Part A limits SNF coverage to 100 days in each benefit period. While long-term care coverage in nursing homes is limited, Medicare provides other important benefits to nursing home residents. Let us help you navigate rehabilitation and Medicare coverage, ensuring that you receive the best possible care. Medicare Part A (hospital insurance) covers medically necessary care you receive at an inpatient rehabilitation facility or unit (sometimes referred to as a “rehabilitation center,” IRF), intensive care rehabilitation center, or patient rehabilitation hospital hospitalized).
You don't have to pay a deductible for inpatient rehabilitation care if Medicare already charged you a deductible for care you received in a previous hospitalization within the same benefit period. Understanding Medicare rehabilitation coverage for outpatient services can help you make informed decisions about your care. This is also true if you stop receiving specialized care while you are in the SNF and return to receiving specialized care within 30 days. People who get their health insurance through one of these plans receive at least the same coverage as people who choose original Medicare.
If your break in specialized care lasts at least 60 consecutive days, this ends your current benefit period and renews your SNF benefits. Medicare payment for care in a skilled nursing facility requires hospitalization for 3 days immediately prior to admission to the nursing home. It should be noted that Medicare only pays for a maximum of 100 days of care in a skilled nursing facility during each benefit period. These two parts of Medicare provide different types of coverage for rehabilitation services, whether you're staying in a facility or going for outpatient therapy. The benefit period begins the day you are admitted to a hospital or inpatient rehabilitation center (IRF) and ends when you haven't received any type of hospital care for 60 consecutive days.
If you don't have an eligible 3-day hospital stay and need care after being discharged from the hospital, ask if you can get care in other settings (such as home health care) or if any other programs (such as Medicaid or veterans benefits) can cover your SNF care. You may not need a minimum 3-day hospital stay if your doctor is involved in a responsible care organization or other type of Medicare initiative approved for an exemption from the 3-day rule in a “skilled nursing facility.”.
