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What are Medicare lifetime reserve days?

Medicare Part A only covers some of the costs of inpatient hospital stays for up to 90 days per benefit period. However, you may be able to use Medicare lifetime reserve days 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.

Medicare Part A inpatient hospital insurance 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.

Medicare lifetime reserve days require a $670 daily co-insurance payment in 2018. All 10 standardized Medicare Supplement insurance plans will pay for this co-insurance cost. They also will cover hospital health care costs up to an additional 365 days after your Medicare benefits are used up.

Medicare Part A and hospital care

To use a lifetime reserve day, first you must be eligible for inpatient hospital care that is covered by Medicare Part A.

To qualify for inpatient hospital care, 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.

You must use Medicare Part A hospital inpatient services for more than 90 days in a benefit period in order for a Medicare lifetime reserve day to be used.

Inpatient hospital health care costs

The Medicare program will charge you deductibles and co-insurance for Part A inpatient hospital stays and health care costs, including a $670 co-insurance payment per lifetime reserve day in 2018. The table below outlines the 2018 costs associated with inpatient hospital stays.

Inpatient hospital stay period You pay
First 60 days $0 daily co-insurance
Days 61-90 $335 daily co-insurance
Days 90+ (lifetime reserve days available) $670 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 $670 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.

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