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For individuals relying on Medicare in 2025, it's essential to understand how the program handles the costs of longer inpatient hospital stays. While Medicare Part A provides substantial coverage for hospitalizations, the out-of-pocket expenses increase dramatically after 60 days of continuous care in a single benefit period.
If your hospital stay stretches beyond that mark, you'll begin paying daily coinsurance rates that can quickly become a financial burden.
Under Medicare rules for 2025, the first 60 days of an inpatient hospital stay are covered in full, after you pay a one-time deductible of $1,676 per benefit period. However, starting on day 61, beneficiaries are responsible for a coinsurance payment of $419 per day through day 90.
Once the stay exceeds 90 days, the cost rises again, this time to $838 per day, which applies during your limited lifetime reserve days (up to 60 total days you can use during your life). After those are exhausted, you're on the hook for all remaining costs.
Understanding how benefit periods and coinsurance work is crucial
Medicare defines a benefit period as beginning the day you're itted as an inpatient and ending when you've been out of the hospital (or skilled nursing facility) for 60 consecutive days. If you return to the hospital after that, a new benefit period begins. This structure can result in more than one deductible and multiple sets of coinsurance charges in a single year, depending on your health needs.
For example, if a person is hospitalized for 75 days, they will pay nothing in coinsurance for the first 60 days. But for the next 15 days, days 61 through 75, they will pay $419 per day, totaling $6,285 in coinsurance. Add in the initial $1,676 deductible, and their out-of-pocket cost reaches $7,961 for that one hospital stay.
These costs can catch patients off guard, particularly those dealing with chronic conditions or complex recoveries. Medicare's coverage, while robust in many areas, still leaves beneficiaries vulnerable to large bills during extended care scenarios.
To guard against these unexpected costs, many individuals choose to enroll in Medigap (also known as Medicare Supplement Insurance) or Medicare Advantage (Part C) plans.
Some Medigap policies, for instance, will cover all or part of the coinsurance for days 61 through 90 and even the lifetime reserve days. Meanwhile, Medicare Advantage plans often place a yearly cap on out-of-pocket expenses, something Original Medicare lacks, but vary widely in how they handle inpatient coverage.