Dear Marci,
I recently had a hip surgery, and my doctor recommended a short stay at a skilled nursing facility (SNF) for rehabilitation. I have Part A but I’m unsure what services are included under the SNF benefit?
– Larry (Sioux Falls, SD)
Dear Larry,
Great question! Skilled nursing facility (SNF) care is post-hospital care provided at a SNF. SNFs can be part of nursing homes or hospitals.
During a Medicare-covered SNF stay, Part A covers:
- A semi-private room and meals
- Skilled nursing care provided by nursing staff
- Therapy, including physical therapy, speech therapy, and occupational therapy
- Medical social services and dietary counseling
- Medications
- Medical equipment and supplies
- Ambulance transportation to the nearest provider of needed services, when other modes of transportation would endanger your health
Each benefit period, Part A covers the full cost of your first 20 days in a SNF. For days 21-100, Part A covers part of the cost and you pay a daily coinsurance. To be eligible for Medicare SNF coverage, your care must be medically necessary.
Medicare Part A covers SNF care if:
- You were formally admitted as an inpatient to a hospital for at least three consecutive days
- You enter a Medicare-certified SNF within 30 days of leaving the hospital, and receive care for the same condition that you were treated for during your hospital stay
- And, you need skilled nursing care seven days per week or skilled therapy services at least five days per week
Keep in mind that the day you become an inpatient count toward your three-day inpatient stay to qualify for Medicare-covered SNF care. However, the day you are discharged from the hospital does not count toward your qualifying days. Also remember that time spent receiving emergency room care or under observation status does not count toward the three-day hospital inpatient requirement for SNF coverage.
Speak to your doctor or hospital discharge planner if you need help finding a SNF that meets your needs. Ask them to find Medicare-certified SNFs in your area that will address your medical needs. If you are in a Medicare Advantage Plan, contact your plan to find out which SNFs are in their network.
Hope this is helpful!
-Marci