Medicare Limits on Hospital Stays

Chances are, if you’re even hospitalized, you won’t spend more than a few days as an inpatient. The fear of catching a serious hospital infection, a leading cause of death, is enough to make anyone want to limit their stay. So the chances of you exhausting your Medicare coverage during a hospital stay is remote. However, in the case you have a serious illness and require a long admission period, here’s how Medicare breaks things down.

If you’re enrolled in traditional Medicare (Parts A & B)

If you need to stay for a long period in the hospital for one spell of illness or injury, that’s known as a benefit period. Medicare will cover 100% of your in-hospital nursing and living costs for the first 60 days after you’ve met your deductible. For 2019 the Part A deductible is $1,364. For days 61 to 90, you’ll be required to pay a copay. For 2019 the co-pay is $341 per day. If you have a Medicare Supplement or Medigap (especially the top three I sell), those Part A deductibles and copays are covered by the supplement.

The above pertains to one per benefit period. There is no limit to the number of benefit periods you can have, provided that 60 days have elapsed between each one. If you require a stay in the hospital longer than 90 days in any one benefit period, you must either pay the full cost yourself or draw on up to 60 additional days for which you pay a daily copay. These 60 days are called lifetime reserve days. The copay for these days are $682 per day. You can use as many as you like or save some, however, once used, they’re gone forever.

It’s important to know that all Medicare Supplement Plans (Medigap) extend Part A hospital coverage for up to an additional 365 days in your lifetime after Medicare benefits have been exhausted. And again, most Medicare Supplement plans pay for the Part A hospital deductible as well.

A Medicare Supplement policy is vital to have. It can literally save you ten of thousands of dollars when considering the cost of a prolonged hospital stay without one.