Medicare covers up to 100 days of SNF care per benefit period. Learn what happens when your coverage runs out and how to qualify for a new benefit. If you are in need of Home Care near Gunpowder MD, learn what happens when your coverage runs out, how to qualify for a new benefit period, and alternative options for continuing care. Part A limits SNF coverage to 100 days in each benefit period. Hospitalizations may have extended your father's skilled nursing facility (SNF) coverage by a few days because the time spent in the hospital shouldn't count toward 100 days. However, you will not receive a new 100-day allowance until you have been out of the hospital and the SNF for at least 60 days.
While Medicare doesn't pay for long-term care, it will cover up to 100 days of care in a skilled nursing facility (SNF). However, there are some fairly strict and somewhat confusing requirements that patients must meet before Medicare extends this benefit. Unfortunately, because the rules have some nuances, many patients have to pay for SNF care that they assumed would be covered. 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.
You may think you've been hospitalized for three days, but you don't qualify yet because the hospital certifies that you're there only for observation, not as an inpatient. If your interruption in specialized care service lasts at least 60 days in a row, this ends your current benefit period and renews your SNF benefits. The actual value of the Medicare benefit for SNF means that for the first 20 days, patients don't pay anything, and for days 21 to 100, patients are responsible for a co-payment (unless they have a Medigap policy that covers co-payments). You may not need a minimum 3-day hospital stay if your doctor is involved in a responsible care organization or other type of approved Medicare initiative to establish a three-day exemption in a skilled nursing facility.
If you need more than 100 days of SNF care in a benefit period, the benefit period is the amount over which Medicare pays for hospital and skilled nursing facility (SNF) services. It is likely that, for as long as a patient remains in the SNF, the center will issue a “notice of lack of coverage” stating that the patient no longer needs specialized care and stating that Medicare coverage will end (even if the patient has not been on the SNF for the allowed 100 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. If your break in specialized care lasts longer than 30 days, you need a new 3-day hospital stay to be eligible for additional care from the SNF. Remember that you can once again qualify for Medicare coverage for your SNF care, once you've been out of the hospital or SNF for 60 consecutive days.
