medicare

“the little place with a big heart"

The following requirements must be met to establish and maintain eligibility for skilled nursing facility coverage under Medicare:

• Medicare Part A insurance coverage indicated on the Medicare card;
• Physician certification that skilled rehabilitation or nursing services are medically necessary;
• Hospital stay over 3 consecutive midnights within the past 30 days.

Medicare pays 100% of the entire cost of a skilled nursing facility stay for the first 20 days, including room and board, nursing care, therapies, medications, and supplies.  If one continues to meet the above criteria, Medicare will continue to pay the cost of the stay, minus $119.00 per day coinsurance on days 21-100.  Medicare supplemental insurance policies will usually pay the coinsurance as long as the policyholder meets Medicare eligibility for a skilled nursing facility stay.  The resident is responsible for paying the coinsurance amount if there is no Medicare supplemental insurance or Medicaid.  A predetermined number of Medicare covered days is never guaranteed but only conditional on the eligibility criteria listed above, as well as participation and progress in the treatment plan.