Medicare Lifetime Reserve Days Explained
As a Medicare beneficiary, it’s important to know all of the rules around your benefits. In this article, we’ll help you understand Medicare lifetime reserve days and how they’re an important piece of your Part A (hospital insurance) coverage.
Key takeaways:
Medicare lifetime reserve days reduce your costs down to a copay for days 91 and beyond of a hospital stay.
You have 60 total lifetime reserve days.
A Medicare Supplement plan will cover many or all of your hospital costs, so you don’t have to worry about how many lifetime reserve days you have.
Medicare Advantage plans have varying copays, coinsurance, and out-of-pocket limits—and some plans may result in lower hospital or skilled nursing costs.
What are Medicare lifetime reserve days?
With Original Medicare, you pay a set deductible, then a daily copay up to day 90 of a hospital stay. Medicare lifetime reserve days allow you to extend Medicare coverage in case you need to stay at the hospital for more than 90 days.
Part A coverage per benefit period
Part A covers hospital visits and stays at a skilled nursing facility. In each benefit period, Medicare covers a certain amount per day and you must cover the rest. Here’s a breakdown of what you’ll pay at the hospital in 2024:
Days 1-60: all costs up to $1,632
Days 61-90: $408 each day
Days 91 and beyond: $816 each day while using lifetime reserve days
Every day after you use your lifetime reserve days: you pay all costs
Part A has a deductible of $1,632. For days 1-60, you’ll pay hospital costs up to $1,632. Every day after that, you’ll have to pay some of the costs of your stay.
Accessing Medicare lifetime reserve days
In some cases, you may need to stay at the hospital beyond 90 days. Medicare gives you an additional 60 lifetime reserve days, during which it will pay for some of your hospital costs. Part A covers everything except for a daily coinsurance while you’re using your lifetime reserve days. They are meant to protect you from catastrophic costs in case you only have Original Medicare and you need to stay at the hospital for a long period of time.
You can also use your lifetime reserve days while staying at a long-term acute care hospital (LTACH).
What is a benefit period?
Medicare uses “benefit periods” to measure your hospital or skilled nursing facility stays. A benefit period starts as soon as you’re admitted to a hospital or skilled nursing facility. It ends after you’ve been discharged and you haven’t returned back to the hospital for 60 days in a row. Part A costs reset for each benefit period. This means that for each new benefit period you’ll need to meet your Part A deductible before Medicare starts to pay its share of the cost. There is no limit to the number of benefit periods you can use in a year.
Remember, you don’t have an allotted lifetime reserve days per benefit period. Once you use the 60 additional days of hospital coverage, you no longer have lifetime reserve days.
How to receive hospital coverage beyond Part A
If you need long-term hospital care, Original Medicare may not fit all of your needs. There are two ways to receive coverage for hospital stays beyond what Original Medicare allows. You can get a Medicare Supplement plan that covers your Part A copays—some also cover your Part A deductible! You can also enroll in a Medicare Advantage plan. These plans have different cost structures and out-of-pocket cost limits that could reduce your annual costs if you require hospitalization.
Medicare Supplement plans and hospital coverage
Medicare Supplement plans are designed to reduce your out-of-pocket costs. Depending on which Medicare Supplement plan you choose, you may not need to worry about lifetime reserve days or paying for hospital costs at all. AllMedicare Supplement plans pay for Part A coinsurance and hospital costs. They also cover all or some of hospice and skilled nursing facility care coinsurance. Finally, most pay all or some of your Part A deductible.
Medicare Advantage plans and hospital coverage
Medicare Advantage plans have to cover the same benefits as Original Medicare, but their structures and out-of-pocket costs vary. Look at your Medicare Advantage plan’s summary of benefits to understand your annual deductible, copayment and coinsurance amounts, and out-of-pocket limit. This will help you understand how much you may owe for a hospital stay.
Talk to a Chapter Medicare Advisor
Your costs for a hospital can be very different depending on your Medicare coverage. Whether you’re currently facing a hospital stay or just want help finding a plan that will reduce your healthcare costs, we’re here to help! A Chapter Medicare Advisor can help you find, compare, and enroll in Medicare coverage that works best for your situation. Talk to an Advisor today 855-900-2427 or schedule a time to chat to see what your options are for Medicare.