Medicare Part A covers up to 90 days of inpatient hospital care per benefit period, with costs shared (deductible first, then coinsurance), plus 60 lifetime reserve days for extended stays, which are non-renewable and require a higher daily coinsurance. A benefit period starts with a hospital admission and ends after 60 consecutive days out of the hospital or skilled nursing facility (SNF). If you have a Medicare Advantage plan, contact your plan for specific coverage details, as they may differ from Original Medicare.
You pay nothing for covered services the first 20 days that you're in a skilled nursing facility (SNF). You pay a daily coinsurance for days 21-100, and you pay all costs beyond 100 days. Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to get current amounts.
Medicare covers
Medicare provides 60 lifetime reserve days of inpatient hospital coverage following a 90-day stay in the hospital.
The Medicare 3-day rule requires beneficiaries to have a medically necessary inpatient hospital stay that lasts at least three consecutive days before Medicare Part A will cover any subsequent care in a skilled nursing facility. The rule gets its name from how Medicare counts days.
Once you meet your deductible, Part A will pay for days 1–60 that you are in the hospital. For days 61–90, you will pay a coinsurance for each day. If you need to stay in the hospital for longer than 90 days, you can use up to 60 lifetime reserve days. These are extra days of Medicare coverage for long hospital stays.
Inpatient stay
Days 1-60: $0 after you pay your Part A deductible. Days 61-90: $434 each day. Days 91-150: $868 each day while using your 60 lifetime reserve days. After day 150: You pay all costs.
When your Medicare Part A hospital days run out (after 90 days in a benefit period), you can use up to 60 non-renewable lifetime reserve days, paying a daily coinsurance; if those also run out, you pay 100% of costs, but Medicare Advantage (MA), supplemental plans, or Medicaid might offer extra coverage, or you'll pay out-of-pocket or seek financial help. A new benefit period starts after you're out of the hospital for 60 days, restarting the 90-day cycle.
Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)
Medicare Part B covers ER visits, but you still pay a deductible and 20% of costs. Part A helps only if you're admitted to the hospital. Medigap can help cover ER costs if you have Original Medicare. Medicare Advantage plans (which replace Original Medicare) cover ER care and may offer lower copays or extra services.
The Medicare 2-Midnight Rule is a Centers for Medicare & Medicaid Services(CMS) guideline for hospital admissions, stating that if a doctor expects a patient to need hospital care crossing at least two midnights, the stay generally qualifies for Medicare Part A inpatient payment;
qualifying inpatient hospital stay. Time that you spend in a hospital as an outpatient before you're admitted doesn't count toward the 3 inpatient days you need to have a qualifying hospital stay for SNF benefit purposes. Observation services aren't covered as part of the inpatient stay.
After you pay the Part A deductible, Medicare pays the full cost of covered hospital services for the first 60 days of each benefit period when you're an inpatient, which means you're admitted to the hospital and not for observational care. Part A also pays a portion of the costs for longer hospital stays.
Medicare covers 90 days of hospitalization per illness (plus a 60-day “lifetime reserve”). If you're admitted to a hospital as a Medicare patient, the hospital may try to discharge you before you're ready. While the hospital can't force you to leave, it can begin charging you for services.
A hospital stay costs roughly $2,500 to $3,500 per day on average in the U.S., but this varies significantly by location, hospital type, and services used, with some sources showing averages from $1,400 to over $4,000 daily, excluding specialized care, procedures, or specialist fees. A typical stay might cost between $10,000 and $40,000 or more in total, depending on complexity and length, with uninsured patients facing much higher rates than those with insurance or Medicare.
The law that gives everyone in the U.S. these protections is the Emergency Medical Treatment and Labor Act, also known as "EMTALA." This law helps prevent any hospital emergency department that receives Medicare funds (which includes most U.S. hospitals) from refusing to treat patients.
Here are some of the biggest Medicare mistakes to avoid:
The Medicare "3-Day Rule" requires a beneficiary to have a qualifying 3-day inpatient hospital stay (admission day counts, discharge day doesn't) before Medicare will cover services in a Skilled Nursing Facility (SNF) for rehabilitation or skilled care, though this rule can be waived in certain Medicare Advantage plans or through specific Accountable Care Organization (ACO) initiatives. Time spent in observation or the Emergency Department doesn't count towards these 3 days, but new demonstration projects and waivers are emerging to offer more flexibility for patients needing SNF care.
Some of the items and services Medicare doesn't cover include: