If you have Medicare, you should be up-to-date of the prospective costs of a hospital stay so that you can plan accordingly. While Medicare Part A normally covers hospital stays, including your room, nursing services, meals, medications, and so on, it only does so for 90 days. So, what if you need to be in the hospital for a longer period of time? This is when lifetime reserve days come into play. Lifetime reserve days are the number of hospital days that an insurance policy will cover beyond the number of days given per benefit period. However, be careful, you only get 60 of these extra days.
How Lifetime Reserve Days Work
Lifetime reserve days are one of many Medicare rules. Your benefit period begins when you enter a medical facility, such as a hospital, and continues until you are discharged from the facility and go 60 days without reentering the hospital. If you have to stay longer than the days provided per benefit period, you can use your lifetime reserve days to do so. For example, assume you have a 100-day hospital stay. The first 60 days are totally covered by Medicare. Days 61 through 90 will have a copay, while the remaining days will be covered by 10 reserve days. However, you will also have to pay a coinsurance for these reserve days, which will be $816 a day in 2024.
That is just an example though you don’t have to use them in this way. In fact, you are free to use these reserve days as you see fit. There are no guidelines for dividing the days. You are not forced to use these days, and you can choose to pay for your additional hospital days out of pocket. When you get close to your 90-day threshold, the hospital will notify you so you can let them know if you want to use your reserve days and how many. You can also change your mind about using your reserve days after you leave the hospital. You have 90 days from the date of discharge to provide the hospital written notice. They will then just bill you for the outstanding sum, and your reserve days will be reinstated.
What Do The Lifetime Reserve Days Cover?
Medicare pays all covered costs, minus your daily coinsurance, for each lifetime reserve day used during a hospital stay. Some of the expenses covered by Part A if you are admitted for inpatient care at a hospital that accepts Medicare. Which includes semi-private rooms, meals, general nursing, and medications for inpatient therapy. If you require care that is not covered by Part A, such as a private room or a private-duty nurse, you have to cover the additional costs on your own.
Medicare Rules
To use a lifetime reserve day, you must first be eligible for Medicare Part A inpatient hospital care. Your hospital status (whether you are an “inpatient” or “outpatient”) influences how much you pay for hospital services (such as X-rays, medications, and lab testing). The choice to admit you to an inpatient hospital is a difficult medical decision based on your doctor’s recommendation and your need for medically necessary hospital treatment. When you are expected to need two or more “midnights”, meaning you stay past midnight, of medically necessary hospital care, an inpatient admission is generally eligible for payment under Medicare Part A (Hospital Insurance), but your doctor must order this admission and the hospital must formally admit you for you to become an inpatient. In order to use a Medicare lifetime reserve day, you must also use Medicare Part A hospital inpatient services for more than 90 days in a benefit period.
As far as cost goes, lifetime reserve days aren’t free. Original Medicare imposes varying co-pays based on the number of days you remain in the hospital, with lifetime reserve days beginning after day ninety. The first sixty days of a hospital stay are free of charge, days 61 to 90 have a daily co-pay of $408 (in 2024), and days over 90 have a $816 co-insurance per lifetime reserve day used.
Your Part A daily lifetime reserve day co-insurance might be covered by a Medicare Supplement insurance coverage. Part A inpatient hospital care co-insurance is covered in full by all Medicare Supplement Plans. If you get eligible Part A hospital inpatient care and need to take advantage of a lifetime reserve day, your Medicare Supplement coverage will cover the daily co-insurance. These plans will also cover up to an additional 365 days in the hospital. Although private insurance companies provide the coverage, the federal government requires that the policies be standardized. Which means no matter where you buy a policy from every plan of the same letter will have the same benefits.
Plans A, B, C, D, F, G, and N all cover 100% of your Medicare Part A hospital cost and coinsurance as well as 100% of your Part A deductible.
Plans K and M will cover 100% of Part A’s coinsurance and 50% of your part A deductible.
Finally Plan L will cover 100% of your Part A coinsurance and 75% of your Part A Deductible.
It’s important to note that Plan C and Plan F are no longer available to new Medicare enrollees. It is still available to those who were eligible for Medicare before January 2020.
Medicare Supplement Plan A only covers the minimal benefits that are needed of all Medicare Supplement Plans. That means this plan is a wonderful option for people looking for a low-cost plan that will still help lower Original Medicare expenses, such as the 20% Part B coinsurance, which can quickly pile up. Plan A further lowers out-of-pocket expenditures by having a yearly out-of-pocket maximum, which Original Medicare does not have. It also covers:
Plan B includes all of the essential benefits of Plan A, as well as some of the added benefits provided by other Medicare Supplement Plans. Although Plan B is not the most comprehensive Medicare Supplement Plan available, it is an excellent choice for those seeking additional coverage for out-of-pocket expenses. Plan B includes:
Anyone who was qualified for Original Medicare before January 1, 2020, is eligible to enroll in Plan C. If you were not Medicare-eligible at the time, you cannot enroll in Plan C. Medicare Supplement Plan C compensates for any Medicare-approved expenses not covered by Original Medicare. This covers, among other things, annual deductibles, copays, and coinsurance. It covers:
Plan F has long been the best-selling plan on the market. It covers all of your out-of-pocket payments, so if you have this plan, you’ll just have to pay the monthly Plan F premium. The only restriction is that, like Plan C, Plan F is not available to anyone who became Medicare eligible after 2020. If you were eligible for Medicare before 2020, you can purchase one of these plans; if you had purchased Plan F and are grandfathered in, you can keep it indefinitely. It includes:
Plan G is the most comprehensive Medicare Supplement Plan accessible to new Medicare beneficiaries. Since the ending of Plan F, this plan has gained in popularity and has become one of the most popular Medicare Supplement Plans available today, if not the most popular. Plan G bridges the gap between what Original Medicare covers and the charges that you have to pay in an extremely cost-effective manner. It includes:
Plan K is a fantastic solution for decreasing your cost-sharing requirements when combined with Original Medicare. This plan, like all Medicare Supplement Plans, seeks to pay some of the expenditures that Original Medicare does not cover, although to varying degrees. It includes:
Plan L, like Plan K, is a supplemental healthcare plan that includes cost-sharing benefits. In addition to the monthly premium for your policy, you will be responsible for deductibles, coinsurance, and copayments with Plan L. However, your plan will have a maximum out-of-pocket limit. It covers:
Plan M is an excellent option for consumers who want to keep their monthly costs low. Its coverage helps with many out-of-pocket expenditures that Original Medicare does not cover, such as copayments, coinsurance, international travel emergency care, and your first three pints of blood. It addresses:
Along with Original Medicare coverage, Plan N offers complete benefits. You will only be liable for your Medicare Part B deductible, minor copays at the doctor’s office, and excess charges if applicable in your situation if you choose this plan. Plan N includes:
Medicare Part A coinsurance and hospital cost
Medicare Part B coinsurance or copayment
First 3 pints of blood
Part A hospice care or coinsurance
Skilled nursing facility coinsurance
Medicare Part A deductible
80% of foreign travel emergency
Need Some Help?
Lifetime reserve days are an effective tool. If you plan ahead of time, you can reduce your out-of-pocket expenses and focus solely on getting better. However, if you believe you will want additional coverage for hospital stays, a Medicare Supplement Plan can help. After you’ve used all your lifetime reserve days, all Medicare Supplement Plans provide an additional 365 days of hospital care.
If you have any concerns or need assistance in locating a Medicare Supplement Plan, EZ.Insure can assist you. Our knowledgeable agents collaborate with the best companies in the country, making it simple for you to find what you require. Simply enter your zip code into the area below to receive your free, no-obligation quote. If you’d rather chat with an agent directly, call 877-670-3602.
About The Author:
Cassandra Love
With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.
