Benefit periods measure your use of inpatient hospital and skilled nursing facility (SNF) services. A benefit period begins the day you are admitted to a hospital as an inpatient, or to a SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row. After you meet your deductible, Original Medicare pays in full for days 1 to 60 that you are in a hospital. For days 61-90, you pay a daily coinsurance.
If you have used your 90 days of hospital coverage but need to stay longer, Medicare covers up to 60 additional lifetime reserve days, for which you will pay a daily coinsurance. These days are nonrenewable, meaning you will not get them back when you become eligible for another benefit period.
Medicare will stop paying for your inpatient-related hospital costs (such as room and board) if you run out of days during your benefit period. To be eligible for a new benefit period, and additional days of inpatient coverage, you must remain out of the hospital or SNF for 60 days in a row. When you start a new benefit period, you will also have a new Part A deductible.
Note that certain Medigap policies pay for your hospital coinsurance and up to an additional 365 lifetime reserve days. Additionally, other Medigap policies pay your full hospital deductible.
If you are enrolled in a Medicare Advantage Plan, contact your plan to learn about the costs and coverage rules for inpatient care.
Read More: What Does Lifetime Reserve Days Mean?
Learn About: What if My SNF Care Needed is Longer than 100 Days?
Return to: Medicare In-Depth
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