Question About Medicare Lifetime Reserve Days

[Waynek]

I'm going on medicare in a month and have been researching my options. I appreciate all the valuable information provided in these forums. It's helped me a lot.

Medigap plans provide an additional 365 Lifetime Reserve days that become available after you've used up your 60 Lifetime Reserve Days allotted by Medicare. The additional 365 days are also Lifetime Reserve Days that can be used only once. After that, you're responsible for 100% of hospital costs on stays beyond 90 days.

Could someone confirm that this is correct? This seems like basic stuff but I've just been told by an agent that the 365 days provided by Medigap reset every year. I would love for that to be true but it goes against my understanding of how it works. I did a search of several sources and they don't quite spell it out. Sometimes they just refer to them as "additional" days without saying Lifetime Reserve. But nowhere have I found anything that says they reset every year.

Thanks, Wayne

 

[taz]

The 365 days are in addition to what Medicare covers. So yes you can say they reset every year.

 

[Chazm]

If you use your days 91-150 up, your 60 reserve days, and then you somehow get back to day 91 again, you will be using your 365 additional days. You only get these once but this is a rare rare situation. I've never seen it nor heard of it occurring

No they do not reset

 

[Waynek]

The 365 days are in addition to what Medicare covers. So yes you can say they reset every year.

Taz,

"Reset" means the Lifetime Reserve days replenish each year. So if you've used up your 60 Medicare Lifetime Reserve days, then use 20 of Medigap days, on the next January 1, your Medigap Reserve Days would reset to 365. In which case, you would never run out of Reserve Days. I don't think that's the case.

Wayne

 

[somarco]

The 365 days are in addition to what Medicare covers. So yes you can say they reset every year.

How do "lifetime" reserve days reset?

Waynek, the information you seek can be found in this booklet by Medicare Your Medicare Benefits, pgs 34 and 60.

60 "lifetime" reserve days are included in Medicare, a Medigap plan extends that to 365 days.

"Reset" means the Lifetime Reserve days replenish each year. So if you've used up your 60 Medicare Lifetime Reserve days, then use 20 of Medigap days, on the next January 1, your Medigap Reserve Days would reset to 365. In which case, you would never run out of Reserve Days. I don't think that's the case.

The reset refers to your hospital benefit period, not the lifetime reserve.

Benefit period is covered on pgs 34, 48, 50 and 60 of the linked Medicare booklet

 

[Waynek]

Somarco,


Yes, I know. I'm not claiming they reset. I was just explaining to Taz what reset means because I think he was misunderstanding what the agent was claiming.

I only brought this up because I have an agent claiming they reset every year and now he's asking me for proof that they don't. I'm gathering up links to send him but I thought I'd post here just to make sure I'm not misinterpreting what I've read.

Wayne

 

[somarco]

Somarco,


Yes, I know. I'm not claiming they reset. I was just explaining to Taz what reset means because I think he was misunderstanding what the agent was claiming.

I only brought this up because I have an agent claiming they reset every year and now he's asking me for proof that they don't. I'm gathering up links to send him but I thought I'd post here just to make sure I'm not misinterpreting what I've read.

Wayne

Sounds like you need a new agent.

 

[Chazm]

Somarco, Yes, I know. I'm not claiming they reset. I was just explaining to Taz what reset means because I think he was misunderstanding what the agent was claiming. I only brought this up because I have an agent claiming they reset every year and now he's asking me for proof that they don't. I'm gathering up links to send him but I thought I'd post here just to make sure I'm not misinterpreting what I've read. Wayne

Yeah that agent is completely wrong. In that case, you'd never run out of lifetime days. Lol doesn't make sense

 

[Waynek]

He's not my agent.

Anyway, thanks for confirming my understanding on the Lifetime Reserve days. I wanted to get this cleared up before asking a more in-depth question about catastrophic coverage. If it's ok, I'm going to start a new thread on that.