Benefit Period
The span of time during which benefits are payable for a given cause of loss, or the period over which the deductible and maximums are measured, commonly a calendar year in medical plans.
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Practice This Concept
Within a Medicare Part A benefit period, the beneficiary must pay a daily coinsurance amount for inpatient hospital days:
61 through 90, after which the 60 lifetime reserve days may be used — Within a benefit period, Part A covers up to 90 days of inpatient hospitalization: the beneficiary pays a single inpatient deductible covering the first 60 days, then a daily copayment for days 61 through 90, and may then draw on a lifetime pool of 60 reserve days for stays beyond day 90. Once a reserve day is used, it is not replenished, and after the reserve is exhausted the beneficiary has no cap on inpatient cost-sharing. The 61-90 copay structure and the 60-day reserve are signature Part A cost-sharing numbers the exam tests together.
National insurance concept
Within a Medicare Part A benefit period, for hospital days 61 through 90, the beneficiary pays:
A daily coinsurance amount for each day of care — In a Part A benefit period, Medicare pays in full for the first 60 days of inpatient hospital care after the deductible. Days 61-90 require the beneficiary to pay a daily coinsurance amount; days 91-150 draw on the 60 lifetime reserve days, which also carry a daily coinsurance. These copay tiers are a specific Part A structure in the A&H objectives.
National insurance concept
- Medical ExpenseWithin a Medicare Part A benefit period, the beneficiary must pay a daily coinsurance a…
- Medical ExpenseWithin a Medicare Part A benefit period, for hospital days 61 through 90, the beneficia…
- Medical ExpenseWithin a Medicare Part A benefit period, for the first 60 days of inpatient hospitaliza…
- Medical ExpenseWithin a Medicare Part A benefit period, for hospital days 61 through 90, the beneficia…
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