What Are Medicare Lifetime Reserve Days?

Lifetime reserve days are additional days in the hospital that Original Medicare pays for if you are hospitalized for more than 90 days. You have only 60 of these days over the course of your lifetime. Medicare pays all covered costs for each lifetime reserve day, but you have to pay daily coinsurance.

What Are Medicare Lifetime Reserve Days?

Medicare Part A hospital insurance provides you with a total of 60 lifetime reserve days over the course of your lifetime.

Medicare only covers up to 90 days hospitalization at a time. If you have to stay in the hospital beyond that, your lifetime reserve days kick in.

You may never need to tap into your lifetime reserve days because Medicare covers 90-day hospital stays, which are relatively rare.

Medicare Part A coverage resets after each benefit period. These begin the day you enter the hospital and run until you’ve been out of the hospital for 60 days.

Once you’ve used all 60 of your lifetime reserve days, that’s it. You don’t get any more.

How Medicare Lifetime Reserve Days Work

Medicare Part A covers care you receive in various types of hospitals or care facilities.

After you meet your Medicare Part A deductible, Medicare covers all approved costs for the first 60 days you spend in the hospital. You have to pay coinsurance for each day after that. Your coinsurance goes up after 90 days when your lifetime reserve days begin.

Your Daily Medicare Coinsurance Costs, 2021
  • Deductible – $1,484 (You must pay this amount each benefit period before Medicare picks up approved hospital costs)
  • Day 1 through day 60 – You pay no coinsurance
  • Day 61 through day 90 – $371 per day
  • Day 90 and beyond – $742 per day
  • After lifetime reserve days are used up – You have to pay all hospital costs

To put your coinsurance costs into perspective, in 2018, the Kaiser Family Foundation estimated that the average cost for an inpatient hospital stay in the United States was $2,517 per day. That ranged from a high of $3,552 per day in Washington state to a low of $1,371 in Mississippi.

Your lifetime reserve days can be applied to certain costs Medicare Part A would normally cover.

Examples of What Medicare Part A Covers
  • Semi-private hospital rooms
  • Meals
  • General nursing
  • Drugs that are part of your inpatient treatment while hospitalized
  • Other hospital services, equipment and supplies

Lifetime reserve days do not come into play for psychiatric hospitals. Medicare Part A only covers 190 days over your lifetime for psychiatric hospital care.

You also cannot apply lifetime reserve days toward skilled nursing facility care. Your coinsurance costs for stays in those facilities have a different schedule than hospital care under Medicare Part A.

Medigap, Medicare Advantage Plans and Lifetime Reserve Days

Medigap and Medicare Advantage plans are private plans that can have a significant impact on your costs and lifetime reserve days.

All Medigap plans — also called Medicare Supplement insurance — pay your hospitalization costs. Medigap also gives you up to a full year (365 days) of inpatient hospital care after you’ve burned through your 60 lifetime reserve days.

Some Medigap plans — Plan A through Plan N — will also cover some or all of your Medicare Part A deductible.

Medicare Advantage plans are required by law to provide at least the same level of coverage as Medicare Part A and Part B. But additional coverage may be available.

You should talk with your plan’s provider to find out exactly what it covers when you’re hospitalized —including how it deals with coinsurance for extended hospital stays and lifetime reserve days.

Last Modified: August 5, 2021

4 Cited Research Articles

  1. Medical News Today. (2020, July 22). Medicare and Lifetime Reserve Days: What to Know. Retrieved from https://www.medicalnewstoday.com/articles/medicare-lifetime-reserve-days#part-a-coverage
  2. U.S. Centers for Medicare & Medicaid Services. (2019, March 1). Medicare Benefit Policy Manual; Chapter 5 - Lifetime Reserve Days. Retrieved from https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c05.pdf
  3. Kaiser Family Foundation. (2018). Hospital Adjusted Expenses per Inpatient Day. Retrieved from https://www.kff.org/health-costs/state-indicator/expenses-per-inpatient-day/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
  4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Inpatient Hospital Care. Retrieved from https://www.medicare.gov/coverage/inpatient-hospital-care#