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It hasn't really been revealed yet. She could have been dreaming, but *SPOILER* i think it really was Ali, because we know that Ali is still alive: she killed her twin sister, Courtney, when she just came back from the mental hospital, and went to her parents saying it was Ali, but they thought it was Courtney so sent Ali to the mental hospital, thinking she was her twin Courtney. Knowing that Ali was currently in a hospital, I think that she left the mental ward and went to talk to Hanna to make let her know that she was still alive, but that mysteriously dissapeared.

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Q: Did Hanna really see Ali in the hospital in Pretty Little Liars or was she dreaming?
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