Inpatient Services

10.2.1 - Inpatient Services (Rev. 1, 09-11-02) In each benefit period, the patient is responsible for coinsurance amounts equal to: • One-fourth of the inpatient hospital deductible for each day of inpatient hospital services from the 61st through the 90th days; • One-half of the inpatient hospital deductible for each lifetime reserve day (the 91st through the 150th days of inpatient hospital services); and • One-eighth of the inpatient hospital deductible for each day of extended care services from the 21st through the 100th days. A beneficiary is not responsible for payment of the coinsurance for a stay if the provider has been determined to be liable because the care was not medically necessary or because the care provided was custodial. Use the chart in §10.3 of this chapter to determine the applicable coinsurance amounts. Where the actual charge to the patient for the 61st through the 90th days of inpatient hospital services is less than the applicable coinsurance amount, the coinsurance is the actual charge per day. Where the actual charge to the patient for lifetime reserve days is less than the coinsurance amount for those days, the beneficiary may be deemed to have elected not to use the days because he/she would not benefit from their utilization.