February 18th 2025
By Ari Parker
Medicare covers hospital stays, including most services you receive during your treatment. Learn about how Medicare works for inpatient and outpatient care.
If you find yourself in hospital, the last thing you want to do is worry about bills. If you’re on Medicare, Medicare Part A covers inpatient hospital stays. Medicare Part B will cover services you receive during an outpatient hospital visit.
While Medicare covers most of your hospital costs, you will have to pay for some out-of-pocket costs in the form of deductibles and coinsurance. A Medicare Supplement plan (also called a Medigap plan) will reduce your out-of-pocket costs.
Let’s dive into the details to find out exactly what Medicare covers and if you should consider a Medigap plan to cover costs not paid for by Original Medicare.
Medicare Part A will cover your hospital stay if both of the following are true:
The hospital accepts Medicare.
An official doctor's order states inpatient hospital care is necessary for treatment.
Medicare Part A is commonly referred to as hospital insurance, but it’s responsible for all inpatient care. Part A covers:
A semi-private room: You'll typically be in a room with at least one other patient unless your doctor indicates you need a private room.
Meals: You'll receive coverage for meals during your stay.
General nursing care: Basic nursing services provided by the hospital staff.
Prescription drugs and other medications: If you receive medications during an inpatient hospital stay, they’ll be covered by Part A (instead of Medicare Part D).
Lab tests and X-rays: Diagnostic tests and blood transfusions are covered during a hospital stay.
Other hospital services and supplies: These may include medical equipment, like wheelchairs, walkers, and crutches.
Rehabilitation services: To help you regain any abilities lost due to injury, illness, or treatment.
When you leave the hospital, Part A also extends to cover:
Limited skilled nursing facility care after you have been in the hospital for three consecutive days
Limited home healthcare provided by a Medicare-approved home health agency
Hospice care when you choose to no longer seek treatment for a serious illness
While Part A covers hospital costs as part of your inpatient care, it doesn't cover the following:
A private room in a hospital or skilled nursing center, unless it's medically necessary.
The first three units of blood you receive as treatment (you won't have to pay if the hospital did not pay for the blood you receive).
A personal nurse to provide private-duty nursing care.
Personal items, such as razors or slipper socks, unless these items are provided to all patients at no extra charge. Many hospitals provide a set of complimentary items, including socks and a bag of basic toiletries.
A television or telephone if there is a separate charge for usage. For example, fees may apply for external calls, premium television channels, or on-demand services
Cosmetic surgery procedures performed solely for aesthetic reasons are not covered. (If cosmetic surgery is necessary due to an injury or surgery, it may be covered.)
Long-term care such as custodial care if that is the only kind of care you need.
Even with insurance, people are still responsible for a portion of the hospital bill. This includes the Part A deductible, potential copayments during extended stays, and other costs that are adjusted annually. A Medicare Supplement plan will reduce your costs by paying for some or all of your Part A deductible and coinsurance.
For 2025, the amount you will have to pay are as follows:
$1,676 deductible for each benefit period
$0 copayment for days 1 to 60 of treatment after you pay your deductible
$419 copayment per day for days 61 to 90 of treatment
$838 copayment per day for days 91 to 150 of treatment while using your 60 lifetime reserve days
100% of the treatment costs for days 151+
Here is how the costs are applied:
Days 1–60 - Original Medicare pays in full after the Part A deductible is met
Days 61–90 - The beneficiary pays a daily coinsurance
Days 91–150 - Medicare pays $838 per day using the 60 lifetime reserve days
After day 150 - The beneficiary pays the full cost
It’s important to note that The Medicare Part A deductible applies to each benefit period when inpatient hospital services are used. This is different from most insurance deductibles which are annual and only need to be paid once in a year. A benefit period begins the day a beneficiary is admitted to a hospital and ends the day they have been out of the hospital for 60 days in a row.
The average length of a hospital stay in the US is 5.5 days, although it’s usually much longer in acute care hospitals that offer short-term medical treatment for patients with severe or urgent health issues. Should someone exceed 90 days, they can draw upon a reserve bank of 60 days to cover the costs—but you only get 60 reserve days for your lifetime.
A Medicare Supplement plan will usually pay the Part A deductibles and copays.
If you qualify for skilled nursing facility (SNF) coverage, you will be sent to a skilled nursing home once you are released from the hospital. There, you can receive inpatient speech, physical, and occupational therapy.
Your financial responsibility is as follows:
You owe nothing for the first 20 days
You’ll owe up to $204 per day (in 2025) for days 21-100
You’re responsible for all costs for days 101 and beyond
Most of these costs for inpatient rehabilitation are covered under Part A. Your costs can be reduced with a Medicare Supplement plan.
When you are discharged from a skilled nursing facility, you may qualify for home health care coverage. You can receive occupational and physical therapy, along with personal care services.
If you receive outpatient services at a hospital, regardless of who treats you, they’ll be covered by Medicare Part B.
Even if you are "under observation," if you are not officially admitted as a patient, Part B covers your care. This distinction can affect your out-of-pocket costs because Part A and Part B have different deductibles and copayments.
Medicare Advantage plans are offered by private insurance companies and must cover at least the same things as Medicare Part A and Part B. However, Medicare Advantage plans may have different rules and costs than Original Medicare. For example, there’s usually only one deductible (versus one for Part A and one for Part B).
For most people, Medicare—and all insurance coverage—can feel incredibly complicated. It’s made even more complicated by the different coverage options: Original Medicare, Medicare Advantage, Medicare Supplement, and Medicare Part D.
That’s why we’re here! Our Medicare agents will help you understand the different Medicare coverage options, including all the pros and cons. We’ll also help you enroll in the coverage that works best for you. Understand how coverage works and see if you can save by giving us a call at 855-900-2427 or choosing a time to talk in advance.
