Skilled Nursing Facility Care

Joleen begins by reviewing the Medicare Part A coverage for SNF care.

Coverage

If a person with Medicare qualifies for SNF care, Medicare will cover the following services:

• A semiprivate room
• Meals
• Skilled nursing services
• Medical social services
• Medications and medical supplies and equipment used in the facility
• Ambulance transportation (when other transportation would endanger health) to the nearest provider of needed services that are not available at the SNF
• Dietary counseling
• Other services that SNFs generally furnish, such as lab tests and x-rays
• Physical, occupational,and speech-language therarpy, when ordered by a physician

Benefit Period

Unlike the 60 Lifetime Reserve Days for hospital stays, a person with Medicare can qualify for SNF care again every time he or she starts a new benefit period. This happens when there is a period of at least 60 straight days during which the person is not in a hospital and does not receive any skilled care in a SNF.

Once Joleen and Todd's father is released from the SNF, he will finish his recovery and rehabilitation at home.

Payment

SNF care is covered in full for 20 days after a minimum 3-day qualifying inpatient hospital stay. The day of discharge does not count. Also, a physician must certify that the person with Medicare needs skilled care in the SNF on a daily basis. For days 21 to 100, SNF care is covered except for coinsurance of up to $114 (in 2005) per day. After 100 days in a benefit period, Medicare Part A no longer covers SNF care, until the person with Medicare starts a new benefit period.

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