Medicare covers most of the cost of a hospital stay, but you pay a share of it

Medicare Part A pays for most inpatient hospital care — the room, meals, nursing, tests, and medications you receive while admitted. You do not pay the full bill, but you are not covered completely either. You pay a deductible at the start of your stay, then Medicare covers most costs for the first 60 days. After that, your costs rise. The amount you pay depends on how long you stay and which part of Medicare is covering you.

The key thing to understand: Medicare Part A is hospital insurance. If you have it, you already have hospital coverage — you do not need to sign up separately or choose a plan. The coverage is automatic if you are 65 or older and have worked long enough to may have access to, or if you have received Social Security Disability Insurance for 24 months.

Key Takeaways

  • Medicare Part A covers inpatient hospital stays after you pay a deductible, which changes each year and is separate from your doctor visit deductible.
  • You pay nothing for days 1 through 60 of a hospital stay (after the deductible), but you pay a daily amount called coinsurance for days 61 through 90.
  • If you stay longer than 90 days, you can use lifetime reserve days, but once those run out, you pay the full cost yourself.
  • Medicare Part A does not cover skilled nursing facilities, rehabilitation centers, or hospice in the same way — each has its own cost structure.
  • If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower because those plans cover some or all of what Medicare Part A does not.

What you pay during a hospital stay in 2024

When you are admitted to the hospital, Medicare Part A requires you to pay a deductible before coverage begins. For 2024, that deductible is $1,632 per benefit period. A benefit period starts when you enter the hospital and ends 60 days after you leave — if you are readmitted after that 60-day window, you pay a new deductible.

After you pay the deductible, Medicare covers the full cost of your hospital care for days 1 through 60. You pay nothing during this time. Starting on day 61, you pay a daily amount called coinsurance. For 2024, coinsurance is $408 per day for days 61 through 90. If you stay beyond 90 days, you can use your lifetime reserve days — Medicare allows you 60 of these across your entire life — and you pay $816 per day for each reserve day used. Once your reserve days are gone, you pay 100 percent of the hospital bill yourself.

These dollar amounts change every year. Medicare announces the new amounts in the fall, and they take effect January 1. You can find the current year's amounts on Medicare.gov or by calling 1-800-MEDICARE.

What Medicare Part A actually covers in the hospital

Medicare Part A covers a wide range of services during an inpatient stay. This includes your hospital room and bed, meals, nursing care, medications given to you in the hospital, blood transfusions, lab tests and X-rays, surgery and operating room costs, and medical equipment and supplies used during your stay. It also covers anesthesia, intensive care, and emergency room visits that lead to admission.

What Medicare Part A does not cover: your doctor's fees (those are covered by Medicare Part B), a private room unless medically necessary, a television or telephone in your room, personal care items, or any care after you are discharged. If you need ongoing care at home after leaving the hospital, that is covered by Medicare Part B (home health) or Part A (skilled nursing facility), but only under specific conditions.

Skilled nursing facilities and rehabilitation centers

If you need care in a skilled nursing facility or rehabilitation center after your hospital stay, Medicare Part A may cover it — but only if you meet strict requirements. You must have been admitted to the hospital as an inpatient (not just treated in the emergency room), stayed at least three consecutive days, and been discharged to the facility within 30 days of leaving the hospital. The facility must also be Medicare-certified.

If you meet these requirements, Medicare Part A covers the first 20 days at no cost to you. For days 21 through 100, you pay a daily coinsurance amount — $204 per day in 2024. After day 100, you pay the full cost. Many people do not realize this is a separate benefit from the hospital stay itself, with its own cost structure and time limits.

How Medigap and Medicare Advantage change what you pay

If you have a Medigap (supplemental insurance) plan, it may cover some or all of the costs Medicare Part A does not. For example, some Medigap plans pay your Part A deductible, your coinsurance during days 61 through 90, and even some of your lifetime reserve day costs. Which costs are covered depends on which Medigap plan (A through N) you choose. Medigap plans are sold by private insurance companies, not by Medicare.

If you have a Medicare Advantage plan (Part C), you have hospital coverage through that plan instead of through Part A directly. Medicare Advantage plans must cover at least as much as Original Medicare does, but they may have different deductibles, coinsurance amounts, and rules about which hospitals you can use. Some Medicare Advantage plans cover the full deductible; others do not. You need to check your specific plan's documents to know what you will pay.

If you have neither Medigap nor Medicare Advantage, you are on Original Medicare (Part A and Part B), and you pay the amounts listed above out of your own pocket.

What happens if you do not have Medicare Part A

If you are 65 or older but did not work long enough to may have access to for free Part A, you can pay a monthly premium to enroll in it. The premium varies depending on how many work credits you have. If you are under 65 and have End-Stage Renal Disease or ALS (Lou Gehrig's disease), you may also be able to enroll in Part A.

If you are not enrolled in Medicare Part A and you are admitted to the hospital, Medicare will not pay for your stay. You will receive the full bill from the hospital. This is why enrollment is important, even if you think you will not need it soon — hospital stays can be unexpected and very expensive.

Frequently Asked Questions

Does Medicare cover emergency room visits?

Medicare Part B covers emergency room visits whether or not you are admitted to the hospital. If the visit leads to hospital admission, Part A takes over and covers your inpatient care. If you are treated and sent home, Part B covers the emergency room costs after you pay your Part B deductible and coinsurance.

What if I stay in the hospital longer than 90 days?

After 90 days, you can use your lifetime reserve days — you have 60 of these across your entire life. You pay $816 per day for each reserve day used. Once those are gone, you pay 100 percent of the hospital bill yourself. This is why some people with chronic conditions or frequent hospitalizations choose Medigap coverage.

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

You pay the deductible once per benefit period. A benefit period starts when you enter the hospital and ends 60 days after you leave. If you are readmitted after that 60-day window closes, a new benefit period begins and you pay a new deductible.

Does Medicare Part A cover a private hospital room?

Medicare covers a private room only if it is medically necessary — for example, if you have a contagious infection or need isolation for your condition. If you request a private room for comfort or preference, you pay the difference between the semi-private room rate and the private room rate yourself.

What if I have both Medicare and employer health insurance?

If you are still working and have employer coverage, that plan is primary and pays first. Medicare is secondary and covers what your employer plan does not. When you retire or lose employer coverage, Medicare becomes primary. Always tell your hospital and doctors about all your insurance so they bill in the correct order.