Staying Fit
Q. Is there a cap on the amount of Medicare services you can use? I’ve had several expensive surgeries, and I’m worried that my benefits may run out.
A. In general, there’s no upper dollar limit on Medicare benefits. As long as you’re using medical services that Medicare covers—and provided that they're medically necessary—you can continue to use as many as you need, regardless of how much they cost, in any given year or over the rest of your lifetime.
However, some individual Medicare benefits do come with limits. These include:
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Hospital lifetime reserve days: Medicare Part A covers a stay in the hospital for any single spell of illness or injury within a time frame of 90 days. This is known as a benefit period, and there’s no limit to the number of benefit periods you can have. But if you need to stay in the hospital for more than 90 days with the same illness or injury, you have the option of using some of your 60 lifetime reserve days. These allow you to extend your hospital stay for a higher copayment ($608 a day in 2014). You can use these days—one or more at a time, or as you need them—over the rest of your life. Once the 60 reserve days are exhausted, you would pay the hospital’s full daily charge (except for services covered under Medicare Part B, such as physician visits) if you need to stay in the hospital for more than 90 days in a benefit period. Here are some exceptions:
* You have the option not to use your lifetime reserve days for any particular extended hospital stay—for example, if you prefer to store them up for a rainy day, or if the hospital’s daily rate is the same as or less than the Medicare copay.
* All standard medigap supplementary policies cover an additional 365 lifetime reserve days, after Medicare’s reserve days are used up.
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