If you’ve ever insured a home or vehicle, you’re probably familiar with an insurance deductible. Typically, you pay your deductible once at the beginning of your plan year. With health insurance, for example, you pay for your health care costs until you reach the deductible, and then your health insurance provider pays for any additional care you receive for the remainder of the year. Medicare is slightly different, and plan deductibles are charged not at the beginning of the plan year, but at the beginning of each benefit period. Understanding your benefit period and when it is can help you estimate your costs in the event you need care.
Medicare Benefit Period Explained
The Medicare benefit period is simply the way Original Medicare measures your use of inpatient hospital and skilled nursing facility (SNF) services. Your benefit period begins the day you’re admitted as an inpatient into a hospital or SNF and ends when you have gone 60 days in a row with no inpatient hospital or SNF care.
The benefit period has nothing to do with the calendar year but is based on your medical care needs. It begins on the first day you are admitted into the hospital or SNF and ends 60 days after the last day you receive treatment. For example, if you are admitted into the hospital on May 1 and receive 15 days of treatment, your benefit period would begin on May 1 and end on July 15. If you need to return to the hospital before the 60 days have expired, you will still be in the same benefit period. However, as soon as 60 days have passed with no care, if you return to the hospital, you will start a new benefit period.
While there is no limit to the number of benefit periods you can have or how long each benefit period can last, you must pay the inpatient hospital deductible for each benefit period.
References:
https://www.medicare.gov/glossary/b.html
https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html
https://www.medicare.gov/coverage/skilled-nursing-facility-care.html
https://blog.medicarerights.org/what-is-a-benefit-period/
MUC63-2017-BCBS
