Under What Circumstances Does Medicare Cover Skilled Nursing Facility Care?Skilled nursing facility (SNF) care is post-hospital care provided at a SNF. Skilled nursing care includes services such as administration of medications, tube feedings, and wound care. Keep in mind that SNFs can be part of nursing homes or hospitals.

Medicare Part A may cover your SNF care if:

  • You were formally admitted as an inpatient to a hospital for at least three consecutive days
  • You enter a Medicare-certified SNF within 30 days of leaving the hospital, and receive care for the same condition that you were treated for during your hospital stay
  • And, you need skilled nursing care seven days per week or skilled therapy services at least five days per week

Note: The day you become an inpatient counts toward your three-day inpatient stay to qualify for Medicare-covered SNF care. However, the day you are discharged from the hospital does not count toward your qualifying days. Also remember that time spent receiving emergency room care or under observation status does not count toward the three-day hospital inpatient requirement for SNF coverage.

If you meet all the above requirements, Medicare should cover the SNF care you need to improve your condition, maintain your ability to function, or prevent your health from getting worse.

During a Medicare-covered SNF stay, Part A covers:

  •  A semi-private room and meals
  • Skilled nursing care provided by nursing staff
  • Therapy, including physical therapy, speech therapy, and occupational therapy
  • Medical social services and dietary counseling
  • Medications
  • Medical equipment and supplies
  • Ambulance transportation to the nearest provider of needed services, when other modes of transportation would endanger your health

Each benefit period, Part A covers the full cost of your first 20 days in a SNF (see What is the Cost of Part A?). For days 21-100, Part A covers part of the cost and you pay a daily coinsurance. If you need more than 100 days of SNF care in a benefit period, you will need to pay out of pocket (see What if My SNF Care Needed is Longer than 100 Days?).

Speak to your doctor or hospital discharge planner if you need help finding a SNF that meets your needs. Ask them to find Medicare-certified SNFs in your area that will address your medical needs. If you are in a Medicare Advantage Plan, contact your plan to find out which SNFs are in-network.

Read More: Under What Circumstances Does Medicare Cover Home Health Care?
Learn About: Under What Circumstances Does Medicare Cover Hospice Care?
Return to: Medicare In-Depth

Under What Circumstances Does Medicare Cover Skilled Nursing Facility Care?Skilled nursing facility (SNF) care is post-hospital care provided at a SNF. Skilled nursing care includes services such as administration of medications, tube feedings, and wound care. Keep in mind that SNFs can be part of nursing homes or hospitals.

Medicare Part A may cover your SNF care if:

  • You were formally admitted as an inpatient to a hospital for at least three consecutive days
  • You enter a Medicare-certified SNF within 30 days of leaving the hospital, and receive care for the same condition that you were treated for during your hospital stay
  • And, you need skilled nursing care seven days per week or skilled therapy services at least five days per week

Note: The day you become an inpatient counts toward your three-day inpatient stay to qualify for Medicare-covered SNF care. However, the day you are discharged from the hospital does not count toward your qualifying days. Also remember that time spent receiving emergency room care or under observation status does not count toward the three-day hospital inpatient requirement for SNF coverage.

If you meet all the above requirements, Medicare should cover the SNF care you need to improve your condition, maintain your ability to function, or prevent your health from getting worse.

During a Medicare-covered SNF stay, Part A covers:

  •  A semi-private room and meals
  • Skilled nursing care provided by nursing staff
  • Therapy, including physical therapy, speech therapy, and occupational therapy
  • Medical social services and dietary counseling
  • Medications
  • Medical equipment and supplies
  • Ambulance transportation to the nearest provider of needed services, when other modes of transportation would endanger your health

Each benefit period, Part A covers the full cost of your first 20 days in a SNF (see What is the Cost of Part A?). For days 21-100, Part A covers part of the cost and you pay a daily coinsurance. If you need more than 100 days of SNF care in a benefit period, you will need to pay out of pocket (see What if My SNF Care Needed is Longer than 100 Days?).

Speak to your doctor or hospital discharge planner if you need help finding a SNF that meets your needs. Ask them to find Medicare-certified SNFs in your area that will address your medical needs. If you are in a Medicare Advantage Plan, contact your plan to find out which SNFs are in-network.

Read More: Under What Circumstances Does Medicare Cover Home Health Care?
Learn About: Under What Circumstances Does Medicare Cover Hospice Care?
Return to: Medicare In-Depth

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