B. Election not to use lifetime reserve days

An election not to use lifetime reserve days may be made by the beneficiary (or by someone acting on their behalf) at the time of admission or at any time thereafter, subject to the limitations on retroactive elections in (2) below.

Hospitals notify patients who have already used, or will use, 90 days of benefits in a benefit period that they can elect not to use their reserve days for all or part of a stay. The notice is given when the beneficiary has five regular coinsurance days left and is expected to be hospitalized beyond that period. When the hospital discovers that the patient has fewer than five regular coinsurance days left, it immediately notifies the patient of this option. The hospital makes available an appropriate election statement or form to be included in the patient's hospital record if they elect not to use reserve days.

(A Medicare beneficiary who is eligible for medical assistance under a State plan is advised that such assistance will not be available if they elect not to use their lifetime reserve days. However, this restriction does not apply when the beneficiary is deemed to have elected not to use lifetime reserve days because the hospital charges do not exceed the lifetime reserve days coinsurance amount (see a.above).