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.

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.

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 U.S. 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.

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 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.