Updated on November 19, 2018
How Does Skilled Nursing Facility Work with Medicare?
You might require a skilled nursing facility if you’ve got a major injury or disorder which requires monitoring or medical procedure. Skilled nursing care offers 24 hrs care for folks who require rehabilitation services or are suffering from serious health disorders which might be too complex for home treatment. A few skilled nursing cares may come with lab, pharmacy & radiology services, educational & social programs, as well as limited transport to essential health services which aren’t offered by the facility.
Ways to Reduce Your Skilled Nursing Care Expenses:
You may want to take into consideration Medicare Supplement plans which can allow you to pay your skilled nursing care out of pocket expenses. Supplemental Plans which are also known as Medigap plans can pay for additional costs under Part A Medicare & Part B Medicare. In a number of states, the benefits of these plans are standardized by the government. Each of the ten Medigap plans offers a different level of coverage and benefits. Majority of these plans might help the enrollee cover some amount of copayments associated with SNF (skilled nursing facility) at a minimum.
Who Is Eligible for Skilled Nursing Care?
Most times, Medicare assists you to pay for your skilled nursing care provided the below requirements are met:
- You were in the hospital as an inpatient for a minimum of 3 days consecutively (excluding the day of your departure), and you utilized a Medicare-approved SNF inside 1 month of leaving the facility.
- You already have Part A Medicare that includes hospital insurance.
- Your physician suggested you to get SNF 7 days per week or services associated with skilled therapy 5 days per week as a minimum.
- You require care which can be only offered via SNF & it’s considered essential and reasonable.
- Your skilled nursing facility is associated with a disorder you received a treatment for in a hospital, or is another disorder which begun while you were receiving the treatment.
You are yet to utilize the given days in Medicare benefit term. The term begins the day when you get admitted as an in-patient to the hospital. It will terminate when you no more stay as an inpatient in the SNF or hospital for 2 months back to back.