The Lords Insurance Blog

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Term of the Day


From our insurance terms section, this is the definition:

Lifetime Reserve Days – Sixty additional days Medicare pays for when you are hospitalized for more than 90 days in a benefit period. These days can only be used once during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance amount.”

So how do Lifetime Reserve Days work?

A benefit period starts when you enter a hospital/skilled nursing facility(SNF) and ends when you’re out of it. The period can also end when you stop receiving Medicare-covered skilled services at the SNF for at least 60 days in a row.

If you’re in the hospital for more than 90 days in a single benefit period, the hospital will start taking days from your lifetime reserve days. For example, if you’re in the hospital for 91 days in a row, your one day would be considered lifetime reserve days (unless you notify the hospital that you don’t want to use your lifetime reserve days). You would then only have 59 lifetime reserve days left to use at a different time.

If you buy a Medicare supplemental insurance policy (Medigap plans A-J) it will pay all your hospital coinsurance plus provide up to 365 additional lifetime reserve days. (Plans B-J also pay your hospital deductible.)

So you can also choose to not use your lifetime reserve days as well and here is why you might want to:

  • Your hospital costs could be a little higher than the coinsurance for lifetime reserve days, you may want to save your lifetime save days for future hospital stays that may be more expensive. If you don’t want to use your lifetime reserve days you have to put your decision in writing and give it to the hospital within 90 days of leaving. You or your insurance will be responsible for the hospital costs. If you decide to use your reserve days and later change your mind, the hospital must approve your decision.
  • If your average daily hospital costs are less than the coinsurance for lifetime reserve days, you will be responsible for the cost but you will not use up any of your lifetime reserve days.

If you are in a Medicare private health plan (HMO, PPO, PFFS), your hospital deductible, copayments and benefit period will probably be different. Call your plan to find out what your out-of-pocket costs are for hospitalizations and what rules you have to follow in order to get coverage.

 

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Written by lordsinsurancelog

December 7, 2010 at 6:44 pm