“Skilled nursing facility” is often shortened to SNF—pronounced like “sniff.” SNF care is post-hospital inpatient care. SNFs can be their own facilities, or they can be part of nursing homes or hospitals.

 

Who is eligible?

Medicare Part A may cover your SNF stay if all apply to you:

• You were admitted as an inpatient to a hospital for at least three days in a row
• You enter a Medicare-certified SNF within 30 days of leaving the hospital.
• You receive care for the same condition that you were treated for during your hospital stay.
• You need skilled nursing care seven days per week, or you need skilled therapy services at least five days per week.

 

What SNF care does Medicare cover?

• A semi-private room and meals
• Skilled nursing care by nursing staff
• Therapy, like physical therapy, speech therapy, and occupational therapy
• Medical social services and dietary counseling
• Medications
• Medical equipment and supplies
• Ambulance transportation to the nearest provider of needed services, in some cases

 

What will SNF care cost me?

Each benefit period:

• Days 1-20: Part A covers the full cost.
• Days 21-100: Part A covers part of the cost, and you pay a daily coinsurance.
• Past day 100: You pay out of pocket.

 

What’s a benefit period?

A benefit period begins the day you are admitted to a hospital or SNF as an inpatient. It ends the day you have been out for 60 days in a row. You can again become eligible for Medicare coverage of your SNF care once you’ve been out of the hospital or SNF for 60 days in a row. You will then be eligible for a new benefit period, including 100 new days of SNF care, after a three-day qualifying inpatient stay.

 

Where can I get more help?

• Speak to your doctor or hospital discharge planner if you need help finding a Medicare-certified SNF.
• If you have a Medicare Advantage Plan, contact the plan to learn which SNFs are in their network. Also ask about the plan’s specific costs and coverage rules for inpatient care.
• Contact your ASR Agent, Medicare or local State Health Insurance Assistance Program (SHIP) for help understanding your SNF coverage.

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FOR OTHER QUESTIONS, CONTACT AMERICAN SENIOR RESOURCES at 1-866-448-0160 TTY 711 M-F or SCHEDULE AN CONSULTATION ONLINE WITH AN ASR LICENSED AGENT.