Original Medicare covers up to 90 days of inpatient hospital care each benefit period. You also have an additional 60 days of coverage, called lifetime reserve days. These 60 days can be used only once, and you will pay a coinsurance for each one ($670 per day in 2018). To better understand lifetime reserve days, let’s imagine an individual who had a 120-day Medicare-covered inpatient stay, meaning they used 30 lifetime reserve days. After they have been out of the hospital for 60 days in a row, they will be eligible for another 90 days of hospital coverage because they will be in a new benefit period. However, if they need inpatient care beyond the benefit period maximum, they will only have 30 of their 60 lifetime reserve days remaining.

As the above example illustrates, lifetime reserve days do not have to be applied toward the same hospital stay. For example, if you need to stay in the hospital twice for 120 days each time during different benefit periods, you can use 30 of your lifetime reserve days each time.

If you are in the hospital for more than 90 days in a single benefit period, the hospital will start deducting days from your lifetime reserve days. You can notify the hospital that you do not want to use your lifetime reserve days (either while in the hospital or up to 90 days after leaving), but be aware that you will be required to pay for the full cost of your care for those days. In some situations, you may find it better to delay using your lifetime reserve days and pay the hospital’s daily charge instead. This could be a good choice if, for example:

  • Your hospital costs are only a little higher than the coinsurance for lifetime reserve days. In this case, you may want to save your lifetime reserve days for future hospital stays that may be more expensive. Remember that if you do not want to use your lifetime reserve days, you should provide the hospital with written notice of your decision within 90 days of leaving. If you change your mind and decide to use your days, the hospital must approve your decision.
  • Your average daily hospital costs are less than the coinsurance for lifetime reserve days. In this case, you should be charged for the regular cost without having to use your lifetime reserve days.

Note: Medigap policies A through L pay for your hospital coinsurance and provide up to an additional 365 lifetime reserve days. In addition, Plans B through J will pay your full hospital deductible.