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.

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, he or she 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.

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 $304 (in 2014), and over ninety days have a $608 co-insurance per lifetime reserve day used.

Planning for hospital stay expenses can help reduce the overall cost of an extended stay. Because of the 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 that 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.

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.