Dear Marci, I have a surgery scheduled soon and will probably need to stay in a skilled nursing facility to recover afterward. Will Medicare cover my stay in the skilled nursing facility? -Megumi (Honolulu, HI) Dear Megumi, Skilled nursing facility (SNF) care is post-hospital care provided at a SNF. Skilled nursing care includes services such as administration of medications, tube feedings, and wound care. Keep in mind that SNFs can be part of nursing homes or hospitals. Medicare Part A may cover your SNF care if: You were formally admitted as an inpatient to a hospital for at least three consecutive days You enter a Medicare-certified SNF within 30 days of leaving the hospital, and receive care for the same condition that you were treated for during your hospital stay And, you need skilled nursing care seven days per week or skilled therapy services at least five days per week The day you become an inpatient counts toward your three-day inpatient stay to qualify for Medicare-covered SNF care. However, the day you are discharged from the hospital does not count toward your qualifying days. Also remember that time spent receiving emergency room care or under observation status does not count toward the three-day hospital inpatient requirement for SNF coverage. If you meet all the above requirements, Medicare should cover the SNF care you need to improve your condition, maintain your ability to function, or prevent your health from getting worse. Note: Because of the coronavirus public health emergency, Medicare has removed the three-day qualifying hospital stay requirement for beneficiaries who experience dislocation or are otherwise affected by the coronavirus public health emergency. According to Medicare, this waiver includes but is not limited to beneficiaries who: Need to be transferred to a SNF, for example, due to nursing home evacuations or to make room at local hospitals Need SNF care as a result of the current public health emergency, regardless of whether they were previously in the hospital Speak to your doctor or hospital discharge planner if you need help finding a SNF that meets your needs. Ask them to find Medicare-certified SNFs in your area that will address your medical needs. If you are in a Medicare Advantage Plan, contact your plan to find out which SNFs are in their network. -Marci |