Original Medicare measures your use of hospital and skilled nursing (SNF) services during benefit periods. The benefit period begins the day you are admitted as an inpatient to a hospital or SNF. The benefit period ends when you haven't received any type of hospital (or specialized in an SNF) care for 60 consecutive days. If you enter a hospital or an SNF after a benefit period has ended, a new one starts.
You must pay the hospital deductible for inpatients for each benefit period. There's no limit to the number of benefit periods you can have. The benefit period begins on the first day of hospitalization and ends after 60 consecutive days have passed without the hospital or skilled nursing facility providing them with any type of hospital care. You'll also pay a co-pay to the hospital for each service you receive on an outpatient basis (except for certain preventive services).
This coverage may apply to stays in general intensive care hospitals, rehabilitation centers, psychiatric hospitals, long-term care facilities, and skilled nursing facilities. For example, if you have two extended hospital stays, of 120 days each, you can use 30 days of lifetime reserve for each period. Hospitals are now required to share standard charges for all their items and services (including standard charges negotiated by Medicare Advantage plans) on a public website so they can make more informed decisions about their care. However, Part A doesn't pay for treatment that doctors administer on an outpatient basis in intensive care hospitals. On November 8, 2024, the Centers for Medicare and Medicaid Services (CMS) released the 2025 premium, deductible and coinsurance amounts for Medicare Part A and Part B programs, and monthly adjustment amounts related to 2025 Medicare Part D income.
Medicare covers this care if the agency believes that it is medically necessary for a person to receive hospital care for these services. The Medicare deductible is the annual amount you pay for covered health care services before your Medicare plan starts paying. Once you reach this limit, you won't be responsible for sharing the costs (deductibles, coinsurance, and copays) of covered services for the rest of the year. For Medicare to cover the hospital stay and the care a person receives, the doctor must order the hospital stay and confirm that the person needs hospital care to treat an injury or illness.
Intensive care hospitals are centers where people receive treatment for brief but serious episodes of illness. However, the 190-day limit does not apply to care a person receives in a Medicare-certified psychiatric unit in an intensive care or intensive care hospital. Once the deductible is reached, Medicare will cover the rest of the hospital care costs for up to 60 days afterward of having been admitted. The Centers for Medicare and Medicaid Services (CMS) has released Medicare deductibles for 2025 for Parts A and B, along with premium amounts and coinsurance.
Both Original Medicare plans and, in general, Medicare Advantage plans require that you meet a deductible, that is, the amount you pay for medical care or prescription drugs before your health plan starts paying. The Part A hospital deductible covers beneficiaries' cost-sharing for the first 60 days of inpatient care covered by Medicare for a period of benefit.
