Jordan Ellis
Medicare Part A covers inpatient hospital care, skilled nursing facility (SNF) care, home health care, and hospice care. It covers up to 90 days of inpatient hospital care in a single benefit period, with the first 60 days being cost-free. Days 61 to 90 require a daily coinsurance payment, and if you exceed 90 days, you can access your 60 lifetime reserve days, which are also subject to a daily coinsurance charge. These lifetime reserve days can only be used once in your lifetime and are intended for lengthy hospital stays.
| Characteristics | Values |
|---|---|
| Number of days covered by Medicare Part A for inpatient hospital care | 90 days |
| Number of days covered by Medicare Part A for inpatient mental health care in a freestanding psychiatric hospital | 190 days |
| Number of lifetime reserve days | 60 days |
| Number of days after which lifetime reserve days start getting deducted | 90 days |
| Number of days after discharge to notify the hospital about not using lifetime reserve days | 90 days |
| Number of days to be out of the hospital to be eligible for a new benefit period | 60 days |
| Number of additional lifetime reserve days provided by Medigap policies A through L | 365 days |
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What You'll Learn
Lifetime reserve days
Original Medicare, also known as Traditional Medicare, covers up to 90 days of inpatient hospital care each benefit period. A benefit period begins the day you are admitted to a hospital as an inpatient and ends the day you have been out of the hospital or skilled nursing facility for 60 days in a row. For days 61-90, you pay a daily coinsurance. If you have used your 90 days of hospital coverage but need to stay longer, Medicare covers up to 60 additional lifetime reserve days, for which you will pay a daily coinsurance. These days can be used only once in your lifetime and are non-renewable.
You can notify the hospital that you do not want to use your lifetime reserve days, either while in the hospital or up to 90 days after leaving. However, be aware that you will be required to pay for the full cost of your care for those days. In some situations, you may find it better to delay using your lifetime reserve days and pay the hospital’s daily charge instead. For example, if your hospital costs are only slightly higher than the coinsurance for lifetime reserve days, you may want to save your lifetime reserve days for future hospital stays that may be more expensive.
Medigap policies A through L pay for your hospital coinsurance and provide up to an additional 365 lifetime reserve days. Additionally, Plans B through N pay some or all of your hospital deductible. If you buy a Medigap policy, it will pay your hospital coinsurance costs and will also cover an extra 365 days of inpatient coverage after your Medicare lifetime reserve days are used up.
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Inpatient hospital care
Starting on day 91, you can use your lifetime reserve days. You only get 60 lifetime reserve days for your entire life. These days can be used only once and you will pay a coinsurance for each day. The coinsurance is usually 20% of Medicare's assignment. For 2024, each lifetime reserve day has a co-payment of $816 per day. After the lifetime reserve days are gone, you are responsible for all hospital costs in full.
Medigap policies A through L pay for your hospital coinsurance and provide up to an additional 365 lifetime reserve days. Additionally, Plans B through N pay some or all of your hospital deductible.
If you are enrolled in a Medicare Advantage plan, also known as Part C, you can get Medicare coverage from a private health plan that contracts with the federal government. All Medicare Advantage Plans must offer at least the same benefits as Original Medicare (Part A and Part B), but can do so with different rules, costs, and coverage restrictions.
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Skilled nursing facility care
Skilled nursing facility (SNF) care is covered by Medicare Part A (Hospital Insurance) for a limited time if certain conditions are met. Firstly, the patient must have Medicare Part A and have days left in their benefit period. Secondly, the patient must have had a qualifying inpatient hospital stay of at least three consecutive days, not counting the day of discharge. Thirdly, the patient must enter the SNF within 30 days of leaving the hospital. Finally, a doctor or healthcare provider must decide that the patient requires daily skilled care, such as intravenous fluids, medications, or physical therapy, which must be provided by or under the supervision of skilled nursing or therapy staff.
Medicare covers the entire cost of SNF care for the first 20 days. From days 21 to 100, the patient pays a daily copayment of $204 to $209.50, depending on the source of information. After day 100, the patient is responsible for paying 100% of the daily costs. It is important to note that Medicare coverage for SNF care may end within 100 days if the patient stops making progress in their rehabilitation or refuses to participate.
The benefit period for SNF care begins on the day the patient is admitted as an inpatient to the hospital or SNF. The benefit period ends when 60 consecutive days have passed without the need for hospital or SNF care. If the patient returns to the hospital or SNF after this 60-day period, a new benefit period begins, and they become eligible for a new set of 100 days of SNF coverage.
Medicare provides coverage for various services during the SNF stay, including a semi-private room, medical care provided by licensed nurses or physicians, therapies pertinent to the patient's care, relevant social services, prescriptions and medications, supplies and durable medical equipment, and emergency transportation if other modes of transportation would hinder the patient's health. It is important to note that Medicare does not cover long-term care at a nursing home or non-medical custodial care, which unlicensed professionals can provide.
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Costs and coverage
Medicare Part A covers most medically necessary inpatient hospital care. Most people don't pay a monthly premium for Part A, although there is a deductible to pay. In 2024, this deductible was $1,632, and in 2025, it was $1,676.
The first 60 days of inpatient care are covered by Medicare, with no additional costs. From days 61 to 90, you will pay a daily coinsurance. In 2024, this was $408 per day, and in 2025, it was $419 per day.
If you exceed 90 days of inpatient care, you can use your 60 lifetime reserve days. You will pay a daily coinsurance for these days, which was $816 per day in 2024, and $838 per day in 2025. These days can only be used once in your lifetime.
If you exceed your 60 lifetime reserve days, you will need to pay for the cost of care yourself. You can purchase a Medicare supplement policy, which can provide an additional 365 days. Alternatively, Medigap policies A through L provide up to an additional 365 lifetime reserve days.
It's important to note that skilled nursing facility (SNF) care is treated differently. Medicare will only cover SNF care if you have spent three days as an inpatient at a hospital first and have a doctor's order stating that it is necessary. Additionally, SNF care does not have lifetime reserve days, so if you reach 101 days in a benefit period, you will need to pay for the cost of care yourself.
Finally, it is worth mentioning that Medicare Part A only covers up to 190 days of inpatient mental health care in a freestanding psychiatric hospital during your lifetime. This limit does not apply to care received in a Medicare-certified psychiatric unit within an acute care or critical access hospital.
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Medicare Part A
To be covered by Medicare Part A, you must be admitted to the hospital as an inpatient after an official doctor's order, which states that inpatient hospital care is required to treat your illness or injury. The hospital must also accept Medicare.
The exact amount of coverage provided by Medicare Part A depends on how long a person stays in the hospital. For the first 60 days of inpatient hospital care, you will need to meet your Part A deductible, which is $1,676 per benefit period. Days 1-60 are then covered by Medicare Part A. For days 61-90, you will pay a coinsurance cost of $419 per day. After 90 days, you can use your 60 lifetime reserve days, which come at a higher cost of $838 per day. These reserve days can only be used once and are non-renewable. If you use all your lifetime reserve days, you will have to pay all costs associated with the hospital stay.
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Frequently asked questions
Medicare covers up to 90 days of inpatient hospital care in a single benefit period.
If you exceed the 90-day limit, you can use your 60 lifetime reserve days. These days can only be used once over your lifetime and you will pay a coinsurance for each day.
The coinsurance for lifetime reserve days in 2024 was $816 per day. This amount changes annually.
You must submit written notification to the hospital within 90 days of being discharged.
Medicare Part A covers hospital and skilled nursing facility care, home health care, and hospice care.
