Under Medicare Part A, if lifetime reserve days are used and hospitalization extends beyond 90 days in a benefit period, the out-of-pocket expense is

Under Medicare Part A, if lifetime reserve days are used and hospitalization extends beyond 90 days in a benefit period, the out-of-pocket expense is

• A. 0%
• B. 100%
• C. 20%
• D. 50%

Answer: (B)

Medicare Part A coverage for inpatient hospital stays is limited by a benefit period. The first 60 days of a stay are covered after a deductible, days 61–90 require a daily coinsurance, and beyond 90 days you can use lifetime reserve days (up to 60 days over a lifetime) to extend coverage, with a daily coinsurance for each of those reserve days. But once all lifetime reserve days have been used, Medicare stops paying for any additional hospital days in that benefit period. At that point, the remaining days are the patient’s responsibility, i.e., 100% out-of-pocket. So if the stay goes beyond 90 days and lifetime reserve days have been used, any further days would cost the patient 100%.

Medicare Part A coverage for inpatient hospital stays is limited by a benefit period. The first 60 days of a stay are covered after a deductible, days 61–90 require a daily coinsurance, and beyond 90 days you can use lifetime reserve days (up to 60 days over a lifetime) to extend coverage, with a daily coinsurance for each of those reserve days. But once all lifetime reserve days have been used, Medicare stops paying for any additional hospital days in that benefit period. At that point, the remaining days are the patient’s responsibility, i.e., 100% out-of-pocket. So if the stay goes beyond 90 days and lifetime reserve days have been used, any further days would cost the patient 100%.