What Inpatient Hospital Services Does Medicare Cover?

Inpatient hospital care refers to the medical care you receive when admitted to the hospital. Medicare Part A is responsible for covering inpatient hospital care in hospitals, critical access hospitals, and Skilled Nursing Facilities (SNF). Medicare Part A doesn’t include custodial or long-term care. 

In this article, we will discuss the inpatient hospital services that Medicare covers.

Hospital Stay

Medicare Part A coverage includes inpatient hospital stays you need to treat your health condition. The plan provides coverage for general nursing care, semi-private rooms, drugs received as an inpatient, and supplementary hospital supplies and services that are medically required for your care. The facilities where you can receive coverage include:

  • General hospitals
  • Critical access hospitals
  • Psychiatric hospitals
  • Acute care hospitals
  • Inpatient rehabilitation facilities

Skilled Nursing Facility (SNF) Coverage

Part A provides coverage for inpatient stays in an SNF following a qualifying 3-day inpatient hospital stay. Before you can qualify for SNF coverage, your health condition must require daily skilled care that only an SNF can provide. Coverage for SNF stays include:

  • Skilled nursing care
  • Semi-private room
  • Meals
  • Medical supplies and equipment that you use in an SNF
  • Medical social services
  • Speech-language pathology services and occupational and physical therapy if needed to meet your health needs
  • Nutrition counseling
  • Drugs administered during your SNF stay
  • Ambulance transportation is required to move you to the nearest facility for medical services SNF doesn’t provide

Hospice Coverage

Medicare provides hospice coverage for terminally ill Medicare beneficiaries. This service can be received either in an inpatient hospital facility or at home. Before you can qualify for hospice care, your doctor must prove that you are terminally ill and you only have six months or less to live. Also, you must agree to accept palliative care and relinquish restorative treatment. Finally, you must agree to accept hospice service instead of Medicare-approved care for your condition. Hospice services covered by Medicare Part A include:  

  • Physician and nursing services
  • Medical supplies and equipment
  • Hospice aide services
  • Physical therapy and occupational therapy
  • Medication for the purpose of controlling symptoms or pain relief
  • Nutrition counseling
  • Grief and loss counseling services
  • Short-term respite care for caregivers
  • Short-term inpatient care

Mental Health Coverage

Medicare covers inpatient mental healthcare services, which include the care you receive in either a general or psychiatric hospital. If you receive doctor services while you are in a hospital, Medicare Part A will cover you. Similar to services received from the general hospital that Medicare Part A covers, mental health coverage includes a semi-private room, general nursing care, and meals.

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Do you have more questions about the inpatient hospital services that Medicare covers? Contact Medicare Sharks today to speak with an experienced Medicare expert.