Yes, Medicare covers skilled nursing facility care for up to 100 days in a benefit period, as long as you meet the eligibility requirements.
Medicare Skilled Nursing Facility Coverage
Skilled nursing facility care is skilled care given by licensed professionals in a Medicare-certified facility. These skilled professionals include registered nurses, licensed practical and vocational nurses, physical therapists, occupational therapists, speech-language pathologists, and audiologists. The care Medicare covers in skilled nursing facilities is care that can only be provided by or performed under the supervision of those skilled professionals.
Medicare-covered skilled nursing facility care does not include long-term care services, such as custodial care or homemaker services.
Skilled Nursing Facility Coverage Eligibility
To be covered for skilled nursing facility care, you have to be enrolled in Medicare Part A and have days left in your benefit period to use. A benefit period spans from the time you are admitted as an inpatient to the time when you have not received inpatient care for 60 days. You must also have a qualified inpatient hospital stay; this is a stay lasting at least three consecutive days, starting when you become an inpatient and not including the day you leave. Medicare wants you to have entered the skilled nursing facility within 30 days of leaving the hospital.
Your doctor must have ordered inpatient services in a skilled nursing facility that require the skills of or are provided by or under the supervision of skilled personnel such as nurses or physical therapists. You will need the skilled care on a daily basis, and it can only be given in a skilled nursing facility.
You need the services for an ongoing condition that was treated during your qualifying hospital stay or a condition which started while you were getting skilled care for the ongoing condition. The skilled nursing services must be reasonable and necessary for your condition, and you must receive the services at a Medicare-certified skilled nursing facility.
Limits to Skilled Nursing Care Coverage
Medicare will only cover the skilled nursing facility care for a limited period of time. Skilled nursing facility coverage lasts up to 100 days in a benefit period. If you have another qualifying inpatient stay of at least three days, you can qualify for another 100 days of coverage in a skilled nursing facility. If you need more care in a skilled nursing facility within 30 days of leaving, you do not need another qualifying inpatient stay to get coverage.
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