Medicare Part A is often referred to as Hospital Insurance and covers a range of inpatient medical care in acute care hospitals, critical access hospitals, rehabilitation facilities, and long-term care hospitals. Any Medicare recipient will be eligible for these Part A benefits under the following conditions:
- Your doctor has written an order stating that you require two or more midnights in a hospital setting in order to treat your illness or injury.
- The hospital must formally admit you.
- You need care that you can only receive in a hospital setting.
- The hospital accepts Medicare.
- The Utilization Review Committee of the hospital approves your stay.
What will Medicare cover during your hospital stay?
Part A will cover general nursing care, semi-private rooms, meals, drugs as part of your inpatient treatment and other hospital services and supplies. In 2019, you will have a deductible of $1,340 to pay before Medicare will cover your expenses. If you are in the hospital for 1-60 days, you will not be responsible for any coinsurance. If you remain in the hospital, you will pay $341 coinsurance for days 61-90. If you are in the hospital 91 days or longer, you will have coinsurance of $682 per each lifetime reserve day for each benefit period up to 60 days over your lifetime. Once your lifetime reserve days have been used, you will be responsible for all costs.
Long-Term Hospital Care Coverage
If you have more than one serious condition that may improve with treatment and medical care, your physician may recommend admitting you to a long-term care hospital (LTCH). Most LTCH patients are expected to remain hospitalized for more than 25 days and are usually transferred from an intensive or critical care unit. Part A will help cover the costs of a stay in a long-term care hospital, including comprehensive rehabilitation, respiratory therapy, head trauma treatment, and pain management.
Medigap and Medicare Advantage Coverage
Many people with Original Medicare choose to purchase supplemental insurance to help cover some of their out-of-pocket costs. A Medigap policy, also known as Medicare Supplement, may help cover coinsurance, copayments, and deductibles incurred by a hospital stay.
Other Medicare recipients choose to get their Part A and Part B benefits through a Medicare Advantage (MA) plan. MA plans are offered by private insurance companies who contract with Medicare to provide at least the same coverage as Original Medicare, but many MA plans offer additional coverage. If you are enrolled in a Medicare Advantage plan, your benefits will likely include an annual out-of-pocket maximum.