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Does Medicare cover Skilled Nursing Facilities?

Brian Kondas
Medicare General Info
Medicare does cover Skilled Nursing Facilities (SNF), however coverage is limited based on certain conditions.
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Under what conditions is SNF coverage limited?

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 a recent Medigap Monday video, Robert Bache aka "Medicare Bob" briefly touches on the three-day qualifying hospital stay requirement and Plan G coverage benefits for SNF days 21-100. 

Common Questions about Skilled Nursing Facilities (SNF)

What is a Skilled Nursing Facility (SNF)?

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

  • Meals

  • Physical Therapy / Occupation Therapy

  • Speech-language pathology services

  • ... and more!

What is the Skilled Nursing Facility Benefit Period?

According to Medicare.gov, your benefit period begins when a Skilled Nursing Facility 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 or your Medigap plan must pay the hospital deductible of $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.

What is a qualifying hospital stay (and when is it needed)?

Medicare does cover a Skilled Nursing Facility (SNF) after a qualifying three-day admission to a hospital. First, you must have three or more days at a hospital. Then you can be transported to an 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. However, during the COVID-19 pandemic, you can get SNF coverage without a qualifying hospital stay.

You must also enter Skilled Nursing Facility care within 30 days of leaving the hospital and require skilled services related to your hospital stay. Moreover, you can leave an SNF and re-enter the same or another SNF within 30 days, and you will not need another three-day qualifying hospital stay.

What are the Medicare-related costs for a Skilled Nursing Facility?

Medicare pays for the first 20 days in a Skilled Nursing Facility. After 20 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 $1,484.00 hospital deductible every Skilled Nursing Facility benefit period. Moreover, Plan G covers SNF coinsurance costs of $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!

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