Medicare Part A Benefits

A patient must have a 3-midnight qualifying hospital stay in order to receive Medicare benefits in a skilled nursing facility.

Day 1-20:
Medicare pays 100%

Day 21-100:
As of January 1, 2017, Medicare pays anything above $164.50 per day for days 21-100. If you have a supplemental insurance policy, this policy may pick up this co-pay. 

These are the maximum number of days Medicare provides. Medicare only covers what they consider a “skilled care need.” This includes skilled physical, occupation or speech therapy, IV medication, extensive wound care and new feeding tube placements. In skilled therapy, the patient must make “significant functional progress” on a weekly basis. If the patient reaches their goal and becomes independent enough to return home, Medicare stops payment. If the patient reaches a point where they plateau and are not making significant functional progress, Medicare stops payment. You/and your POA or family will be notified if the Interdisciplinary team observe this happening. 

For more information visit: http://www.medicare.gov