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Caring Senior Service of New Braunfels

Caring Senior Service of New Braunfels Blog

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Skilled Nursing Facilities: When Does Medicare Pay?

Posted by Ruby Cemental on Sep 12, 2017 5:30:00 PM

Rehab_seniors-LR.jpgAt one time or another, many seniors will need to be hospitalized. After the hospitalization though, there may still be some medical needs that can only be met in a skilled nursing facility (SNF). Under what conditions will Medicare pay for this care? Here are the general requirements.

  • You have Part A Medicare and still have some days remaining in your benefit period. A benefit period begins the day you become an inpatient and ends after you haven't received any inpatient care, in a hospital or SNF, for 60 consecutive days.
  • You have a qualifying inpatient hospital stay of 3 days or more. The time spent in the emergency room 'under observation' does not count towards the 3 days.
  • Your doctor has decided you need daily skilled care. Even if it is just for rehab that isn't provided every single day, you must need and accept these services each day that they are offered.
  • It could be tempted to go to the facility that is closest to your home or to family members. But, in order to be covered, the SNF must be certified by Medicare.
  • The services you need must be for a condition that was treated during a hospital stay or started when you were an inpatient at a hospital or SNF. In other words, even if it wasn't the original reason you were admitted, it could still be a qualifying condition.

If you unsure if your stay at a skilled nursing facility will be covered by Medicare, speak with a social worker or call Medicare or your managed care plan. You can also find helpful information here.

Caring Senior Service has the experience, compassion, and training necessary for comprehensive home care, and we also offer a wide range of home care services that are all designed to make life easier for seniors and their families. To learn more about the services we provide, contact us today!

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Topics: Medicare