Medicare Coverage Questions

[Anonymous]

Medicare website states the following:

Hospital inpatient stay
You pay:
• Days 1–60: $1,156 deductible for each benefit period.
• Days 61–90: $289 coinsurance per day of each benefit period.
• Days 91 and beyond: $578 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
• Beyond lifetime reserve days: all costs.


I'm having trouble understanding this particular part.

for days 1-60, does benefit period refer to a one year period? For days 1-60, does this mean you are responsible for the first $1,156 deductible for the hospitalization?

for "Days 91 and beyond: $578 coinsurance per each 'lifetime reserve day' after day 90 for each benefit period (up to 60 days over your lifetime)." What does this mean? What is a "lifetime reserve day?"

[Anonymous]

Bump

[Anonymous]

benefit period is usually annual depending on when coverage started for you. So if your coverage started 1/1/2012, it is for Calendar 2012. The benefit period is always 12 months, then annual deductibles reset.

for 1-60, yes you are responsible for the deductible only, your coinsurance is 0%, after that, you pay $289 per day.

From CMS:
Each beneficiary has a lifetime reserve of 60 days of inpatient hospital services to draw upon after having used 90 days of inpatient hospital services in a benefit period. Payment will be made for such additional days of hospital care after the 90 days of benefits have been exhausted unless the individual elects not to have such payment made (and thus saves the reserve days for a later time).
A coinsurance amount equal to one-half of the inpatient hospital deductible applies to lifetime reserve days.

[Anonymous]

Here's the link, pp here.

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c05.pdf