Note that although the CMS definition of benefit period clarifies that it begins “the day you go to a hospital or skilled nursing facility,” Medicare Part A will only cover skilled nursing facility (SNF) care if:
So in reality, the benefit period begins with the day you’re admitted to a hospital. It can include up to 100 subsequent days in a skilled nursing facility, but skilled nursing facility care is not covered by Medicare if it’s not preceded by an inpatient hospital stay. That hospital stay might be the start of a benefit period, or it might be a continuation of a benefit period that began with a previous hospitalization, if there wasn’t a stretch of at least 60 days between the two hospitalizations.
How does Medicare's benefit period affect my out-of-pocket costs?
The concept of a benefit period is important because the Medicare Part A deductible is based on the benefit period, rather than a calendar year.
In 2025, the Part A deductible is $1,676 for each benefit period. This will cover all inpatient care you receive during the benefit period (physician services you receive while in the hospital will be billed separately, under Medicare Part B).
So if you’re admitted to the hospital in 2025, you’ll owe the $1,676 deductible. This amount will be the same regardless of how long you’re in the hospital, up to 60 days (if you’re hospitalized for more than 60 days, you’ll start to incur additional per-day costs). If you’re discharged but then readmitted a few weeks later — so you’re still in the same benefit period — you won’t pay another deductible.
But let’s say you’re admitted to the hospital in February, discharged a week later, and then admitted to the hospital again in August. In that case, you’ll pay two deductibles, because you went more than 60 days without receiving inpatient or SNF care.
With most other types of health insurance, the deductible is based on the calendar year. Once you meet it, your plan will pay all or part of your costs for the remainder of the year, but then your deductible resets on January 1. So the scenario described above, with a hospital admission in February and another in August, would generally only require one deductible to be paid with most non-Medicare insurance, whereas it will require two deductibles if you’re enrolled in Original Medicare.
But if you happen to be hospitalized from December 30 to January 2, you’d have to pay two deductibles with most non-Medicare plans. If you have Original Medicare, however, you’ll only pay one deductible in that scenario, since your benefit period doesn’t reset with the calendar year.
If you have supplemental coverage (from an employer-sponsored plan, Medicaid, or Medigap), it will pay some or all of the Medicare Part A deductible. And Medicare Advantage plans design their own benefits, which generally do not utilize the benefit period concept. These plans tend to be more similar to other commercial insurance, with an annual deductible and out-of-pocket limit.
