As of 2013, Medicare covers up to 100 days in a skilled nursing facility, and the patient receives full coverage for the first 20 days in the facility. From days 21 to 100, the patient pays $148 per day, and Medicare pays the rest. After 100 days, the patient must pay the full cost of staying in the facility. Furthermore, Medicare will only cover skilled nursing facility care under the following conditions:
• The patient has been in the hospital for three days or more.
• The patient has Part A and days left in their benefit period.
• Their doctor has determined that the patient needs daily skilled care and/or rehabilitation care.
• The treatment can only be provided in a nursing facility on an inpatient basis.
• The skilled services are necessary and reasonable to treat or diagnose the patient.
• The facility is Medicare-certified.
• The condition the patient is getting treated for was the reason for the hospital stay or began during the stay at the facility. The patient must enter the nursing facility within a relatively short time period after leaving the hospital (usually within 30 days).
Related FAQs
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What Does Part B Cover?
What Does Part A Cover?
