Medicare covers up to 100 days in a skilled nursing facility. Learn more about what qualifies for coverage and what doesn't. Understanding the parts and costs of Medicare can help make it easier to understand. The large number of Medicare-related terms can make it difficult to understand. Understanding the definitions of these terms can help.
While long-term care coverage in nursing homes is limited, Medicare provides other important benefits to nursing home residents. You don't have to pay a deductible for inpatient rehabilitation if Medicare has already charged you a deductible for care you received at a hospital during the same benefit period. In addition, Medicare members who permanently reside in nursing homes “can certainly use their health care benefits for their intended purposes,” Newsholme said. If you or someone you know is considering nursing home care, make sure you fully understand what services Medicare does and doesn't pay for.
Medicare Part A (hospital insurance) covers medically necessary care you receive in an inpatient rehabilitation center or unit (sometimes referred to as a “rehabilitation center,” IRF, intensive care rehabilitation center, or inpatient rehabilitation hospital). A person doesn't have to pay a deductible for inpatient rehabilitation if Medicare already charged a deductible for care they received at a hospital during the same benefit period. Your doctor must certify that you have a medical condition that requires intensive rehabilitation, ongoing medical supervision, and coordinated care from your doctors, other healthcare providers and therapists. 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.
Be sure to visit the NCOA BenefitsCheckUp to look for other benefit programs that can help you pay for health care, food, prescription drugs, utilities and other basic living costs. Inpatient rehabilitation can help if you are recovering from serious surgery, illness or injury and need an intensive rehabilitation therapy program, the supervision of a doctor and the coordinated care of your doctors, other health professionals and therapists. People who get their health insurance through one of these plans receive at least the same coverage as people who choose original Medicare. It should be noted that Medicare only pays for up to 100 days of care in a skilled nursing facility during each benefit period.
Your doctor must certify that you have a condition that requires ongoing medical supervision, intensive rehabilitation, and coordinated care so that Medicare can cover inpatient rehabilitation.
