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Ashford Insurance

Understanding Medicare Part A Inpatient Hospitalization and Lifetime Reserve Days for 2024

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Sarah Fuhrmann

Sarah Fuhrmann is an agent of Ashford Insurance an independent health insurance agency specializing in Texas Medicare insurance.

Medicare Part A provides coverage for inpatient hospital stays, but it's important to understand the specifics, especially when it comes to costs and coverage limits.

Understanding Medicare Part A Inpatient Hospitalization and Lifetime Reserve Days for 2024

Medicare Part A provides coverage for inpatient hospital stays, but it’s important to understand the specifics, especially when it comes to costs and coverage limits.

Inpatient Hospital Coverage: Days 1-60

For 2024, Medicare Part A covers an inpatient hospital stay with a $1,632 deductible for the first 60 days. This deductible includes a semiprivate room and board, general nursing, and miscellaneous services and supplies. It’s important to note that you may be subject to this $1,632 deductible up to six times a year, depending on your hospital admissions.

Coverage Beyond 60 Days

If your inpatient hospital stay extends beyond 60 days:

  • Days 61-90: Medicare covers all costs except for $408 per day, which you are responsible for.
  • Days 91 and Beyond: Medicare covers all costs except for $816 per day. This coverage applies to the 60 “lifetime reserve days” available to you.

Once you have exhausted your 60 lifetime reserve days, Medicare will no longer cover any costs for your inpatient stay, and you will be responsible for all expenses.

Medicare Supplement Plans and Lifetime Reserve Days

Medicare Supplement Plans, such as Plan G, offer additional coverage beyond what Original Medicare provides. When Medicare’s lifetime reserve days are exhausted, a Medicare Supplement plan steps in to cover the costs for up to an additional 365 days.

According to the summary of benefits for Medicare Supplement plans (not Medicare Advantage plans), there is a critical notice regarding lifetime reserve days: “When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid up to an additional 365 days as provided in the policy’s ‘Core Benefits.’ During this time, the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.”

This means that with a Medicare Supplement plan, you receive an additional 365 days of inpatient hospital benefits, ensuring that you pay $0 for these additional days, except for any applicable annual deductible.

Personalized Medicare Planning

During a Medicare consultation, we emphasize the importance of personalized planning for your Medicare Part D and other benefits. It’s crucial to make informed decisions, as once you enroll in a plan, changes can typically only be made during the Medicare Annual Enrollment Period from October 15 to December 7.

For more information or to schedule a personalized consultation, contact us today. Let us help you navigate the complexities of Medicare and find the best plan for your needs.

 

Photo by Caleb Oquendo

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Picture of Sarah Fuhrmann

Sarah Fuhrmann

Sarah Fuhrmann has been helping Medicare eligibles in Texas with their Medicare Insurance since 2018.