What Options Do I Have After Exhausting My Medicare Benefits?

Medicare only provides a certain number of hospitalization days for a person’s life time. It also places yearly limits on what a person can receive for certain services. For some people, there is no limit to what a person can receive in a year or a lifetime. When a person exceeds the amount of services that Medicare provides, the options available to him depend on the situation. In some cases, he can use a Medigap plan to extend the services covered. In some cases, he may want to wait until he receives a new benefit period. People who require long time nursing care may be forced onto the Medicaid program.

Medicare Benefits and Long Term Nursing Care

Exhausting the benefit days Medicare provides for a skilled nursing facility can have the far reaching consequences. Once a person exhausts his benefit days, he must pay for his nursing care out of his own resources until the resources a drained to a certain point. After the resources are drained, he gets put onto Medicaid. Medicaid coverage usually lasts until the end of a person’s life in this situation. Rehabilitation benefits, which operate on a yearly rather than a lifetime cap, work differently.

Rehabilitation and Other Medicare Benefits

Medicare places a yearly dollar limit on these services. If a beneficiary needs these items, Medicare will cover them up until the patient reaches the cap set by the governing board. At that time, a person either needs to pay for the services out of his own pocket, use an extension from a Medigap policy or rely on private insurance to cover the gap. The amount resets at the beginning of the next calendar year. Beyond a few benefits, such as pints of blood, most Medicare benefits do not have a set yearly or lifetime benefit.

One Response to “What Options Do I Have After Exhausting My Medicare Benefits?”

  1. Jay Tunnison says:

    The first sentence in this article is not correct. Medicare limits available hospital days per BENEFIT PERIOD, not per lifetime. According to the information on the Medicare site, a person on Medicare can have unlimited benefit periods during his lifetime. Each benefit period lasts 90 days, according to Medicare information. Once the 90 days are up (30 days hospitalization and 60 days at home) a new BENEFIT PERIOD BEGINS.