What is considered an Inpatient Hospital?

For Medicare Part A
  • Hospitals
  • Inpatient Rehabilitation Centers/Facilities
  • Critical Access Hospitals
  • Long-term care hospitals
  • Mental care hospitals
  • Acute care hospitals

What is Covered by Medicare Part A – Inpatient Care ?

Your semi-private room, standard nursing care and meals are included in Part A coverage. Prescription drugs ordered by a physician needed for your inpatient treatment is also covered. Inpatient mental health care provided within a psychiatric facility or hospital is covered too. Original Medicare allows for clinical research studies under the Part A coverage umbrella.

What’s Not Covered by Original Medicare (Parts A and B)

• Private Duty Nursing Care
• Private Room
• Personal use items (Toothpaste, Razors, Phone, Etc.)

How Do You become Eligible for Inpatient Hospital coverage?

The kind of care you require can only be provided at a hospital and a doctor orders that you need 2 or more nights of treatment for your injury or illness.

Also, a hospital must formally admit you for inpatient care and accepts Medicare.

“The Utilization Review Committee of the hospital approves your stay while you’re in a hospital.” Medicare.gov

Your Inpatient Hospital Costs with Original Medicare

• Each Benefit Period requires payment of a $1,316 deductible
• Days 1 – 60: $0 Coinsurance for each benefit period
• Days 61 – 90: $329 Coinsurance per day of each benefit period
• Days 91 and beyond: $658 coinsurance per “lifetime reserve day” after day 90 for each benefit period. (You receive 60 reserve days in your lifetime)

Guide to Choosing a Hospital – Medicare.gov (PDF)

Do You Need a Licensed Health Agent?

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