How Many Days Does Medicare Cover in a Long-Term Acute Care Hospital?
There is no separate day limit for "long-term acute care." A long-term care hospital (LTCH) stay is covered under Medicare Part A inpatient hospital benefits — up to 90 days per benefit period, plus a one-time bank of 60 lifetime reserve days, after which you pay all costs.
How Medicare counts the days
Long-term acute care is delivered in a long-term care hospital (LTCH) — a facility for patients who need extended, hospital-level care, often after an intensive-care stay. Medicare does not treat LTCH care as its own benefit with its own clock. Instead, it is paid through the same Part A inpatient hospital benefit that covers a regular hospital admission.
That means the day count is tied to your benefit period, not to the type of hospital. Within a single benefit period, Medicare helps pay for up to 90 inpatient days. If you need more, you can draw on a separate, lifetime reserve of 60 additional days.
- Days 1–60: covered in full after you pay the Part A deductible
- Days 61–90: a daily coinsurance applies
- Days 91 and beyond: you tap lifetime reserve days, each with a higher daily coinsurance
- After reserve days are exhausted: you pay all costs
What you pay in 2026
These are the standard Part A amounts for 2026. They apply to an LTCH stay the same way they apply to any inpatient hospital stay.
- Part A deductible: $1,736 per benefit period
- Days 1–60: $0 coinsurance (after the deductible)
- Days 61–90: $434 per day
- Days 91+ (lifetime reserve days): $868 per day, for up to 60 reserve days total over your lifetime
- After all reserve days are used: you pay 100% of costs
Why the benefit period matters more than the day count
A benefit period starts the day you are admitted as an inpatient and ends only after you have gone 60 days in a row with no inpatient hospital care and no skilled care in a skilled nursing facility. There is no limit on how many benefit periods you can have in your lifetime.
This is important for long-term acute care because many LTCH patients arrive by transfer directly from a short-term hospital. If you were already charged the Part A deductible for the earlier hospital stay in the same benefit period, you do not pay it a second time when you move to the LTCH — the 90-day count simply continues from where the prior stay left off.
The flip side: starting a new benefit period resets your 90 days but also charges a new $1,736 deductible. Lifetime reserve days, by contrast, never reset — once you use them, they are gone.
Medicare Advantage works differently
Everything above describes Original Medicare (Part A and Part B). If you are enrolled in a Medicare Advantage (Part C) plan, the day limits and cost-sharing can differ. These plans must cover at least what Original Medicare covers, but they often use their own daily copay structures, prior-authorization rules, and network requirements for hospital and LTCH stays.
Coverage specifics vary by plan and by year. Check your plan's Evidence of Coverage or call the plan directly before assuming any particular benefit applies to an LTCH admission.
What is and isn't covered
When Medicare covers your LTCH stay, the inpatient benefit includes a semi-private room, meals, nursing, drugs given as part of your inpatient treatment, and other hospital services and supplies — the same categories covered in a regular inpatient hospital stay.
Medigap (Medicare Supplement) policies can help with the Part A deductible and the daily coinsurance, and most Medigap plans add an extra 365 hospital days after your lifetime reserve days run out. Whether and how much your specific policy pays depends on which Medigap plan letter you bought.
Frequently asked questions
Does Medicare have a special 100-day limit for long-term acute care?
No. The 100-day figure people remember applies to skilled nursing facility (SNF) care, not long-term care hospitals. An LTCH stay is paid as inpatient hospital care: up to 90 days per benefit period plus up to 60 lifetime reserve days.
What happens after I use all 90 days and my 60 lifetime reserve days?
Once both are exhausted, Medicare stops paying for that stay and you are responsible for all costs. Starting a new benefit period (after 60 days with no inpatient or skilled care) restores the 90 days but not the reserve days, and it triggers a new Part A deductible.
If I transfer from a regular hospital to an LTCH, do I pay the deductible twice?
No, not if both stays fall in the same benefit period. The benefit period begins on day one of your first hospital admission, so a deductible already paid carries over and your day count continues rather than restarting.
Will a Medicare Supplement (Medigap) plan help with these costs?
Often, yes. Many Medigap plans cover the Part A coinsurance and add 365 extra hospital days beyond your lifetime reserve days, and several also cover the Part A deductible. The exact help depends on which Medigap plan letter you have.
Are long-term acute care costs different under Medicare Advantage?
They can be. Medicare Advantage plans must cover at least what Original Medicare covers but set their own copays, authorization rules, and networks for hospital stays. Coverage varies by plan, so confirm the details with your plan before admission.
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Medicare Login Guide is an independent resource and is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency. This article is for general information only — confirm current figures and your specific options at medicare.gov or by calling 1-800-MEDICARE.