Medicare Part A, or hospital insurance, covers inpatient services, including hospital stays, skilled nursing facility care, hospice care, and some home health services. This coverage is not indefinite; it operates under specific time limits defining how long the federal program will pay for a beneficiary’s care. Understanding these time constraints is important, as financial responsibility shifts entirely to the patient once the limits are reached.
Understanding the Medicare Benefit Period
The “benefit period” is the mechanism Medicare uses to measure a beneficiary’s use of inpatient services. This period begins the day a patient is formally admitted as an inpatient to a hospital or a skilled nursing facility (SNF). A single benefit period ends only after the patient has been out of a hospital or SNF for 60 consecutive days.
If a patient is readmitted before that 60-day break, the stay continues the same benefit period. This means the patient does not pay the Part A deductible again but continues drawing from the same pool of days. If the patient remains out of inpatient care for 60 days and is then readmitted, a new benefit period begins, restoring the full allotment of days and requiring a new deductible payment.
The Staggered Tiers of Inpatient Coverage
Within each benefit period, the financial responsibility for an inpatient hospital stay is divided into three tiers of coverage. The initial tier covers the first 60 days of a hospital stay. The beneficiary pays a single deductible (e.g., $1,676 in 2025), after which Medicare covers all approved costs with no daily copayment.
The second tier applies to days 61 through 90 of the same benefit period. During this time, the patient is responsible for a daily coinsurance amount (e.g., $419 per day in 2025). Medicare pays the remaining portion of the covered hospital costs for this 30-day period.
The final tier involves the use of Lifetime Reserve Days (LRDs), which begin on day 91 of a continuous stay. Each beneficiary receives 60 LRDs to use over their entire lifetime; these days do not renew with a new benefit period. When an LRD is used, the patient pays a higher daily coinsurance (e.g., $838 per day in 2025). These 60 days serve as a final safety net, extending coverage up to a total of 150 days within a single benefit period.
Financial Consequences When All Days Are Exhausted
Medicare Part A coverage ceases entirely when a patient exhausts both the standard 90 days and all 60 Lifetime Reserve Days within one benefit period. This occurs on the 151st day of a continuous inpatient stay. At this point, the financial liability shifts completely, and the patient becomes responsible for 100% of all hospital charges. This includes costs for room, board, supplies, and services, which can amount to thousands of dollars per day.
The hospital is required to provide the patient with a notice, such as a Notice of Non-coverage. This notice informs them that Medicare coverage has ended and that they must now pay the full bill themselves.
Next Steps: Planning for Extended Recovery and Costs
Planning for continued recovery involves exploring alternative funding and care settings when hospital days are exhausted. Supplemental insurance, known as Medigap, can mitigate these costs. Many Medigap plans cover the daily coinsurance for days 61 through 90 and the Lifetime Reserve Days, substantially reducing the financial burden. Some Medigap policies also offer an additional 365 hospital days of coverage after Medicare benefits are exhausted.
Another option is transitioning recovery to a different facility or setting that operates under separate Medicare rules. A move to a Skilled Nursing Facility (SNF) may be appropriate, as SNF care has its own coverage limits of up to 100 days per benefit period. Home health care also has separate coverage rules, offering an opportunity for continued care. Individuals with limited income may also qualify for Medicaid, which can cover long-term care costs when Medicare coverage ends.