Skilled care is health care that requires skilled nursing or rehabilitation staff, including registered nurses; licensed practical and vocational nurses; physical, occupational, speech-language therapists; and audiologists to treat, manage, observe, and evaluate care.
Medicare will pay for covered care in a Medicare-certified skilled nursing facility (SNF) or rehabilitation facility after a qualifying hospital stay, which must be at least three overnights. A shortterm rehabilitation stay generally lasts 2 to 8 weeks.
The Medicare benefit period can be renewed if there is a 60- day wellness period. This means that the individual has not been in a SNF or hospital for 60 days.
|For Days||Medicare Pays for Covered Services||You Pay for Covered Services|
|21-100||All but a daily co-pay||Daily co-pay|
|Beyond 100||Nothing||Full Cost|
Medicaid is a state and federal program that pays for most SNF costs for individuals with limited income and assets. Check the Medicaid requirements in your state for eligibility requirements.
Called Medigap, this private insurance helps to cover gaps in Medicare, such as co-pays and deductibles for covered Medicare services. Employer group plans or long-term care insurance may also help to cover nursing home costs.
To learn more, call 800-MEDICARE (800-633-4273) and request a copy of Guide to Health Insurance for People with Medicare.
Nearly half of all SNF residents pay nursing home costs out of their savings and other assets. Once these resources are depleted, residents eventually become eligible for Medicaid.