Talk:Lifetime reserve days

Under section 1861 of the Social Security Act (the Act), a beneficiary is entitled to an unlimited number of benefit periods, each of which includes 90 days of covered inpatient hospital services. A benefit period, or “spell of illness,” begins on the first day the beneficiary is an inpatient in a Medicare certified acute care hospital or skilled nursing facility (SNF). The benefit period ends 60 days after the hospital or SNF discharges the beneficiary. Section 1812 of the Act defines the scope of inpatient hospital benefits and includes the provision regarding 60 nonrenewable lifetime reserve days, which a beneficiary may draw upon whenever hospitalized for more than 90 days in a benefit period. Pursuant to the implementing regulations, which are contained in 42 CFR § 409.65, hospitals may bill Medicare for lifetime reserve days, unless the beneficiary elects not to use them or is deemed to have elected not to use them. Hospital notification requirements are delineated in the Medicare Benefit Policy Manual, which was developed by the Centers for Medicare & Medicaid Services. If the beneficiary elects not to use lifetime reserve days, the beneficiary becomes responsible for hospital charges beginning with the 91st day in the benefit period. Similarly, if the beneficiary uses all 60 lifetime reserve days and remains in the hospital beyond 150 days, the beneficiary becomes responsible for hospital charges on the 151st day. — Preceding unsigned comment added by Hjg1131 (talk • contribs) 16:00, 27 July 2011 (UTC)