Long-term care hospital services
Medicare Coverage Information
Overview
Medicare provides coverage for long-term care hospital services for patients with complex medical conditions requiring extended, specialized hospital care. These services are designed for patients who need intensive, prolonged medical treatment beyond standard hospital stays.
- Covers medically necessary long-term hospital care for complex conditions
- Typically for patients requiring specialized, intensive medical treatment
- Services must be ordered by a physician and deemed medically necessary
- Limited duration of coverage based on patient's medical needs
- Requires prior authorization and ongoing medical documentation
- Medicare Part A beneficiaries
- Patients with complex medical conditions requiring specialized care
- Referral from primary care physician or specialist required
- Must have a qualifying medical condition that requires intensive treatment
- Part A hospital insurance typically covers long-term care hospital services
- Beneficiaries may be responsible for deductibles and coinsurance
- Exact costs depend on length of stay and specific medical services
- Medicare Advantage plans may have different cost structures
- Must meet specific medical necessity criteria
- Limited to patients with complex, chronic medical conditions
- Requires continuous medical assessment and treatment plan
- Coverage is time-limited and subject to medical review
- Not intended for custodial or long-term nursing home care
- Consult with your healthcare provider about long-term care hospital needs
- Verify coverage and medical necessity with Medicare
- Obtain detailed documentation from treating physicians
- Contact Medicare at 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicarelong-term care hospitalextended hospital servicesMedicare hospital coveragechronic illness treatment
Related Coverage Topics
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