Medicare Part A covers inpatient hospital charges

Medicare Part A is the part that pays for inpatient hospital stays — meaning you are admitted to the hospital and stay overnight or longer. Part A covers the hospital bed, meals, nursing care, medications given in the hospital, and basic medical supplies like bandages or catheters while you are there. It does not cover doctor fees (those come from Part B), but it does cover the hospital's costs for your stay.

Part A also covers some care after you leave the hospital. If you go to a skilled nursing facility within 30 days of a hospital stay of at least three nights, Part A will help pay for up to 100 days of skilled nursing care. Part A also covers home health care and hospice in certain situations, but the focus here is hospital charges themselves.

Key Takeaways

  • Part A covers the hospital facility charges during an inpatient stay, including the room, meals, nursing, and hospital-provided medications.
  • You pay a deductible per benefit period (currently $1,556 in 2024, though this amount changes yearly) before Part A begins to pay.
  • After you meet the deductible, Part A covers all covered hospital charges for days 1 through 60 with no copay, but you pay a daily copay for days 61 through 90.
  • Part A does not cover doctor visits, surgeon fees, or outpatient services — those are covered by Part B.
  • If you have Original Medicare, you must have Part A to be covered for inpatient hospital stays.

What you pay out of pocket for a hospital stay

When you are admitted to a hospital as an inpatient under Part A, you pay a deductible before Medicare starts to pay. For 2024, this deductible is $1,556 per benefit period. A benefit period starts the day you enter the hospital and ends 60 days after you leave — if you are readmitted after that 60-day window, a new benefit period begins and you owe another deductible.

After you pay the deductible, Part A covers all covered hospital charges with no copay for the first 60 days of your stay. If you stay longer than 60 days, you pay a daily copay for days 61 through 90 (currently $389 per day in 2024). If you stay even longer and use your "lifetime reserve days" — which Medicare provides as a safety net — you pay a higher daily copay for those days. Most hospital stays do not last this long, so many people never reach this point.

These dollar amounts change each year. Medicare announces the new deductible and copay amounts in the fall for the following year, so check your Medicare materials or call 1-800-MEDICARE if you need the current year's amounts.

The difference between inpatient and outpatient hospital care

It matters whether you are admitted as an inpatient or treated as an outpatient, because the coverage is different. Inpatient means the hospital admits you formally — you receive a hospital gown, stay overnight, and the hospital is responsible for your care around the clock. Part A pays for this. Outpatient means you come to the hospital for a procedure or test, stay a few hours, and go home the same day. Outpatient services are covered by Part B, not Part A, and you typically pay a copay rather than meeting a deductible.

Sometimes a hospital stay that feels like an overnight stay is actually classified as outpatient. This can happen if the doctor does not formally admit you — for example, you might come in for observation in the emergency department and stay 20 hours, but if you were never admitted as an inpatient, Part A does not cover it the same way. Ask the hospital directly whether you are being admitted as an inpatient or kept for observation, because the billing and your out-of-pocket costs will be different.

What Part A does not cover in the hospital

Part A covers the hospital facility and its services, but not the doctors and surgeons who treat you. When a surgeon operates on you in the hospital, the surgeon's fee is billed separately and covered by Part B, not Part A. The same is true for radiologists who read your X-rays, anesthesiologists, and other physicians. You will receive separate bills from these doctors, and Part B will cover 80 percent of the approved amount after you meet your Part B deductible.

Part A also does not cover private duty nursing, a private room (unless medically necessary), or a television or telephone in your room — these are considered amenities and are your responsibility. If you want a private room for comfort rather than medical need, you pay the difference between the semi-private room rate and the private room rate.

How Part A works with other insurance

If you have both Original Medicare (Part A and Part B) and a Medigap policy (supplemental insurance), the Medigap plan typically covers some or all of your Part A deductible and copays. The exact coverage depends on which Medigap plan you have — plans G, F, and C cover the Part A deductible, while other plans may cover the copays for days 61 through 90. Check your Medigap policy documents to see what it covers.

If you are in a Medicare Advantage plan (Part C), that plan replaces Part A and Part B. Your hospital coverage works differently — you pay a copay per hospital stay (often $250 to $500) rather than a deductible, and the plan sets its own rules about which hospitals you can use and how long stays are covered. Review your Medicare Advantage plan's summary of benefits to understand your hospital costs.

When to contact your hospital or Medicare

Before you are discharged from the hospital, ask the billing department for an estimate of what you will owe out of pocket. They can tell you whether you have met your deductible and what your copay will be for the days you stayed. If you receive a hospital bill after discharge that seems wrong — for example, you were charged for days you were not there — contact the hospital's billing office first to ask for an explanation.

If you believe Medicare should have covered a hospital stay and it did not, or if you want to understand why you received a certain bill, call 1-800-MEDICARE. You can also ask to speak with a patient advocate at the hospital itself; most hospitals have one, and they can help you understand your bill and work with Medicare on your behalf.

Frequently Asked Questions

Does Part A cover the doctor's bill when I am admitted to the hospital?

No. Part A covers the hospital facility charges only. Your doctor's or surgeon's fees are billed separately and covered by Part B. You will receive a separate bill from the physician, and Part B will cover 80 percent of the approved amount after you meet your Part B deductible.

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

After 90 days, you can use your lifetime reserve days — Medicare gives you 60 of these over your lifetime. You pay a higher daily copay for reserve days. Once you use all 60 reserve days, you pay all costs yourself unless you have Medigap or other insurance that covers it.

If I am kept in the hospital for observation, does Part A cover it?

Not the same way. Observation stays are outpatient services covered by Part B, not Part A. You pay a copay instead of meeting a deductible. Ask the hospital to clarify whether you are being admitted as an inpatient or kept for observation, because the costs are very different.

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

No. You pay the deductible once per benefit period. A benefit period runs from the day you enter the hospital until 60 days after you leave. If you are readmitted after that 60-day window closes, a new benefit period begins and you owe another deductible.

What if I have a Medicare Advantage plan instead of Original Medicare?

Medicare Advantage replaces Part A and Part B. Your hospital coverage works differently — you typically pay a copay per stay rather than a deductible, and the plan controls which hospitals you can use. Check your plan's summary of benefits to see your exact hospital costs.