare Advantage plan, you cannot also have Medigap. Medicare Advantage already includes some coverage of out-of-pocket costs, though usually not as much as Medigap does.
What Happens If You Stay in the Hospital for a Very Long Time
Long hospital stays are rare, but they do happen — after a major surgery, a serious infection, or a stroke. If you stay past day 90, you are using your lifetime reserve days, which cost $838 per day in 2024. Once you have used all 60 of your lifetime reserve days, Medicare stops paying, and you owe 100 percent of the hospital bill.
This is where supplemental insurance becomes critical. If you have Medigap Plan G or Plan F, those plans cover the full cost of hospital care after your lifetime reserve days are exhausted. If you have Original Medicare alone and no Medigap, you will face a very large bill.
If you are approaching day 90 of a hospital stay, ask the hospital's financial counselor about your options. Some hospitals have programs to help uninsured or underinsured patients. You may also want to discuss discharge planning — whether you can move to a skilled nursing facility (which has different Medicare coverage) or return home with home health services.
Frequently Asked Questions
Does Medicare cover the doctor's bill separately from the hospital bill?
Yes. The hospital bill is covered by Part A (after your deductible and coinsurance). Doctors' fees are billed separately under Part B, and you owe 20 percent of what Medicare allows after you meet your Part B deductible. This means you may receive multiple bills from different providers during a single hospital stay.
What if I am admitted to the hospital but discharged the same day?
You still owe the full Part A deductible ($1,676 in 2024), even for an outpatient procedure or observation stay. Medicare counts this as a hospital admission. If you are kept for observation rather than admitted as an inpatient, different rules explore — ask the hospital whether you are being admitted as an inpatient or kept for observation, because it affects what you owe.
Can I use my lifetime reserve days all at once, or do they have to be spread out?
You can use them however you need to. If you have a 100-day hospital stay, you can use all 60 lifetime reserve days during that one stay. Once they are used, they are gone for the rest of your life, so use them only when necessary.
What if the hospital bills me more than Medicare allows?
If you signed a form before admission saying you understood the hospital does not accept Medicare assignment, the hospital can charge you the difference. If you did not sign such a form, the hospital cannot balance-bill you — they can only collect what Medicare allows plus your deductible and coinsurance. Ask the hospital for an itemized bill and compare it to what Medicare says it will pay.
Does my Medicare Advantage plan cover me if I travel out of state?
Medicare Advantage plans cover emergency care anywhere in the United States at in-network rates. For non-emergency care, coverage depends on your plan — some plans cover out-of-state hospitals; others do not. Check your plan documents or call the plan before you travel.