Medicare Part A limits coverage for inpatient hospital stays to 90 days per benefit period. However, you may be able to use a lifetime reserve day to extend your Part A coverage if you need inpatient hospital care past the 90-day limit. You have a total of 60 lifetime reserve days that you can use for this purpose.
Part A inpatient hospital care covers “hospital services, including semi-private rooms, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies,” according to Medicare.gov.
Using a lifetime reserve day requires a $630 daily co-insurance payment in 2015. All 10 standardized Medicare Supplement insurance plans will pay for this co-insurance cost. They also will cover hospital costs up to an additional 365 days after your Medicare benefits are used up.
To use a lifetime reserve day, first you must be eligible for Part A inpatient hospital care.
To qualify for that inpatient hospital care, there are a number of restrictions, including that your hospital doctor must make an official order stating that “you need 2 or more midnights of medically necessary inpatient hospital care to treat your illness or injury and the hospital formally admits you.” Medicare.gov provides a guide to determine if you are a hospital outpatient or inpatient.
Second, you must use Medicare Part A hospital inpatient services for more than 90 days in a benefit period.
The Medicare program will charge you deductibles and co-insurance for Part A inpatient hospital stays, including a $630 co-insurance payment per lifetime reserve day. The table below outlines the 2015 costs associated with inpatient hospital stays.
|Inpatient hospital stay period||You pay|
|First 60 days||$0 daily co-insurance|
|Days 61-90||$315 daily co-insurance|
|Days 90+ (lifetime reserve days available)||$630 daily co-insurance|
|Days 90+ (no lifetime reserve days available)||All costs|
Medicare Supplement insurance coverage
A Medicare Supplement insurance policy can pay for your Part A daily lifetime reserve day co-insurance. All Medigap plans offer full coverage for the Part A inpatient hospital care co-insurance. If you receive qualifying Part A hospital inpatient care and need to use a lifetime reserve day, your Medigap policy will pay for the daily $630 co-insurance.
Your Medigap policy also provides additional coverage that can be used if you surpass your Medicare lifetime reserve days. If you use more than the 60-day lifetime limit, your Medigap policy will provide coverage for up to 365 additional lifetime days.