What are Medicare lifetime reserve days?

If you’re ill or injured and unable to leave the hospital after 90 days, you may have the option of using up to 60 additional days of inpatient hospital coverage. These are called “lifetime reserve days.”

How do Medicare lifetime reserve days work?

Medicare Part A—hospital insurance—provides coverage for an in-patient hospital stay of up to 90 days. If your hospital stay is longer, lifetime reserve days can offer big savings, but there are some limitations:

Lifetime reserve days can only be used once in a Medicare member’s lifetime.
They are not renewable from year to year.
You’ll pay a deductible for each reserve day you use.
Lifetime reserve days don’t apply to stays at skilled nursing facilities.
Your 60 lifetime reserve days can be split up over more than one hospital stay.

So, let’s say you’ve been in an accident. Your injuries have required surgery and on-going inpatient physical rehabilitation. Here’s how your Medicare Part A coverage works for one benefit period in 2025:

Days 1–60: you pay $0 after you meet your Part A deductible ($1,676).
Days 61–90: you pay $419 each day.
After day 90, if you opt to use your lifetime reserve days: you pay $838 for each day up to your 60-day limit of lifetime reserve days.
After you use up your lifetime reserve days: you pay 100% of your hospital costs until you go home.

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What do Medicare lifetime reserve days cover?

For each lifetime reserve days, Medicare pays all covered costs except for a daily copay. In 2025, that daily copay is $838 per day.

Out-of-pocket costs of lifetime reserve days

$838 per day is a lot of money. You may want to explore adding a Medicare Supplement (Medigap) plan to your Original Medicare coverage. All Med Supp plans pay the 61-90 day copay, the 60 day lifetime reserve copay and the additional 365 days after Medicare benefits are exhausted. (The only exceptions are Plans K and L, which only pay a percentage of those amounts.)

Take time to understand your options

If you’re new to Medicare and opting for Original Medicare Parts A and B, consider adding a Medicare Supplement plan as an added layer of protection against high healthcare costs.

If you have Medicare and you’re facing an extended hospital stay for a serious illness or injury, Medicare Part A lifetime reserve days may offer valuable extended coverage.

Frequently asked questions

1. What happens if I run out of Original Medicare Part A coverage for a hospital stay?

After 90 days, when Medicare Part A stops paying, you can use up to 60 lifetime reserve days, but you’ll pay a steep copay. In 2025, it’s $838 per day.

If you have a Medicare Supplement plan and your hospital stay lasts longer than the 90 days covered by Medicare Part A, your supplement plan may kick in. All Medicare Supplement plans provide coverage for days 61 and after, but not all provide coverage for the Medicare Part A deductible.

2. What happens if I run out of Medicare lifetime reserve days?

Once you use your 60 lifetime reserve days, they’re gone. If you have another hospital stay longer than 90 days in one benefit period, you’ll pay 100% of your hospital costs in full from Day 91 until you’re discharged.

You can tell the hospital that you don't want to use your lifetime reserve days if you want to save them for a later stay. You can also opt to split up your 60 lifetime reserve days over more than one hospital stay.

3. Do Medicare Advantage (MA) plans limit coverage for hospital stays?

All Medicare Advantage Part C plans offer an annual maximum out-of-pocket limit on costs. For example, if your MA plan’s out-of-pocket maximum is $5,000, once you’ve paid $5,000 for your healthcare, your plan pays 100% of all covered services for the rest of the plan year. The 2025 Medicare Advantage out-of-pocket maximum is $9,350 for in-network services, but plans can set lower limits.