Medicare Part A covers inpatient mental health and addiction recovery services that you receive in either a psychiatric hospital (a hospital or distinct unit in a hospital that only treats mental health patients) or a general hospital. Your doctor should determine which hospital setting you need. If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care in your lifetime. If you have used your lifetime days but need additional mental health care, Medicare may cover additional inpatient care at a general hospital.
You will have the same out-of-pocket costs with Original Medicare whether you receive inpatient care in a general or psychiatric hospital:
- The Part A deductible: Before Medicare covers the cost of inpatient care, you have to meet the deductible for the benefit period. In 2021, the deductible is $1,484.
- Benefit periods measure your use of inpatient hospital and skilled nursing facility (SNF) services. A benefit period begins the day you are admitted to a hospital as an inpatient, or to an SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row.
- Days 1-60 of a benefit period: After you meet the deductible, Medicare pays in full for the first 60 days of your care.
- Days 61-90 of a benefit period: Medicare pays part of the cost, and you are responsible for a daily coinsurance charge. In 2021, the coinsurance is $371 per day.
- Lifetime reserve days: For up to 60 lifetime reserve days, Medicare pays part of the cost, and you are responsible for a daily coinsurance charge. The coinsurance in 2021 is $742 per day. Note that if you enter a psychiatric hospital within 60 days of being an inpatient at a different hospital, you are in the same benefit period and do not have to pay the Part A deductible again.
If you have a Medicare Advantage Plan, your plan must cover the same mental health and addiction recovery services as Original Medicare but may impose different costs and restrictions. If you need information about the costs and coverage requirements, or if you are experiencing problems, you should contact your Medicare Advantage Plan.
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