MEDICARE COVERAGE Q & A
Below are some of the most frequently asked questions about how Medicare coverage works for skilled nursing/rehabilitation services. We hope you find this helpful. Our Caring Place Healthcare Group Admissions Directors are available to answer questions you have, whether you stay with us or not. Your insurance plan could be different, so we encourage you to contact us for specifics on your policy.
Q: What charges does Medicare cover?
A: It will cover your room and board, therapy, medications, and medical equipment for the first 20 days of your Medicare stay. X-rays and blood testing are also included in the coverage for the first 20 days.
Q: Will I have any co-pays?
A: Depending on the type of coverage you have, you may have a co-pay. Any one of our Caring Place Healthcare Group facilities listed on the right page will be able to check your benefits once we have your insurance information.
Q: If I feel that I am not strong enough after returning home, am I able to come back into the facility for more rehabilitation?
A: Medicare allows you a 30 day window from your hospital or rehab discharge date to be admitted or readmitted to a rehab/skilled nursing facility for further treatment. Medicare can continue to pay up to your maximum available days as long as you continue to meet Medicare guidelines.
Q: My loved one has been in the hospital for 3 days. Will they qualify for traditional Medicare coverage? What if my loved one has Managed Medicare?
A: Traditional Medicare requires that a person be admitted as an “inpatient” for 3 consecutive midnights. Any time spent in “observation status” does NOT count toward the required three consecutive midnight stay. Managed Medicare, on the other hand, does not necessarily require a hospital stay. However, clinical information must be submitted to the insurance company and prior authorization must be obtained prior to the start of a skilled stay. Admission to a skilled facility prior to pre-authorization being obtained may result in un-paid days.
Our Admission Directors have years of experience working with Medicare, Medicaid and private insurances. We are here to help you with any questions .Visit our Contact Us page for a complete list of our locations, Admission Director’s name and a phone number.
We also offer this official booklet from the Centers for Medicare & Medicaid Services that explains coverage of skilled nursing facility care in more detail. Click here.
Some rules may change so we advise you to visit their website or contact us. Visit Medicare.gov