Medicare covers most of the cost of a hospital stay, but you’re responsible for a deductible of $1,736 in 2026 before coverage kicks in. After that, your first 60 days are fully covered with no daily cost. Stays longer than 60 days start adding daily coinsurance charges that climb the longer you remain hospitalized.
What You Pay for the First 60 Days
Every hospital stay begins with a single deductible payment of $1,736 (the 2026 amount). This is a per-benefit-period charge, not an annual one, which is an important distinction. Once you’ve paid that deductible, Medicare Part A covers days 1 through 60 at no additional cost to you. That includes your semi-private room, meals, nursing care, medications administered during your stay, lab work, and any surgeries or procedures performed while you’re admitted.
A benefit period starts the day you’re formally admitted as an inpatient and ends after you’ve been out of any hospital or skilled nursing facility for 60 consecutive days. If you’re discharged and then readmitted within that 60-day window, you’re still in the same benefit period and don’t owe another deductible. But if you’re readmitted after 60 days out, a new benefit period begins and you’ll pay the $1,736 deductible again. There’s no limit on how many benefit periods you can have in a year, so multiple hospitalizations can mean multiple deductibles.
Daily Costs After Day 60
If your hospital stay extends beyond 60 days, you start paying coinsurance for each additional day. For days 61 through 90, the cost is $434 per day in 2026. That adds up quickly: a full 30 days at this rate would cost you $13,020 out of pocket on top of the initial deductible.
After day 90, Medicare provides a safety net called lifetime reserve days. You get 60 of these total, not per benefit period, but across your entire lifetime. Each lifetime reserve day costs $868 per day in 2026. Once you’ve used all 60, they’re gone for good. Any hospital days beyond that point are entirely your responsibility.
Here’s the full breakdown for a single benefit period:
- Days 1–60: $0 per day after paying the $1,736 deductible
- Days 61–90: $434 per day
- Days 91–150: $868 per day (using lifetime reserve days)
- Beyond 150 days: You pay all costs
Observation Status Can Change Everything
Not everyone who spends a night in the hospital is technically an “inpatient.” If your doctor hasn’t written an order formally admitting you, you may be classified as an outpatient receiving observation services, even if you sleep in a hospital bed for multiple nights. This distinction matters for two reasons.
First, observation stays are billed under Part B instead of Part A, which means different cost-sharing rules. You’ll pay the Part B deductible and typically 20% of each service rather than the flat Part A deductible structure described above. Medications you receive during an observation stay may not be covered at the same rate as inpatient drugs, and you could end up paying more out of pocket for what feels like the same experience.
Second, observation time doesn’t count toward the three-day inpatient requirement for skilled nursing facility coverage. If you need rehab or nursing care after leaving the hospital, Medicare only covers it if you were formally admitted as an inpatient for at least three consecutive days. Time spent under observation doesn’t qualify, which can leave you paying the full cost of a nursing facility stay.
Hospitals are required to give you a Medicare Outpatient Observation Notice if you’ve been receiving observation services for more than 24 hours. This notice explains your status and how it affects your costs both during and after the hospital visit.
Skilled Nursing Facility Costs After Discharge
When a hospital stay leads to a skilled nursing facility transfer, Medicare covers the first 20 days at no cost to you (assuming you met the three-day inpatient requirement). From days 21 through 100, you pay a daily coinsurance amount. After day 100, Medicare stops covering skilled nursing care entirely for that benefit period.
This coinsurance can be a significant expense during recovery, so many people rely on supplemental insurance (Medigap) or Medicare Advantage plans to help cover it.
Psychiatric Hospital Stays Have a Lifetime Cap
If you’re admitted to a freestanding psychiatric hospital rather than the psychiatric unit of a general hospital, Medicare imposes a 190-day lifetime limit. The daily cost structure is the same: no charge after the deductible for days 1 through 60, $434 per day for days 61 through 90, and $868 per day for lifetime reserve days. But once you’ve used 190 total days of inpatient psychiatric hospital care across your lifetime, Part A stops covering it entirely. Psychiatric care in a general hospital’s psychiatric unit doesn’t count against this 190-day cap.
What Medicare Doesn’t Cover During a Stay
Medicare covers the core medical services you receive as an inpatient: your room (semi-private), meals, nursing care, operating room time, lab tests, imaging, and hospital-administered medications. It does not cover private rooms unless medically necessary, personal convenience items like a phone or television if the hospital charges separately for them, or non-medical services.
Blood transfusions are covered after you meet the Part A deductible, with no additional copayment while you’re an inpatient. As an outpatient, blood processing and handling charges carry a separate copayment that varies but won’t exceed the inpatient deductible amount.
How Supplemental Coverage Reduces Your Costs
Most people on Original Medicare don’t face these costs alone. Medigap plans (Medicare Supplement Insurance) are specifically designed to cover Part A cost-sharing. The most popular Medigap plans cover the Part A deductible entirely, all daily coinsurance for days 61 through 90, and the full cost of lifetime reserve days. Some plans even add 365 extra hospital days after Medicare’s coverage runs out.
Medicare Advantage plans (Part C) set their own cost-sharing rules, which vary by plan. Many charge a fixed daily copay for hospital stays rather than following the Original Medicare structure. Some cap hospital copays at a certain number of days per admission. Your plan’s annual out-of-pocket maximum also limits total spending in a way that Original Medicare alone does not.
If you don’t have supplemental coverage, a long hospital stay can become expensive quickly. A 90-day stay under Original Medicare alone would cost $1,736 for the deductible plus $13,020 in daily coinsurance, totaling $14,756 before any lifetime reserve days are used.