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 looking for Home Care near Phoenix MD, learn what happens when your coverage runs out, how to qualify for a new benefit period, and alternative options for continuing care. While Medicare doesn't pay for long-term care, it will cover up to 100 days of care in a skilled nursing facility (SNF) near Phoenix MD.
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 are forced to pay for the SNF care they thought would be covered. If you don't have an eligible 3-day hospital stay and need medical care after being discharged from the hospital, ask if you can receive care in other settings (such as home health care) or if there are any other programs (such as Medicaid or veterans benefits) that may cover the care you receive in the SNF. If you need more than 100 days of SNF care in a benefit period, the benefit period is the amount of time that Medicare pays for the services of a hospital and a skilled nursing facility (SNF).Remember that you can once again be eligible for Medicare coverage for your SNF care, once you've been out of the hospital or SNF for 60 straight days. It is likely that, during the time a patient is admitted to 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 admitted to the SNF for the allowed 100 days).
This is also true if you stop receiving specialized care while you are in the SNF and you receive it again within 30 days. You may not need a minimum 3-day hospital stay if your doctor is involved in a responsible care organization or other type of Medicare initiative approved for a “3-day exemption in a skilled nursing facility”. If your break in specialized care lasts longer than 30 days, you will need a new 3-day hospitalization to qualify for additional care from the SNF. The real value of the Medicare benefit for SNF means that for the first 20 days, patients pay nothing and, for days 21 to 100, patients are responsible for a co-payment (unless they have a Medigap policy, which covers co-payments).
It should be noted that Medicare only pays for a maximum of 100 days of care in a skilled nursing facility during each benefit period. If your break in specialized care lasts at least 60 consecutive days, this ends your current benefit period and renews your SNF benefits.
