Medicare Part A covers inpatient hospital stays, but you pay a deductible and daily coinsurance after that

Medicare Part A is the hospital insurance portion of Medicare. It covers the cost of a hospital room, meals, nursing care, medications given in the hospital, and most medical equipment and supplies you use during an inpatient stay. You do not pay the full bill yourself — Part A pays the hospital directly for most of these costs.

However, you are responsible for specific out-of-pocket costs. In 2024, you pay a deductible of $1,632 for each benefit period (the deductible amount changes each year). After you meet the deductible, Medicare covers all costs for days 1 through 60. From day 61 to day 90, you pay a daily coinsurance amount — in 2024, that is $408 per day. If you stay longer than 90 days, your costs rise further. These numbers change annually, so confirm the current amounts with Medicare before your hospital stay if possible.

A benefit period begins the day you enter the hospital and ends 60 days after you leave. If you are readmitted to the hospital more than 60 days after discharge, a new benefit period starts and you pay the deductible again.

Key Takeaways

  • Medicare Part A covers inpatient hospital stays after you pay an annual deductible, which was $1,632 in 2024.
  • You pay nothing out of pocket for days 1 through 60 of a hospital stay once the deductible is met, but you pay daily coinsurance for days 61 through 90.
  • Hospital stays longer than 90 days in a single benefit period are covered only if you have unused lifetime reserve days, which are limited and non-renewable.
  • Skilled nursing facility care after a hospital stay is covered by Part A under specific conditions, but only if you were admitted to the hospital first and stayed at least three days.
  • Part A does not cover outpatient hospital services like emergency room visits, lab work, or imaging done at a hospital but without admission.

What Part A covers during a hospital stay

Part A covers a semiprivate room (two to four beds), all meals, nursing services, and medications administered by hospital staff. It also covers blood transfusions, medical equipment such as oxygen or wheelchairs, and diagnostic tests performed in the hospital. Anesthesia, operating room costs, and surgeon fees are included. If you need intensive care or a specialized unit, those costs are covered under the same deductible and coinsurance structure.

Part A does not cover a private room unless it is medically necessary — for example, if you have a severe infection that requires isolation. You would need to request this in advance and have your doctor document the medical need, or you may be charged the difference between a semiprivate and private room rate out of pocket.

What you pay: deductible, coinsurance, and daily costs

Your costs depend on how long you stay. You pay the Part A deductible once per benefit period, regardless of how many times you are admitted during that period. Once you meet the deductible, Medicare covers 100 percent of covered hospital costs for the first 60 days.

From day 61 to day 90, you pay a daily coinsurance amount. In 2024, this was $408 per day. You are responsible for this amount each day you remain in the hospital. If you stay 30 days in this range (days 61 to 90), you would pay $12,240 out of pocket, in addition to the initial deductible.

If your hospital stay extends beyond 90 days in a single benefit period, Medicare covers the cost only if you have lifetime reserve days remaining. You have a total of 60 lifetime reserve days available to you for your entire life. Once you use them, they do not renew. For each reserve day used, you pay $816 per day in 2024. After your lifetime reserve days are exhausted, you pay 100 percent of all hospital costs.

Skilled nursing facility care after hospital discharge

If you need continued care after leaving the hospital — such as physical therapy or wound care — you may move to a skilled nursing facility (SNF). Part A covers SNF care, but only if you meet three conditions: you were admitted to the hospital (not just treated in the emergency room), you stayed in the hospital for at least three consecutive days, and you are admitted to the SNF within 30 days of hospital discharge.

Part A covers all SNF costs for the first 20 days. From day 21 to day 100, you pay a daily coinsurance amount — $204 per day in 2024. After day 100 in a benefit period, you pay all costs yourself. Like hospital stays, SNF care is tied to your benefit period, so the timing of your hospital discharge matters.

Not all nursing homes are certified as skilled nursing facilities. Assisted living facilities and custodial care homes are not covered by Part A. Before discharge, ask the hospital social worker whether your destination facility is Medicare-certified for skilled nursing care.

Hospital stays that Part A does not cover

Part A covers only inpatient hospital stays — meaning you are admitted to the hospital and assigned a bed. If you are treated in the emergency room and sent home the same day, that is outpatient care and Part A does not cover it. Medicare Part B covers emergency room visits instead, with a copay.

Observation stays are a gray area. Sometimes hospitals admit you for "observation" rather than as an inpatient. During observation, you may occupy a hospital bed and receive hospital services, but you are technically an outpatient. Part B covers observation stays, not Part A, and the rules are different. Ask the hospital staff directly whether you are being admitted as an inpatient or placed on observation — this distinction affects what you pay and what happens if you need SNF care afterward.

Part A also does not cover custodial care — help with daily activities like bathing or dressing when no skilled medical care is needed. If your hospital stay ends but you still need help with activities of daily living, that care is not covered by Medicare.

How to know your costs before admission

If you know you will be admitted to the hospital, call Medicare at 1-800-MEDICARE before you go. They can tell you whether the hospital is in the Medicare system, confirm the current deductible and coinsurance amounts, and explain what your specific costs might be based on your situation. You can also ask the hospital's financial counselor to estimate your out-of-pocket costs.

If you have a Medigap policy (supplemental insurance), it may cover some or all of your Part A coinsurance and deductible. If you have a Medicare Advantage plan, your costs are different — Advantage plans have their own deductibles and coinsurance, which vary by plan. Check your plan documents or call your plan's customer service line to understand your costs under your specific coverage.

For emergency admissions, you will not have time to call ahead. In that case, ask the hospital billing department about your costs as soon as you are stable enough to do so. Many hospitals have financial information programs for patients who cannot pay their share.

What happens if you cannot pay your share

If you receive a bill you cannot pay, do not ignore it. Contact the hospital's financial counselor or billing department and ask about payment plans, financial hardship programs, or charity care. Many hospitals are required by law to offer financial information to low-income patients. You can also contact your state's health insurance counselor — each state has a program called SHIP (State Health Insurance information Program) that offers free help understanding Medicare bills and resolving billing disputes.

If you believe the hospital billed you incorrectly, you have the right to request an itemized bill and to dispute charges. Medicare has a process for appealing bills you think are wrong. Your SHIP counselor can guide you through this process at no cost.

Frequently Asked Questions

Does Medicare Part A cover the entire cost of a hospital stay?

No. You pay a deductible at the start of each benefit period, and you pay daily coinsurance for stays longer than 60 days. Medicare covers the full cost only for days 1 through 60 after you meet the deductible. Costs rise significantly after day 60.

What is the difference between an inpatient stay and observation?

An inpatient stay means you are admitted to the hospital and Part A covers it. Observation means you are in the hospital but technically an outpatient, and Part B covers it instead. This matters because observation stays do not count toward the three-day requirement for SNF coverage. Ask the hospital staff directly which status you have.

If I have a Medicare Advantage plan instead of Original Medicare, does Part A still explore?

Medicare Advantage plans include hospital coverage, but the deductibles and coinsurance are set by your plan, not by the Part A amounts listed here. Check your plan documents or call your plan to learn your specific costs for a hospital stay.

Can I use my lifetime reserve days if I need a hospital stay longer than 90 days?

Yes, but only once. You have 60 lifetime reserve days total across your entire life. Once you use them, they do not come back. After they are exhausted, you pay 100 percent of hospital costs for any stay beyond 90 days in a benefit period.

What if the hospital bills me for something Part A should have covered?

Request an itemized bill and review it carefully. If you believe a charge is incorrect, contact the hospital's billing department and ask them to explain it. You can also file an appeal with Medicare. Your state's SHIP program offers free help with billing disputes and appeals.