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How Medicare Hospital Coverage and Benefit Periods Work
Understanding 'benefit periods' and lifetime reserve days helps you avoid surprise hospital costs.
Talk to a Licensed Agent: (302) 407-0876What a Benefit Period Is
Part A hospital coverage is organized around 'benefit periods,' not calendar years. A benefit period starts the day you're admitted as an inpatient and ends once you've gone 60 consecutive days without inpatient hospital or skilled nursing care. If you're readmitted after that 60-day gap, a new benefit period — and a new deductible — begins.
Within a single benefit period, you generally pay a one-time deductible for days 1 through 60 with no additional daily coinsurance. Starting on day 61, a daily coinsurance applies, and it increases further after day 90.
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Call (302) 407-0876Lifetime Reserve Days
If a hospital stay extends beyond 90 days in a single benefit period, you can draw on your 60 lifetime reserve days — a one-time bank of extra covered days that doesn't renew and can be used across any benefit period in your lifetime. Reserve days carry a higher daily coinsurance than days 61–90.
A Medigap policy can help cover the Part A coinsurance and reserve-day costs, which is one reason many people with Original Medicare choose to pair it with a Medigap plan. Check Medicare.gov for the current-year exact deductible and coinsurance dollar amounts, since they're adjusted annually.
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