Handling your care at home after an inpatient hospital or skilled nursing facility (SNF) stay can be confusing and difficult.

Medicare Part B pays your primary care provider, internist or general practitioner, to manage your care at home in the first 30 days after you leave a SNF or hospital. Medicare pays 80% of a set fee for this care coordination benefit. You pay 20% of the Medicare-approved amount. If your doctor doesn’t take Medicare assignment, you may pay more.

Medicare covers this service whether you were an inpatient or an outpatient. Your primary provider may automatically provide you with care coordination services following your hospital stay. Otherwise, you can ask. Although the hospital or SNF may have already notified your primary care provider, it’s a good idea to make sure the hospital or SNF sends along information.

Before you return home, the staff at your hospital or SNF may provide you and your caregivers with instructions on how to manage your care.  They may also give you referrals to home health care agencies and other resources. To understand these instructions and follow up with referrals, you should have your primary care provider help you manage and organize your care.

Under this benefit, your provider should examine you in his or her office within 14 days of your return home, or 7 days if your condition is more complicated. This benefit also includes communication from your primary care provider and their staff outside of an office visit, including:

  • Contacting you within 2 days of your leaving the hospital or SNF
  • Talking with your home health agency and other community groups helping you
  • Working with other health care providers (i.e. specialists) who are helping you
  • Making sure you are taking the right medication in the right way once you get home
  • Reviewing your need for follow-up visits and tests and helping you arrange them
  • Helping to identify and connect you to other community organizations for more help
  • Educating you and your caregivers about caring for you at home

If you have questions about receiving this benefit, speak to your primary care provider.