Are Skilled Nursing Facilities Covered by Medicare?
As some older adults age, they may need specialized medical care. Fortunately, skilled nursing facilities (SNFs) provide necessary care and attention to seniors with complex medical and rehabilitation needs. However, the cost of such care can be costly. Enter Medicare. It can be a huge relief to millions of seniors and their families. But does it cover skilled nursing facilities? Here’s what you need to know.
What Are Skilled Nursing Facilities?
Skilled nursing facilities (SNFs) are dedicated medical centers. Designed to provide round-the-clock skilled nursing care and rehabilitation services, they’re a great fit for seniors with complex medical needs. These needs may include:
- Post-surgical recovery
- Wound care
- Therapy after a stroke or heart attack
- Palliative care for patients with degenerative diseases
- Occupational, speech, and physical therapy
Additionally, skilled nursing facilities staff a wide range of healthcare professionals. Some of these may include:
- Physical, occupational, and speech therapists
- Registered nurses (RNs)
- Certified nursing assistants
- Audiologists
Does Medicare Cover Skilled Nursing Facilities?
The short answer is: Yes. Medicare Part does cover skilled nursing facilities. However, in order to qualify, you must meet specific criteria. Here’s a rundown of eligibility criteria:
- You have Part A and days left in your benefit period (according to Medicare.gov)
- Your doctor has stated you need daily skilled care
- You must have a qualifying hospital stay of three days or more, with the same diagnosis that requires skilled care that will be provided in a skilled nursing facility.
- You must choose a participating facility.
- You may receive up to 100 days of coverage, with no deductible necessary for the first 20 days.
What Services Do Skilled Nursing Facilities Offer?
Skilled nursing facilities offer a wide range of services to seniors with complex medical needs. These include:
- Help with daily activities such as bathing, grooming, and dressing.
- Rehabilitative care services such as physical therapy, occupational therapy, and speech and language therapy.
- Nutritious meals and dietary guidance according to the patient’s needs.
- Medication management and administration.
- Personalized care plans tailored to the individual patient’s needs.
- Hospice and palliative care for patients requiring end-of-life care.
What Are the Out-Of-Pocket Costs?
While Medicare Part A covers 100 days of care, you may have to pay some out-of-pocket costs. These may include deductibles, copayments, or other uncovered medical services, such as dental care. Understanding these costs and having a plan in place to pay for them will help you avoid any financial stress.
Looking for More?
If you or your loved one needs skilled nursing care, make sure to understand the coverage options available through Medicare. Also, speak to your healthcare provider or retirement planner to explore your options. Still looking for more great sources? Then check out these articles next:
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Originally published February 01, 2024
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