Key Takeaways
- Medicare Part A provides coverage for inpatient hospital care including surgeries, bloodwork, and other diagnostics. It also covers hospice care and limited skilled nursing facility and home health services.
- While Medicare Part A covers inpatient hospital stays, patients are responsible for paying a portion of costs, including a 2025 deductible of $1,676 per benefit period, plus daily copayments of $419 for days 61 to 90 of a hospital stay.
- Medicare provides 60 lifetime reserve days beyond the initial 90 days of covered inpatient care, with a higher copayment cost of $838 per day while using these reserve days.
Medicare Part A can provide some coverage for inpatient care and significantly reduce costs for extended hospital stays. However, in order to receive the full scope of benefits, you may need to pay a portion of the bill.
Glossary of common Medicare terms
- Out-of-pocket cost: This is the amount you pay for care when Medicare doesn’t pay the full cost or offer coverage. It includes premiums, deductibles, coinsurance, and copayments.
- Premium: This is the monthly amount you pay for Medicare coverage.
- Deductible: This is the annual amount you must spend out of pocket before Medicare begins to cover services and treatments.
- Coinsurance: This is the percentage of treatment costs you’re responsible for paying out of pocket. With Medicare Part B, you typically pay 20%.
- Copayment: This is a fixed dollar amount you pay when receiving certain treatments or services. With Medicare, this often applies to prescription medications.
Medicare Part A, the first part of Original Medicare, is hospital insurance. It typically covers inpatient surgeries, bloodwork, diagnostics, and hospital stays.
Part A also includes coverage for:
- blood transfusions, when done during a hospital stay
- limited skilled nursing facility care
- limited home healthcare
- hospice care
If admitted into a hospital, Medicare Part A will help pay for:
- a semiprivate hospital room
- nursing services
- meals
- medications
- medical supplies
- durable medical equipment used while in hospital care, like wheelchairs, walkers, and crutches
- diagnostic testing
- rehabilitation services provided while an inpatient
Even with Medicare, you are still responsible for paying a portion of the hospital bill. These costs typically include a deductible and coinsurance.
Medicare Part A deductible
In 2025, the Medicare Part A deductible is $1,676 per benefit period.
This means the deductible applies to the length of time you’re admitted to the hospital and continues for 60 consecutive days after you’ve been discharged from the hospital and have not received any inpatient care.
If you’re discharged from the hospital and return within the 60-day period, you don’t need to pay another deductible.
If you’re admitted after the 60-day period, then you’ve started another benefit period, and you will be expected to pay another deductible.
Medicare Part A coinsurance
Once the deductible is met, Medicare will cover the remainder of hospital care costs for up to 60 days after being admitted.
In 2025, if you need to stay longer than 60 days within the same benefit period, you’ll be required to pay a daily coinsurance of $419.
This coinsurance applies to an additional 30-day period, or days 61 through 90 if counted consecutively. After day 90, if you require a longer stay, you can either use all or part of your lifetime reserve days, or you can pay for all costs out-of-pocket.
| Cost type | Amount |
|---|---|
| Inpatient hospital deductible | $1,676 |
| Coinsurance days 1 to 60 | $0 (after deductible is met) |
| Coinsurance days 61 to 90 | $419 per day |
| Coinsurance after day 90 | $838 (while using lifetime reserve days) |
| Coinsurance after day 150 | full cost of all services |
Medicare provides an additional 60 days of coverage beyond the 90 days of covered inpatient care. These 60 days are known as lifetime reserve days.
Lifetime reserve days can be used only once, but they don’t have to be used all in one hospital visit. For example, if you have two extended hospital stays, each amounting to 120 days, you can use 30 lifetime reserve days for each period.
Using lifetime reserve days will come at a higher cost or coinsurance. The 2025 coinsurance cost for these days is $838.
If you paid Medicare taxes during your working years, you may qualify for premium-free Medicare Part A. To be eligible, you’ll need to have worked for 40 quarters, or 10 years, and paid Medicare taxes during that time.
In 2025, if you’ve accumulated at least 30 quarters of coverage or are married to someone who has, you can expect to pay a premium of $285 per month.
If you haven’t had coverage for at least 30 quarters or you’re living with a disability and have exhausted other benefits, you will have to pay a higher premium of $518 per month.
Another option for hospital coverage is a Medicare Advantage (Part C) plan. These plans are offered through private providers and include all benefits covered through Original Medicare (Part A and Part B).
These plans often include extra benefits, too, such as Medicare Part D (prescription drug coverage). They may also offer coverage for:
- dental
- vision
- hearing
- health perks like fitness memberships
Another option is to add a Medigap plan to your Medicare coverage. Like Medicare Advantage plans, these are offered through private insurance providers and can help provide additional coverage toward coinsurance or deductible costs.
It’s important to note that you can’t have a Medicare Advantage (Part C) plan and a Medigap plan at the same time.
While Medicare covers much of your medical expenses, there are still some costs you will need to pay out of pocket. This includes premiums, deductibles, copayments, and coinsurance.
After meeting your annual deductible, Medicare will cover 80% of approved expenses for treatments that are deemed medically necessary with an in-network health professional.
There are no restrictions on the amount of money you may have to pay out of pocket with either Part A or Part B. However, Medigap plans can provide some relief from these costs. The limits for out-of-pocket expenses in Medicare Advantage plans differ depending on your insurance provider.
The nine medical services or products Medicare doesn’t cover are:
- custodial care
- dental care
- eye exams for prescription glasses
- dentures
- plastic surgery, unless medically necessary
- massages
- routine physical exams
- hearing aids and related exams
- concierge medicine
In addition, Medicare won’t pay for anything that would normally be covered if it’s provided by a health professional who is out of network or doesn’t accept assignment.
Medicare Part A can assist with inpatient care costs, but only for a specific time period.
If you or a family member anticipates an extended hospital stay for an underlying health condition, treatment, or surgery, review your insurance coverage to understand your premiums and analyze your costs.
Though Medicare provides coverage for some of your hospital stay, you’ll be expected to pay a portion of the bill.