CMS Pub. 100-18, ch. 6, § 20.2.1

The issue of applicability of Part D coverage has also arisen in the context of inpatients in acute

care hospital settings (including long-term care (LTC) hospitals, which are certified as acute care

hospitals) who have exhausted their Part A inpatient stay benefit, but who require and continue

to receive a level of care that qualifies them for a Part A inpatient stay.

Drugs provided in an inpatient setting to an individual who has exhausted his or her lifetime

inpatient hospital benefit under Part A are not drugs that could be covered under Part A for that

individual. Unlike a beneficiary who, for example, chooses not to buy into Part B, there is no

way for an individual who has exhausted his or her Part A inpatient stay benefit to obtain

coverage under Part A for his or her drugs; therefore, Part D coverage may be available to a Part

D enrollee who has exhausted his or her Part A inpatient stay benefit and who remains in that

inpatient setting (provided the drug would otherwise be covered under Part D). See chapter 5,

section 50.5.4, regarding sponsor contracting requirements when a beneficiary has exhausted

inpatient Part A benefit days.