Paying for Care Rehabilitation

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Medicare

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.

From day 21-100, Medicare will pay all fees except for a daily co-pay, which may be reduced if the individual has a Medigap policy or participates in a Medicare Advantage Plan. If the rehabilitation stay goes beyond 100 days, payment is the individual’s responsibility.

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

How much is covered by the Original Medicare Plan?

For Days Medicare Pays for Covered Services You Pay for Covered Services
1-20 Full Cost Nothing
21-100 All but a daily co-pay Daily co-pay
Beyond 100 Nothing Full Cost

Medicaid

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.

Medicare Supplemental Insurance

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.

Medicare.gov/NHcompare   Eldercare.gov

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