What is a Skilled Nursing Facility Coverage?

Original Medicare (Part A and B) Skilled Nursing Facility (SNF) coverage requires certification by Medicare or Medicaid. SNF’s are regulated by the Department of Health. Medicare certifies that these facilities are staffed and equipped to provide rehabilitation services, skilled nursing care and other related health care.

Please keep in mind that custodial care is not typically covered by Medicare. Custodial care is non-medical assistance like bathing, eating, dressing, toileting and other activities of daily living.

Services Provided by a Skilled Nursing Facility?

• Physical Therapy
Occupational Therapy
• Speech-Language Pathology
• Rehabilitation

Eligibility for Skilled Nursing Care

• A qualifying minimum 3 day hospital stay*
• Your physician determined that you require skilled nursing care
• You receive skilled nursing care in a Medicare certified facility
• Your condition is a hospital related or started within a hospital or SNF

*You must be considered an inpatient and formally admitted to a hospital for at least 3 days.

Skilled Nursing Facilities Provide…

• Semi-Private Room
• Meals
• Skilled Nursing Care
• Medications
• Supplies and Equipment for Medical use in SNF
• Ambulance Transportation

Skilled Nursing Facilities Staffing typically Include…

• Licensed Physical Therapists
• Licensed Occupational Therapists
• Registered Nurses
• Vocational Nurses
• Speech-language Pathologists

Your Skilled Nursing Facility Costs under Original Medicare

• Days – 1-20: $0 for each benefit period
• Days – 21-100: $164.50 Coinsurance Per Day for Each Benefit Period
• Days 101 and Beyond: All Costs

30 days after release from a Skilled Nursing Facility or Hospital requires a new 3 day hospital stay to qualify again for SNF care.

Important! You may lose your Skilled Nursing Facility coverage if you refuse daily care and therapy, unless an illness precludes you from treatment (ie. Flu, Viruses, etc) See more coverage details at Skilled Nursing Facility (Medicare.gov)

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