Original Medicare offers some benefits for Skilled Nursing Facility care. Unfortunately, few people understand what SNF is and how it works. First, you should know that Skilled Nursing Facility care is not Custodial Care, which refers to nurses that ONLY help people get in and out of bed, feed them, bathe them, help them put on clothes and use the bathroom. Medicare doesn’t cover Custodial Care.
What is Skilled Nursing?
Skilled Nursing is basically inpatient rehab. Physical, occupational, and speech Therapy are examples of Skilled Nursing. Nearly anything that helps treat and manage your post hospitalization will fall under this category as long as it takes place at a Skilled Nursing Facility.
Medicare Covers some Skilled Nursing
Original Medicare covers 100% of Skilled Nursing for the first 20 days per benefit period. The next 80 days you are required to pay $176 per day. If you need more than 100 days of Skilled Nursing you will have to pay for any extra days out of your own pocket.
If you are enrolled in a Medicare Supplement insurance plan (Medigap), most will cover all or part of the Skilled Nursing Facility coinsurance. A Medigap plan could save you up to $12,160.
Skilled Nursing Facility’s “Dark” Secret
Before Medicare covers your Skilled Nursing Facility care you need a 3 day qualifying hospital stay. This means 3 consecutive days or more, starting with the day the hospital admits you as an inpatient, but not including the day you leave the hospital. If you don’t have 3+ days as an admitted patient (hospital observation does not count), you will have to pay 100% of your inpatient rehab.
Many people who are not aware of this hospital rule find themselves with large bills not covered by Medicare AND their Medigap policy. Additionally, you must require the skilled care on a daily basis to qualify for Skilled Nursing Facility care.
Advice for Skilled Nursing Facility Care
The following is advice to receive the best Skilled Nursing Facility care:
- Make sure you are officially admitted to the hospital for 3 full days before seeking skilled nursing treatment. Hospitals often list patients as under observation and this will not count towards the requirement.
- Consider a Medigap plan to pay for the Skilled Nursing portion not covered by Medicare. Medigap plans C, D, F, F-high deductible, M and N all cover 100% of the $176 daily copay for an additional 80 days per benefit period.
- Consider a Long Term Care (LTC) policy if you are interested in custodial care.
For further questions about Skilled Nursing Facility care call the number above or if you’re interested in learning more about Medigap policy click here to get an instant Medicare Supplement quote.