Hailey Tran
A Medicare hospital benefit period is a term used to describe the period of time in which a Medicare beneficiary is covered for inpatient hospital care. This period begins when an individual is admitted to the hospital as an inpatient and ends once they have gone 60 days in a row without receiving inpatient care. During the benefit period, Medicare Part A covers most of the medically necessary inpatient hospital care, skilled nursing facility care, home health care, and hospice care. The deductible for Part A in 2025 is $1,676 for each benefit period, and there is no limit to the number of benefit periods in a single year.
| Characteristics | Values |
|---|---|
| Medicare Part A deductible | $1,676 for each benefit period |
| Days 1–60 | $0 after you meet your Part A deductible |
| Days 61–90 | $419 each day |
| Days 91 and beyond | $838 each day for each lifetime reserve day (up to a maximum of 60 reserve days over your lifetime) |
| Each day after you use all of your lifetime reserve days | You pay all costs |
| Maximum inpatient hospital care days covered by Original Medicare | 90 days in a single benefit period |
| Maximum inpatient mental health care days covered in a freestanding psychiatric hospital | 190 days during your lifetime |
| Maximum lifetime reserve days | 60 days |
| Maximum number of benefit periods in a year | No limit |
| Benefit period start date | The day you enter a hospital or skilled nursing facility for care |
| Benefit period end date | After 60 days have passed since you last received hospital or skilled nursing facility care |
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What You'll Learn
The Medicare Part A deductible
It's important to note that the Medicare Part A deductible is based on the benefit period, which can include multiple benefit periods in a single year, rather than a calendar year. The benefit period begins the day you enter a hospital or skilled nursing facility for care and ends when 60 days have passed since your last inpatient care or skilled nursing facility care. If you're discharged and then readmitted within the same 60-day period, you won't pay another deductible. However, if you go more than 60 days without inpatient care, you'll start a new benefit period and will need to pay the deductible again.
During each benefit period, you'll have a deductible to pay upfront before Medicare pays its portion of your care. If you need inpatient care beyond 60 days, you'll have to cover the per-day copayments. Original Medicare will only cover 90 days of inpatient hospital care in a single benefit period, with the first 60 days having no cost-sharing. Starting on day 91, you'll tap into your "lifetime reserve days," of which you only get 60 for your lifetime. Once those are used up, you'll pay all costs yourself if you exceed the 90-day coverage limit during a hospital benefit period.
It's worth mentioning that Medicare Part A also covers skilled nursing facility (SNF) care. The benefit period for SNF care starts on the day of admission and ends once 60 days have passed without receiving SNF care. Costs for SNF care differ, and in 2025, the copay is $209.50 from days 21 to 100. Additionally, skilled nursing coverage doesn't include lifetime reserve days.
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Multiple benefit periods in a year
A Medicare benefit period is how Medicare counts and pays for inpatient care. It begins the day that you enter a hospital or skilled nursing facility and ends when you have not received inpatient hospital or Medicare-covered skilled care in a skilled nursing facility for 60 days in a row.
There is no limit to the number of benefit periods you can have in a year. If you are admitted to the hospital in February and discharged a week later, and then admitted again in August, you will pay two deductibles, because you went more than 60 days without receiving inpatient or skilled nursing facility care. However, if you are discharged and then readmitted a few weeks later, you are still in the same benefit period, and you won't pay another deductible.
The deductible for a Medicare benefit period is not based on the calendar year. Instead, you pay a separate deductible for each benefit period, meaning you could pay more than one deductible in the same year. The benefit period for skilled nursing facility care starts on the day you're admitted and ends once you've gone 60 days in a row without getting skilled nursing facility care.
The Medicare Part A deductible is based on the benefit period, rather than a calendar year. In 2025, the Part A deductible is $1,676 for each benefit period. This will cover all inpatient care you receive during the benefit period.
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Lifetime reserve days
It is important to note that patients have the option to choose whether or not to use their lifetime reserve days. If they opt not to use them, they will be responsible for paying the full cost of their hospital stay beyond the 90-day limit. Patients must notify the hospital of their decision and can do so up to 90 days after being discharged.
Additionally, lifetime reserve days do not apply to stays in skilled nursing facilities. While Medicare Part A covers skilled nursing facility care, these stays have their own benefit periods, which are separate from hospital inpatient care.
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Inpatient hospital care
- You are admitted to the hospital as an inpatient after an official doctor's order, which states that inpatient hospital care is necessary to treat your illness or injury.
- The hospital accepts Medicare.
The Medicare Part A hospital benefit period starts when you are admitted as an inpatient at a hospital or skilled nursing facility. This benefit period lasts until you have gone 60 days in a row without inpatient care. If you are admitted to the hospital for a week, for example, your benefit period starts on the day of admission and runs until you have had 60 consecutive days without inpatient hospital care. Any other hospital admissions during this time will be included in the same benefit period, meaning you won't need to pay the deductible again.
If you go 60 days without being admitted to the hospital, your Part A benefit period starts over, and you will have to pay the deductible again. During each benefit period, you will have a deductible to pay upfront before Medicare pays its portion of your care. If you need inpatient care beyond 60 days, you will have to cover the per-day copayments.
In 2025, the Part A deductible is $1,676 for each benefit period. Days 1-60 are $0 after you meet your deductible. Days 61-90 are $419 each day, and days 91 and beyond are $838 each day for each lifetime reserve day. You only get 60 lifetime reserve days for your life. Once those are used up, you will pay the costs yourself if you exceed the 90-day coverage limit during a hospital benefit period.
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Skilled nursing facility care
A Medicare hospital benefit period refers to the duration of inpatient hospital care coverage under Medicare Part A. This period begins when an individual is admitted as an inpatient at a hospital or skilled nursing facility and ends after 60 consecutive days without inpatient care. Notably, there is no limit to the number of benefit periods one can have in a single year.
Skilled nursing facility (SNF) care is a type of post-hospital care that is covered by Medicare Part A. This coverage includes semi-private rooms, meals, therapy, and ambulance transportation when other means of transportation could endanger the patient's health. It is important to note that SNF care is not covered by Medicare unless it is preceded by an inpatient hospital stay. However, there are certain exceptions to this rule, such as when a doctor participates in an Accountable Care Organization or a Medicare Advantage Plan.
The benefit period for SNF care is consistent with that of hospital inpatient care. It starts on the day of admission and ends after 60 days without receiving SNF care. During each benefit period, there is a deductible that must be paid upfront before Medicare covers its portion of the care. For 2025, the copay for SNF care ranges from $0 for the first 20 days to $209.50 for days 21-100. After 100 days in a benefit period, the patient is responsible for all costs.
It is worth noting that SNF coverage does not include lifetime reserve days, unlike hospital inpatient care. Additionally, if an individual leaves an SNF and re-enters the same or another SNF within 30 days, they do not need another 3-day qualifying hospital stay to receive SNF benefits. This also applies if they start receiving skilled care again within 30 days after stopping.
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Frequently asked questions
A Medicare hospital benefit period starts when you are admitted as an inpatient at a hospital or skilled nursing facility and ends once you've gone 60 days in a row without inpatient care.
In 2025, the Part A deductible is $1,676 for each benefit period. Days 1-60: $0 after you meet your deductible. Days 61-90: $419 each day. Days 91 and beyond: $838 each day for each lifetime reserve day (up to a maximum of 60 reserve days over your lifetime).
There is no limit to the number of benefit periods you can have in a single year.
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