Medicare covers up to 100 days of care in a skilled nursing facility (SNF) each benefit period. If you need more than 100 days of SNF care in a benefit period The benefit period is the amount of time during which Medicare pays for hospital and skilled nursing facility (SNF) services. A benefit period begins the day you are admitted to a hospital as an inpatient, or to a SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row. With each new benefit period, you pay a new deductible. Your coinsurance is determined by the number of days you have been in the facility during each benefit period. , you will need to pay out of pocket. If your care is ending because you are running out of days, the facility is not required to provide written notice. It is important that you or a caregiver A caregiver is anyone who provides help and support to someone who is either temporarily or permanently unable to function or someone who can function but not optimally. Most caregivers are unpaid, and are often a family member, friend, or neighbor. Formal caregivers are paid care providers or volunteers associated with a service system. keep track of how many days you have spent in the SNF to avoid unexpected costs after Medicare coverage ends.
Remember that you can again become eligible for Medicare coverage of your SNF care, once you have been out of a hospital or SNF for 60 days in a row. You will then be eligible for a new benefit period, including 100 new days of SNF care, after a three-day qualifying inpatient stay.
If you are receiving medically necessary physical, occupational, or speech therapy, Medicare may continue to cover those skilled therapy services Skilled therapy services include physical, speech, and occupational therapy services necessary for treating illness or injury, and performed by or under the supervision of a licensed therapist. See also: Physical Therapy, Speech-Language Pathology, and Occupational Therapy. even when you have used up your SNF days in a benefit period—but Medicare will not pay for your room and board, meaning you may face high costs. Check with your provider to see if you qualify for therapy at home through Medicare’s home health benefit, or if you could safely receive therapy as an outpatient An outpatient is a patient who has not been formally admitted into the hospital as an inpatient. Most outpatient care is covered under Medicare Part B (medical insurance). while living at home.
If you have long-term care insurance Long-term care insurance is provided by private insurance companies. It generally covers nursing home stays and can limit your health care costs, but the policies are often very expensive and may be subject to medical underwriting or provide limited benefits. , it may cover your SNF stay after your Medicare coverage ends. Check with your plan for more information. If your income is low, you may be eligible for Medicaid to cover your care. To find out if you meet eligibility requirements in your state, contact your local Medicaid office.