Medicare: What Will You Pay for Nursing Facility Care?

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Original Medicare offers partial coverage for Skilled Nursing Facility (SNF) care. There are rules and limitations that apply to Skilled Nursing Facility coverage and care.

What Happens at a Skilled Nursing Facility?

A Skilled Nursing Facility facilitates inpatient rehab. Physical, Occupational, and Speech Therapy are among services for boomers and seniors at a SNF. Basically, anything that helps treat and manage your post hospital care.

Don’t Confuse Custodial Care for Skilled Nursing Facility Care

Skilled Nursing Facility care is not custodial care. This is important to make the distinction because Original Medicare doesn’t cover care that only helps you get in and out of bed, feed you, bathe you, and/or help you put on your clothes and use the bathroom provide Custodial Care.

How Medicare Covers Skilled Nursing Facilities

Onursingriginal Medicare covers only a portion of Skilled Nursing Facility fees. This is what you’ll pay if you are admitted into a SNF:
• First 20 days at a Skilled Nursing Facility you pay $0.
• Days 21-100 at an SNF you pay $152 per day in 2014.
• After 100 days you pay everything out of pocket.

The majority of Medicare Supplement plans cover the $152 Skilled Nursing Facility coinsurance. This could save you $12,160. But even Medigap won’t cover you if you fall into the 3 day Skilled Nursing Facility dark secret.

Skilled Nursing Facility’s Dark Secret

Medicare will only cover your Skilled Nursing Facility costs if you have a qualifying 3-day hospital stay. Seems simple, right? But it’s actually not. Many hospitals will keep you under “observation” as an out-patient, rather than admit you as an in-patient even if you’re there for 3 days. It’s important that you keep up with your status.

adviceSkilled Nursing Facility Advice

1) Make sure you are officially admitted to the hospital for 3 full days before seeking Skilled Nursing Facility care.
2) Consider Medigap Plan F or C, D, M, or N to pay for 100% of the Skilled Nursing Facility coinsurance.
3) Consider a Long Term Care (LTC) policy if you are interested in custodial care.

Amy De Vore writes articles that pertain to health issues for Senior65 and Medicoverage.com. She is an MFA candidate of fiction at University of California, Riverside, and is completing her first novel.

 

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