Medicare Part A covers hospitalization. It pays for inpatient hospital stays, including your room, meals, nursing care, and medications you receive while admitted. But the cost-sharing structure changes depending on how long you stay, and a few important details (like whether you’re officially “admitted” versus under “observation”) can significantly affect what you owe.
What Part A Pays For
Part A is the hospital insurance portion of Original Medicare. When you’re admitted as an inpatient, it covers a semi-private room, meals, general nursing care, drugs administered during your stay, and other hospital services like lab tests and imaging. It also covers inpatient care at critical access hospitals, skilled nursing facilities (after a qualifying hospital stay), and inpatient psychiatric facilities.
Part A does not cover everything you encounter in the hospital. Your doctors’ professional fees are billed separately under Part B, even when those doctors treat you while you’re an inpatient. So a surgeon operating on you during a hospital stay bills Part B for their services, while the hospital bills Part A for the operating room, recovery room, and nursing care.
What You Pay During a Hospital Stay
Part A uses a “benefit period” system rather than annual limits. A benefit period starts the day you’re admitted and ends once you’ve been out of a hospital or skilled nursing facility for 60 consecutive days. Each benefit period comes with its own deductible, which is $1,736 in 2026. That means if you’re hospitalized twice in the same year but had a 60-day gap between stays, you pay the deductible twice.
For the first 60 days of a hospital stay within a benefit period, you pay nothing beyond that deductible. From days 61 through 90, you pay $434 per day in coinsurance (2026 rates). After day 90, you begin using lifetime reserve days, which cost $868 per day. You get 60 lifetime reserve days total, and once they’re gone, they don’t renew. If you exhaust both your 90 regular days and all 60 reserve days, you’re responsible for the full cost of any additional hospital time.
Inpatient vs. Observation Status
One of the most consequential details in Medicare hospital coverage is whether you’re classified as an inpatient or an outpatient under observation. You can spend multiple nights in a hospital bed, receive medications and tests, and still be considered an outpatient if your doctor hasn’t written a formal inpatient admission order. Observation status means your stay is billed under Part B, not Part A, which typically results in higher out-of-pocket costs for drugs and services.
This distinction also affects what happens after you leave. Medicare only covers care in a skilled nursing facility if you first had a qualifying inpatient stay of at least three consecutive days. Time spent under observation doesn’t count toward those three days. So a patient who spends four nights in the hospital under observation status and then needs rehab at a nursing facility could be stuck paying the full cost out of pocket.
If you’re in the hospital for more than 24 hours under observation, the hospital is required to give you a Medicare Outpatient Observation Notice (MOON) explaining your status and how it affects your costs. If you believe you should be admitted as an inpatient, you can ask your doctor to reconsider. Some Medicare Advantage plans and certain Accountable Care Organizations can waive the three-day inpatient requirement for skilled nursing coverage, so it’s worth asking whether that applies to your situation.
Skilled Nursing Facility Coverage After Hospitalization
When you do meet the three-day inpatient requirement, Part A covers up to 100 days of skilled nursing facility care per benefit period. The first 20 days are fully covered. Days 21 through 100 require a daily coinsurance payment. After day 100, Part A coverage ends entirely.
The key word here is “skilled.” Part A covers nursing care and rehabilitation services like physical therapy that require trained medical professionals. It does not cover custodial care, which includes help with daily activities like bathing, dressing, eating, and getting in and out of bed. If the only care you need is custodial, Medicare won’t pay for a nursing facility stay regardless of how long you were hospitalized.
Inpatient Psychiatric Care
Part A covers inpatient psychiatric care in both general hospitals and freestanding psychiatric hospitals. In a general hospital, the standard benefit period rules apply with no special lifetime cap. In a freestanding psychiatric hospital, however, there is a 190-day lifetime limit. Once you’ve used 190 days of care in a specialty psychiatric facility, Part A won’t cover additional days there, though inpatient psychiatric care in a general hospital would still be covered under normal rules.
What Part A Does Not Cover
Several categories of care are excluded from Medicare coverage even during a hospital stay. Personal comfort items like televisions, radios, and barber or beauty services aren’t covered. Private rooms aren’t covered unless medically necessary. Private-duty nursing is excluded.
Medicare also won’t pay for hospital services that could have been provided in a less expensive setting, like your home or a nursing facility. Dental care, including tooth extractions and denture preparation, is excluded even when performed in a hospital. Routine foot care such as nail trimming, corn removal, and treatment of flat feet is generally not covered either.
How Part B Fits Into Hospital Stays
Even though Part A is the hospital insurance component, you’ll almost certainly use Part B during any hospitalization. Every doctor who sees you, from the attending physician to the radiologist reading your scans to the anesthesiologist during surgery, bills their professional services through Part B. Diagnostic tests, surgical procedures, and specialist consultations are all Part B charges.
This means a single hospital stay generates bills under both parts of Medicare. Part A covers the facility costs, and Part B covers the professional services. If you have a Medigap supplemental policy, it may help cover the Part A deductible and coinsurance, but the specifics depend on which plan you have. Medicare Advantage plans bundle Parts A and B together and may have different cost-sharing structures, including maximum out-of-pocket limits that Original Medicare doesn’t offer.