Lifetime Reserve Days
Lifetime reserve days are the number of hospital days that an insurance policy will cover above the number of days allotted per benefit period. The first sixty days of hospital stay have no co-pay, days sixty-one to ninety have a daily co-pay of $352 (in 2020), and over ninety days have a $704 co-insurance per lifetime reserve day used. For example, a patient who expects to only need one lifetime reserve day during a particular hospital stay may want to pay the cost of the one additional day out of pocket, if the cost of that day is close to the cost of the lifetime reserve days. For example, if a patient stays in the hospital or nursing facility for 100 days but is only allotted 90 days per benefit period, the patient will have to use 10 lifetime reserve days. Lifetime reserve days are the number of days of hospital stay that an insurance policy covers beyond the number of days allotted per benefit period.
What are Lifetime Reserve Days
Lifetime reserve days are the number of hospital days that an insurance policy will cover above the number of days allotted per benefit period. These days are capped at a certain number over the entire lifetime of the policy. They do not have to be used during a particular hospital stay.
Understanding Lifetime Reserve Days
Lifetime reserve days are most often associated with Medicare policies. When an insured person enters a medical facility, such as a hospital, the benefit period begins, lasting until the person leaves the facility. If the policyholder needs to stay longer than the days allotted per benefit period, they may continue to stay using the lifetime reserve days. For example, if a patient stays in the hospital or nursing facility for 100 days but is only allotted 90 days per benefit period, the patient will have to use 10 lifetime reserve days. As of 2020, Medicare offered 60 lifetime reserve days during a patient's lifetime.
Medicare Rules
Original Medicare requires different co-payments (co-pays) depending on the number of days a patient stays in the hospital, with lifetime reserve days beginning after day ninety. The first sixty days of hospital stay have no co-pay, days sixty-one to ninety have a daily co-pay of $352 (in 2020), and over ninety days have a $704 co-insurance per lifetime reserve day used.
Planning for hospital stay expenses can help reduce the overall cost of an extended stay. Because of higher fees, patients and their families may want to determine ahead of time whether to use the lifetime reserve days, pay out of pocket, or use a separate policy to cover the difference.
For example, a patient who expects to only need one lifetime reserve day during a particular hospital stay may want to pay the cost of the one additional day out of pocket, if the cost of that day is close to the cost of the lifetime reserve days. Patients are expected to foot all costs associated with a hospital stay beyond the lifetime reserve days requirement.
Medigap policies A through L pay for your hospital coinsurance and provide up to an additional 365 lifetime reserve days. Also, Plans B through J will pay your full hospital deductible. Also called Medicare Supplement Insurance, Medigap is health insurance coverage provided by private companies designed to cover excess costs not covered by original Medicare. Medigap covers all or a portion of those extra charges depending on the coverage type. Although private insurance companies offer the coverage, the federal government requires companies to offer standardized policies. Your choices are Plans A, B, C, D, F, G, K, L, M and N, although some will no longer be available to newly eligible participants.
Related terms:
Copay
A copay is a fixed amount paid by an insured for covered services. Insurance providers often charge co-pays for services such as doctor visits or prescription drugs. read more
Health Insurance
Health insurance is a type of insurance coverage that pays for medical and surgical expenses that are incurred by the insured. read more
Medicare Part A
Medicare Part A, or Medicare hospital coverage, is one of the four parts of Medicare, the government’s health insurance program for older adults. read more
Medicare Supplement Insurance
Medicare supplement insurance, also known as Medigap, is private insurance sold to complement original Medicare coverage. read more