Medicare coverage of skilled nursing facility (SNF) care

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Medicare may help pay for skilled nursing facility care if:

  • You need skilled nursing care seven days a week or skilled therapy services at least five days a week;
  • You were formally admitted as an inpatient to a hospital* for at least three consecutive days. You must enter a Medicare-certified skilled nursing facility within 30 days of leaving the hospital;
  • You have Medicare Part A before you are discharged from the hospital; and 
  • You need care that can only be provided in a SNF.

If you meet these requirements, Medicare should cover the skilled nursing facility care needed to improve your condition or maintain your ability to function. Although you may hear otherwise, Medicare should cover skilled care that helps you maintain your ability to function or helps prevent or slow you from getting worse.

*Note: If you are admitted to the emergency room under observation or only receive emergency room services, this time does not count toward meeting the three-day prior hospital requirement for SNF coverage.


Case Examples
Mrs. M was billed for her skilled nursing facility care.

Mr. D was worried that his father-in-law might need Part B to cover rehabilitative care in a nursing facility.

Related Questions
Can my state give me more rights and protections than federal law regarding Medigap plan enrollment?

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GO TO
Finding a Medicare skilled nursing facility that meets your needs

 
LINKS
National Directory of Medicare Regional Carriers and Intermediaries

Medicare.gov: National A/B MAC Information

 
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