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Considering Inpatient Hospital Care

Generally, Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.   

Generally, Medicare Part A covers inpatient hospital care when both of the following conditions are met:

1)  After an official doctor’s order stating you need impatient hospital care to treat your illness or injury, you are admitted to a hospital as in inpatient. 

2)  Medicare is accepted at the Hospital.

Medicare Coverage during hospital stays:

Inpatient hospital services that are generally included by Medicare are:  Semi-private rooms, Meals, General nursing and some Drugs.

Medicare generally will not cover:  Private-duty nursing, Private room (unless medically necessary), Personal care items.

Your costs in Original Medicare

​Medicare Part A costs: 

1)  You normally pay a deductible for each benefit period (usually per hospital stay).  

2)  You may be responsible for coinsurance costs based on the length of the hospital stay after the deductible is met.

Lifetime Reserve Days:

These are additional days that Medicare will generally pay for when you're in a hospital for more than 90 days in Original Medicare.

Over your lifetime, you have access to a total of 60 lifetime reserve days.   Medicare generally pays covered cost except for a daily coinsurance for each Lifetime Reserve Day.  You may have to pay all costs after you use all of your lifetime reserve days.

Situations may occur where your doctor or other health care provider may recommend services for you more often that Medicare covers.  They may recommend services that Medicare does not cover.  You may have to pay some or all of the costs if this happens.

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