Tag: skilled nursing care

What does Medicare Cover in a Skilled Nursing Facility?

You or a family member have a serious health event like a stroke or a broken hip and are admitted to the hospital. Rehabilitation services are needed. What will Medicare cover?

Medicare will cover skilled nursing and rehabilitation services, that is medically necessary services ordered by a physician and performed by a physical therapist, occupational therapist or other skilled professional, under Medicare Part A.

To qualify for the coverage the patient must meet the following criteria:

  1. Patient must have been admitted to the hospital and spent three overnights. Important note: observation
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What Skilled Nursing Care is Covered by Medicare? And Dealing with Denials

Medicare Part A (Hospital Insurance) will pay up to 100 days of skilled nursing care in a nursing home or at home, if the patient is home-bound and it is physician authorized, or inpatient care in a rehabilitation facility.

Coverage includes meals, skilled nursing care, physical and occupational therapy, speech-language pathology service, medications, medical supplies and equipment, and dietary counseling.

There is no charge for the first 20 days. However, there is a co-pay of $152 per day for the next 80 days, with Medicare covering the remaining expenses.

Sometimes a patient is determined… Read the rest

Does Medicare Cover Nursing Home Care Costs?

Medicare Part A provides limited coverage for skilled nursing care if certain requirements are met.   However, even if your care is Medicare Part A eligible, it only covers the cost of a skilled nursing facility for up to 20 days, with the possibility of an additional 80 days on a co-payment basis. The average nursing home stay is 2.4 years.

Beyond the limited time that Medicare Part A will cover care is the simple fact that it does not cover the majority of nursing home care because most residents of a nursing home do not require skilled care, which is a prerequisite for Medicare Part A coverage. … Read the rest