Speak with a Licensed Insurance Agent
Have questions? We can help!
Call to speak with a licensed insurance agent.
1- TTY 711Touch to Call
Many of us may need hospital care at some point in our lives. It’s important to understand what type of Medicare hospital coverage you’re eligible for and what benefits you’re entitled to under Original Medicare, Part A and Part B.
Hospitals provide inpatient and outpatient services through specialized staff and equipment. They are staffed by physicians, surgeons, and nurses. Hospital care includes treatment that you receive in the following types of facilities:
If you need inpatient care, the length of your hospital stay may vary, depending on the seriousness of your condition and the type of care you need. If you require a longer hospital stay, you may be transferred to a long-term care hospital, which is a facility that specializes in treating patients who need more time to recover. Patients who enter these facilities are often transferred from the intensive-care unit of a general hospital. Long-term care hospitals specialize in treating individuals with particularly serious conditions and may offer specialized rehabilitative, trauma, and pain management services.
Medicare will cover your inpatient hospital stay if you meet all of these requirements:
If you need hospital services, keep in mind that your hospital status affects whether you’re covered through Medicare Part A or Part B and the costs you pay. Your hospital status may also affect whether you’re covered for skilled nursing facility (SNF) care after your hospital stay, since Medicare only covers SNF care after a qualifying three-day inpatient hospital stay. If you’re admitted to the hospital as an inpatient, you’ll be covered under Medicare Part A. If you’re getting outpatient surgery, observation services, or other doctor services in a hospital, you’ll be covered by Medicare Part B. Remember, an overnight hospital stay doesn’t mean you have an inpatient status if the hospital hasn’t formally admitted you as an inpatient.
Medicare Part A: If you’re admitted to the hospital as an inpatient, Medicare hospital coverage generally includes (but isn’t limited to):
Medicare Part B: Medically necessary outpatient services are covered through Medicare Part B, even if you receive them in a hospital setting. Medicare Part B may cover services and supplies such as:
Original Medicare, Part A and Part B, doesn’t cover the costs of private-duty nursing, a phone or television, personal items (like toothpaste), or a private room (unless a private room is medically necessary).
Medicare Part A generally covers drugs given to you during your inpatient hospital stay. Medicare Part B offers limited prescription coverage for drugs that are administered in a hospital outpatient setting or a doctor’s office.
If you’re an outpatient, Medicare doesn’t usually cover the prescription drugs that you can “self-administer” (take by yourself). You may be able to get these medications covered through a stand-alone Medicare Prescription Drug Plan (Part D) or a Medicare Advantage Prescription Drug plan. Call your Medicare plan for more information.
Costs and benefits for hospital services
Costs for hospital care such as deductibles, copayments, and/or coinsurance may change from year to year. For the most up-to-date cost information, visit Medicare.gov.
Under Medicare Part A, your costs for an inpatient hospital stay include:
Under Medicare Part B:
Medicare Advantage plans are required to cover at least the same level of benefits as Original Medicare; however, these plans may have different costs. Check with your individual plan for more information on costs for hospital care.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.