Medicare covers most of your hospital bill, but you pay a deductible and daily copayments after day 60

Medicare Part A pays for inpatient hospital care, but the amount you pay depends on how long you stay. For 2024, you pay a one-time deductible of $1,632 when you enter the hospital. After that, Medicare covers all costs for days 1 through 60. Starting on day 61, you pay a daily copayment (called coinsurance) for each day you stay, up to a maximum of 90 days per benefit period. If you stay longer than 90 days, you can use lifetime reserve days, but those come with higher copayments and a limited supply.

The exact amounts change each year, so the numbers above may differ from what you owe when you need hospital care. Your hospital bill includes a room, meals, nursing care, medications, and medical equipment — all covered by Part A once you meet the deductible. You do not pay separately for these services during the covered days.

Key Takeaways

  • You pay a one-time deductible per benefit period (currently $1,632 for 2024) when admitted to the hospital, and Medicare covers everything for the first 60 days.
  • From day 61 through day 90, you pay a daily copayment (currently $408 per day for 2024) for each day you remain in the hospital.
  • A benefit period starts when you enter the hospital and ends 60 days after you leave; if you are readmitted within 60 days, you do not pay a new deductible.
  • Lifetime reserve days allow you to extend coverage beyond 90 days, but they are limited and carry higher copayments, so you should understand them before using them.
  • Medicare Part B covers doctor visits and outpatient services during your hospital stay, but you still owe your Part B deductible and copayments for those services.

How the deductible and daily copayments work

When you are admitted to the hospital, you pay the Part A deductible once per benefit period. A benefit period is not a calendar year — it starts the day you enter the hospital and ends 60 days after you leave. If you are readmitted within 60 days of leaving, you do not owe a new deductible; you are still in the same benefit period. If you are readmitted 61 days or more after leaving, a new benefit period begins and you owe the deductible again.

For the first 60 days of your stay, Medicare pays 100 percent of covered hospital costs after you pay the deductible. On day 61, you begin paying a daily copayment for each day you stay. This copayment is separate from the deductible and continues through day 90. After day 90, you can use lifetime reserve days if you have them remaining, but the copayment per day is much higher.

The hospital will send you a bill showing what Medicare paid and what you owe. You may also receive an Explanation of Benefits (EOB) from Medicare in the mail or through your online account at Medicare.gov. This document shows the charges, what Medicare covered, and your responsibility.

What happens if you stay longer than 90 days

If your hospital stay extends beyond 90 days in a single benefit period, you can draw on lifetime reserve days. Medicare gives you 60 lifetime reserve days when you first enroll in Part A, and you can use them only once in your lifetime. Each reserve day you use comes with a copayment that is higher than the day 61–90 copayment. For 2024, the copayment for each lifetime reserve day is $816 — double the copayment for days 61 through 90.

Once you use a lifetime reserve day, it is gone forever. If you use all 60 reserve days and still need hospital care, Medicare stops paying and you pay the full cost of the hospital stay. This is why it matters to understand these limits before a long hospitalization happens. If you have a Medigap policy (supplemental insurance), it may cover some or all of these copayments and reserve day costs — check your policy documents or call your insurance company to find out.

If you think your stay will be very long, ask the hospital social worker or discharge planner about your options. They can explain what you will owe and may help you understand financial information programs or payment plans the hospital offers.

What Medicare Part A hospital coverage includes and excludes

Part A covers a semiprivate room (two or more beds), all meals, nursing care, medications given in the hospital, medical equipment and supplies, lab tests, X-rays, and surgery. It also covers blood transfusions after the first pint (you or someone else must donate or replace the first pint). Rehabilitation services in the hospital are covered if they are medically necessary and ordered by your doctor.

Part A does not cover private rooms unless medically necessary, television or telephone charges, personal care items, or any care after you are discharged. Once you leave the hospital, Part A hospital coverage ends, even if you go to a skilled nursing facility or rehabilitation center. If you need ongoing care after discharge, you may be covered under Part A's skilled nursing facility benefit, which has its own rules and copayments.

If you receive care from doctors, specialists, or other providers during your hospital stay, those services are billed under Part B (medical insurance), not Part A. You will owe your Part B deductible and copayments for those services separately from your hospital deductible and copayments.

How readmission within 60 days affects your costs

If you leave the hospital and return within 60 days, you are still in the same benefit period. This means you do not owe a new deductible — you only owe the daily copayment if your second stay extends beyond day 60 of the combined time. For example, if you stayed 50 days, left, and returned 10 days later for another 20-day stay, your total is 70 days in one benefit period. You would owe the day 61–90 copayment for 10 of those days (days 61 through 70).

However, if you are readmitted 61 or more days after you left the hospital, a new benefit period begins. You owe a new deductible, and the 60-day clock resets. Understanding this timing can help you anticipate what you will owe if you need hospital care more than once in a short window.

Medigap and Medicare Advantage coverage of hospital costs

If you have a Medigap policy (supplemental insurance sold by private insurers), it may pay some or all of your Part A deductible and copayments. Different Medigap plans cover different amounts — some plans pay the full deductible and copayments, while others pay part of them. Check your policy documents or call your insurance company to see what your plan covers for hospital stays.

If you have Medicare Advantage (Part C), your hospital coverage works differently. Instead of the deductible and copayment structure described above, you pay according to your plan's rules. Most Medicare Advantage plans have an in-network deductible and copayment for hospital stays, which may be lower or higher than Original Medicare. You should review your plan documents or call your plan to understand your hospital costs before you need care.

Neither Medigap nor Medicare Advantage changes what Medicare Part A covers — they only change what you pay out of pocket. The hospital stay itself is still covered the same way; the supplemental or Advantage plan just helps with your share of the cost.

How to find out what you will owe before admission

Before a planned hospital stay, call the hospital's billing or financial counseling department and ask what your out-of-pocket cost will be. Bring your Medicare card and any supplemental insurance card. Tell them how many days you expect to stay, and ask them to estimate your deductible and copayments based on your coverage.

You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to confirm your Part A coverage and ask about the current deductible and copayment amounts. If you have Medigap or Medicare Advantage, call your insurance company and ask what they will pay toward your hospital stay.

For emergency admissions, you may not have time to call ahead. In that case, ask the hospital to explain your bill after you are admitted or discharged. If you do not understand the charges or what you owe, ask to speak with a patient advocate or financial counselor at the hospital — they can walk you through the bill and may be able to set up a payment plan if the amount is large.

Frequently Asked Questions

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

No. 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 within 60 days, you are still in the same benefit period and do not owe a new deductible. If you are readmitted 61 or more days after leaving, a new benefit period begins and you owe the deductible again.

What if I have a Medigap policy — does it cover the hospital deductible?

It depends on your Medigap plan. Some plans pay the full Part A deductible and copayments, while others pay part of them or none at all. Check your policy documents or call your insurance company to see what your specific plan covers for hospital stays.

Can Medicare stop paying for my hospital stay?

Yes, if you stay longer than 90 days in one benefit period and use all 60 of your lifetime reserve days, Medicare stops paying. After that, you pay the full cost of the hospital stay. This is rare, but it can happen with very long hospitalizations. Ask your hospital social worker about payment options if you are concerned about this.

Does Medicare Part A cover the doctor's bill during my hospital stay?

No. Doctors and specialists who treat you in the hospital bill under Part B (medical insurance), not Part A. You will owe your Part B deductible and copayments for their services separately from your hospital deductible and copayments.

What is the difference between the daily copayment and the lifetime reserve day copayment?

Days 61 through 90 have a lower daily copayment (currently $408 for 2024). Lifetime reserve days, which you use after day 90, have a much higher copayment (currently $816 for 2024). Once you use a lifetime reserve day, it is gone forever and cannot be replaced.