Medicare does cover a Skilled Nursing Facility (SNF). However, Medicare coverage is limited based on the following conditions:
- SNF Benefit Period
- Qualifying hospital stay
- Your need for skilled services to treat a hospital-related medical condition
In the Medigap Monday video, MedicareBob briefly mentions the 3-day qualifying hospital stay requirement and Plan G coverage benefits for SNF days 21 – 100.
What is a Skilled Nursing Facility?
A Skilled Nursing Facility (SNF) is where you receive skilled nursing or therapy to treat a hospital-related medical condition. What does Medicare cover in a Skilled Nursing Facility?
- Semi-private room
- Physical Therapy / Occupation Therapy
- Speech-language pathology services
- And more!
Skilled Nursing Facility benefit period
According to Medicare.gov, your benefit period begins when a Skilled Nursing Facility (SNF) admits you. After 60 consecutive days have passed without you receiving SNF benefits, your benefit period ends. The next time a hospital admits you, you must pay the hospital deductible $1484 in 2021.
However, during the COVID-19 pandemic, you may be able to get renewed SNF coverage without waiting 60 days for a new benefit period to begin.
Qualified Hospital Stay
Medicare does cover a Skilled Nursing Facility (SNF) after a qualifying 3-day admission to a hospital. First, you must have three or more days at a hospital. Then you can be transported to SNF, and Original Medicare covers the first 20 days.
Medicare.gov states your three days at a hospital must be as an inpatient (not outpatient). Furthermore, a qualifying hospital stay does not include inpatient observation services. Moreover, during the COVID-19 pandemic, you can get SNF coverage without a qualifying hospital stay.
Read the article, What Medicare Does Not Cover, and discover other Medicare length-of-stay limitations.
Care for a Hospital-Related medical condition
You must enter a Skilled Nursing Facility (SNF) care within a short time (30 days) of leaving the hospital and require skilled services related to your hospital stay. Moreover, you can leave SNF and reenter the same or another SNF within 30 days, and you will not need another 3-day qualifying hospital stay.
Medicare Costs for Skilled Nursing Facility
Medicare pays for the first 20 days in a skilled nursing facility. After twenty days, your coinsurance cost for days 21 to 100 is $185.50. After 100 days, Medicare does not cover the cost for a skilled nursing facility. Read the article, What Medicare Does Not Cover, and discover other Medicare length-of-stay limitations.
With Medigap Plan G, you do not pay $1484 hospital deductible every Skilled Nursing Facility benefit period. Moreover, Plan G covers SNF coinsurance costs $185.50 per day from days 21 – 100. Shop Medicare Supplement Plans, call Senior Healthcare Direct at 1-855-368-4717 or get your quote!
Change Your Medicare Plan
If you have Original Medicare and want to upgrade to a Medicare Supplement, discover when to shop Medigap Plans. If you have Medicare Advantage and want to switch to a Medigap Plan, find out when you can change.