Skilled Nursing Facility Care
Medicare Part A (Hospital Insurance) covers skilled nursing care provided in a Skilled Nursing Facility (SNF) in certain conditions for a limited time (on a short-term basis) if all of these conditions are met:
- You have Part A and have days left in your benefit period to use.
- You have a qualifying hospital stay.
- Your doctor has decided that you need daily skilled care. It must be given by, or under the supervision of, skilled nursing or therapy staff.
- You get these skilled services in a SNF that’s certified by Medicare.
- You need these skilled services for a medical condition that’s either:
- A hospital-related medical condition treated during your qualifying 3-day inpatient hospital stay, even if it wasn’t the reason you were admitted to the hospital.
- A condition that started while you were getting care in the SNF for a hospital-related medical condition (for example, if you develop an infection that requires IV antibiotics while you’re getting SNF care)
What is it?
Skilled care is nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel. It’s health care given when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care.
- Semi-private room (a room you share with other patients)
- Skilled nursing care
- Physical therapy (if needed to meet your health goal)
- Occupational therapy (if needed to meet your health goal)
- Speech-language pathology services (if they’re needed to meet your health goal)
- Medical social services
- Medical supplies and equipment used in the facility
- Ambulance transportation (when other transportation endangers health) to the nearest supplier of needed services that aren’t available at the SNF
- Dietary counseling
- Swing bed services
What are my costs?
- Days 1–20: $0 for each benefit period.
- Days 21–100: $176 coinsurance per day of each benefit period.
- Days 101 and beyond: all costs.