What if My SNF Care Needed is Longer than 100 Days?

Medicare covers up to 100 days of care in a Skilled Nursing Facility (SNF) each benefit period. If you need more than 100 days of SNF care in a benefit period, you will need to pay out of pocket. If your care is ending because you are running out of days, the facility is not required to provide written notice. It is important that you or a caregiver keep track of how many days you have spent in the SNF to avoid unexpected costs after Medicare coverage ends.

Remember that you can again become eligible for Medicare coverage of your SNF care, once you have been out of a hospital or SNF for 60 days in a row. You will then be eligible for a new benefit period, including 100 new days of SNF care, after a three-day qualifying inpatient stay.

If you are receiving medically necessary physical, occupational, or speech therapy, Medicare may continue to cover those skilled therapy services even when you have used up your SNF days in a benefit period—but Medicare will not pay for your room and board, meaning you may face high costs. Check with your provider to see if you qualify for therapy at home through Medicare’s home health benefit, or if you could safely receive therapy as an outpatient while living at home.

If you have long-term care insurance, it may cover your SNF stay after your Medicare coverage ends. Check with your plan for more information. If your income is low, you may be eligible for Medicaid to cover your care. To find out if you meet eligibility requirements in your state, contact your local Medicaid office.

Note: In response to the coronavirus public health emergency, Medicare has made changes to coverage for SNF care. Beneficiaries who cannot start a new benefit period because of the public health emergency can get another 100 days of covered SNF care without having to begin a new benefit period.

Read More: How Does a Medigap Policy and Skilled Nursing Facility Care Work?
Learn About: My Skilled Nursing Facility Is Discharging Me Too Early, What Should I Do?
Return to: Medicare In-Depth

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