Original Medicare shares the cost of medical care with enrollees through deductibles, copayments, and coinsurance payments. With this cost-sharing structure, many people may worry about whether their coverage might run out — specifically, if their benefits are subject to a lifetime limit. In reality, the concept of a lifetime limit in Medicare may not work as you would expect.
If you’ve ever wondered about these limits and how they impact your costs and coverage, here’s what you need to know.
Is there a lifetime limit on Medicare?
Thanks to the Affordable Care Act, insurance providers aren’t allowed to set cost limits on providing essential health benefits for the entire time you’re enrolled in the plan. In short, if the service or supply is medically necessary and meets the “accepted standards of medicine,” the service is likely to be at least partially covered by your insurance.
Original Medicare also covers most medically necessary services. Keep in mind: While there aren’t any limits on how many services you can use, there are benefit period limits and lifetime reserve days that cap the length of covered inpatient stays.
What are the lifetime limits on hospital stays with Medicare?
Benefit period limits and lifetime reserve days mostly apply to inpatient stays at general and psychiatric hospitals and skilled nursing facility care. Here’s how you can expect each to work.
Benefit period limits
Benefit period limits represent how long your inpatient stays are covered. For example, once you meet the Part A deductible, Medicare fully covers 60 days of a hospital stay and partially covers days 61-90 (you pay $419 per day).
This 90-day span is a benefit period, and it resets once you’ve been out of the hospital for 60 days. Your Part A deductible ($1,676 in 2025) also resets for each new benefit period, but there are no limits on the number of benefit periods that can occur in a year.
Lifetime reserve days
If you need continuous inpatient care after the first 90 days, you’ll tap into your lifetime reserve days. Each Original Medicare enrollee gets 60 lifetime reserve days. So, for example, if you stay an additional 20 days after the original 90 in the same benefit period, you’ll have 40 total lifetime reserve days left.
For inpatient stays at freestanding psychiatric hospitals specifically, Medicare covers a separate 190 lifetime reserve days. Plus, Part B covers 80% of the Medicare-approved amount for services you receive while you’re an inpatient. Once you’ve used up all your lifetime reserve days, you don’t get them back, and you’re responsible for all inpatient costs.
Also, skilled nursing care doesn’t have lifetime reserve days but does have benefit period limits. After you meet the Part A deductible (and other eligibility requirements for receiving skilled nursing care), you pay $0 for the first 20 days and $209.50 for days 21-100. After that, all costs are your responsibility.
Does Medicare Advantage have lifetime limits?
There are no lifetime limits or lifetime reserve days on Medicare Advantage (MA). The limits described above only apply to Original Medicare. Each MA insurance provider can use their discretion to determine how to handle the cost structure after the initial 90 days per benefit period.
In fact, unlike Original Medicare plans, which don’t have an out-of-pocket maximum, MA plans limit how much enrollees spend out-of-pocket each year. Medicare Advantage yearly out-of-pocket limits can’t exceed $9,350 in-network and $14,000 out-of-network, and some providers can set lower limits depending on the plan. Once you meet the out-of-pocket max, your MA plan takes care of your costs for the rest of the year.
What about lifetime limits on Part D prescription drug plans?
Medicare Part D (prescription drug) doesn’t have lifetime limits on coverage. Even if it were part of Original Medicare (which it isn’t), it’s an outpatient benefit, which doesn’t use or require any lifetime reserve days.
Instead, there’s an annual $590 deductible ($615 in 2026), and drugs cost 25% of original costs once you meet it. Thanks to the Inflation Reduction Act, out-of-pocket spending for Part D is capped at $2,000 ($2,100 in 2026), and enrollees pay $0 for covered drugs for the rest of the coverage year.
Can Medigap extend my lifetime limits?
Medigap (or Medicare Supplement) plans extend lifetime reserve days and provide additional coverage for hospice and skilled nursing care. Medigap plans A-N offer an additional 365 days after the initial 60, for a total of 425 lifetime reserve days.
Some Medigap plans also cover other out-of-pocket expenses, like the Part A deductible and Part B coinsurance or copay. Each plan has a different set of coverage options, but plans of the same letter offer the same benefits. For example, all Plan Gs cover Part B excess charges. Medigap is a good way to keep annual out-of-pocket costs down and extend your runway for lifetime reserve days.
All in all, lifetime reserve days are the only true limits on Medicare coverage, as they’re the only ones that don’t renew after a period of time, and Medicare Advantage doesn’t have lifetime limits. If you need help comparing potential out-of-pocket and coverage limits of your Original Medicare or Medicare Advantage plan, the licensed insurance agents at UMA can help you fully evaluate your options.
