Medicare covers most of your hospital bill, but not all of it, and what you pay depends on how long you stay

Medicare Part A pays for inpatient hospital care — the bed, meals, nursing, and most tests and procedures while you are admitted. You pay a deductible for each hospital stay, then Medicare covers the full cost for days 1 through 60. From day 61 to day 90, you pay a daily coinsurance amount. If you stay longer than 90 days, the costs shift again. The deductible and coinsurance amounts change each year; in 2024, the deductible is $1,632 per stay, and the daily coinsurance for days 61–90 is $408.

The key word is "per stay." If you are discharged and readmitted within 60 days, Medicare may treat it as a new stay, which means a new deductible. This matters because hospitals sometimes discharge you to a skilled nursing facility or home, then readmit you days later — and you could end up paying two deductibles instead of one.

Medicare does not pay for a private room, a telephone in your room, or television unless these are medically necessary. It also does not cover the cost of a companion who stays with you, or meals for visitors.

Key Takeaways

  • You pay a single deductible per hospital stay (currently $1,632), then Medicare covers all approved costs for the first 60 days.
  • From day 61 to day 90, you pay a daily coinsurance amount (currently $408 per day), and Medicare covers the rest.
  • If you stay longer than 90 days, you can use lifetime reserve days — 60 additional days Medicare will cover during your lifetime, though you pay coinsurance for those too.
  • A new hospital stay within 60 days of discharge may trigger a second deductible, so ask your hospital whether readmission will be treated as a new stay.
  • Medicare Part A does not cover private rooms, phone service, television, or companion care unless medically necessary.

How the deductible and coinsurance work

When you are admitted to the hospital, you owe the Part A deductible upfront — or at least, the hospital will bill you for it. You pay this once per benefit period, not once per day or once per procedure. A benefit period starts the day you are admitted and ends 60 days after you leave the hospital. If you are readmitted after that 60-day window closes, a new benefit period begins and you owe a new deductible.

After you pay the deductible, Medicare covers 100% of approved hospital charges for days 1 through 60. This includes your room, meals, medications, lab work, imaging, and most procedures. You do not pay anything more during these 60 days — Medicare and the hospital handle the billing between them.

On day 61, your coinsurance kicks in. You now pay a set amount per day (currently $408), and Medicare covers the rest. This continues through day 90. If you stay exactly 61 days, you pay coinsurance for one day. If you stay 90 days, you pay coinsurance for 30 days.

What happens if you stay longer than 90 days

Medicare Part A includes lifetime reserve days — 60 additional days of hospital coverage that you can use once in your lifetime. These are not automatic; you have to agree to use them. If you stay past day 90, the hospital will ask whether you want to use your reserve days.

For each reserve day you use, you pay a daily coinsurance amount (currently $816 per day in 2024 — double the regular coinsurance). Medicare covers the rest. Once you have used all 60 reserve days, Medicare stops paying, and you are responsible for the full cost of the hospital stay.

Very few people stay long enough to exhaust their reserve days. Most hospital stays last fewer than 10 days. But if you have a serious illness or injury that requires months of inpatient care, knowing about reserve days matters.

Readmission within 60 days and the "new stay" question

The 60-day window is crucial because it determines whether you owe one deductible or two. If you leave the hospital on day 1 and return on day 30, Medicare treats both stays as part of the same benefit period. You do not pay a second deductible — you only pay the coinsurance for any days past 60 in the combined stay.

But hospitals and Medicare do not always agree on what counts as a readmission. If you are discharged to a skilled nursing facility (SNF) and then readmitted to the hospital, the rules are different. The SNF stay does not reset your 60-day clock. However, if you go home for 60 days or more and then return to the hospital, a new benefit period starts and you owe a new deductible.

Before you are discharged, ask the hospital or your discharge planner: "If I need to come back within the next two months, will I owe another deductible?" The answer depends on your specific situation, but the question forces the hospital to think through the plan and flag potential costs for you.

What Medicare Part A does not cover during a hospital stay

Medicare Part A covers the hospital itself — the facility, the staff, the standard room, and the medical care. It does not cover amenities or services that are not medically necessary. A private room costs extra unless your doctor orders it for medical reasons (for example, if you have a contagious infection). A semi-private room is standard.

Telephone service, television, and Wi-Fi in your room are not covered by Medicare. Some hospitals include these free; others charge. Ask when you arrive.

If someone stays with you as a companion or caregiver — a family member who sleeps in your room or sits with you during the day — Medicare does not pay for their meals or lodging. You or your family covers that cost.

Prescription drugs you take after you leave the hospital are covered by Medicare Part D (prescription drug coverage), not Part A. While you are in the hospital, the hospital provides medications as part of your inpatient care, and those are covered by Part A.

How to find out what your specific hospital stay will cost

Before you are admitted (if it is planned), or as soon as you arrive (if it is an emergency), ask the hospital for an estimate. Tell them you have Medicare Part A and ask what your out-of-pocket costs will be. They should be able to tell you the deductible amount and estimate how many days you might stay.

If you are unsure whether a readmission will trigger a new deductible, ask your discharge planner or call Medicare directly at 1-800-MEDICARE (1-800-633-4227). Medicare can tell you whether you are still in the same benefit period.

Keep your Medicare Summary Notice (the bill Medicare sends you after a hospital stay). It shows what Medicare paid, what you paid, and how many days you used. If you are readmitted soon after, this document helps you and the hospital figure out whether you owe a second deductible.

Supplemental insurance and hospital costs

Many people with Medicare also carry a Medigap (supplemental) policy or a Medicare Advantage plan. These can reduce or eliminate your deductible and coinsurance. If you have Medigap, your policy may cover the Part A deductible and coinsurance amounts. If you have Medicare Advantage, your out-of-pocket costs depend on your specific plan — some have lower deductibles, some have higher ones.

Check your policy documents or call your insurance company before a hospital stay to find out exactly what you will owe. Do not assume Medicare Advantage covers the same amount as Original Medicare; each plan sets its own cost-sharing.

Frequently Asked Questions

Do I have to pay the deductible before the hospital admits me?

No. The hospital bills you after you are discharged or after Medicare processes the claim. You do not need to pay upfront. However, the hospital may ask for your insurance information and may contact you later about payment arrangements if you cannot pay the full amount at once.

What if I stay in the hospital for only one day?

You still pay the full deductible (currently $1,632). Medicare does not pro-rate it. A one-day stay and a 60-day stay both cost you the same deductible, then Medicare covers the rest.

Can I use my lifetime reserve days more than once?

No. You have 60 lifetime reserve days total, and once you use them, they are gone. If you use 20 reserve days in one hospital stay, you have 40 left for the rest of your life. Use them wisely and only when you truly need them.

Does Medicare pay for a hospital stay outside the United States?

Generally, no. Medicare Part A covers hospital stays in the U.S., U.S. territories, and certain situations involving ships or planes. If you travel abroad, you need travel insurance or out-of-pocket funds to cover hospital costs. Check with Medicare before you travel if you have questions about your specific destination.

What happens if I cannot pay my hospital bill?

Contact the hospital's billing department and ask about payment plans or financial hardship programs. Many hospitals offer sliding-scale fees based on income or can set up a monthly payment plan. Do not ignore the bill — working with the hospital is better than letting it go to collections.