Medicare will cover skilled nursing care if all the following are true:

  1. You have Medicare Part A (Hospital / Institutional Insurance) and have days left in your benefit period.
  2. You have a qualifying hospital stay.  This means an inpatient hospital stay of 3 consecutive days or more.  You must enter the Skilled Nursing Facility (SNF) within a short period of time of leaving the hospital.
  3. Your doctor has ordered the services you need for SNF care, which require the skills of professionals such as registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech-language pathologists, etc.
  4. You require the skilled care daily and the services must be ones that can only be provided in a SNF on an inpatient basis.
  5. You need these skilled services for a medical condition that:
    1. Was treated during a qualifying 3-day hospital stay, or
    2. Started while you were getting SNF care for a medical condition that was treated during a qualifying 3-day hospital stay.
  1. Your Costs in Original Medicare (your responsibility):
    1. Days 1-20 $0 for each benefit period (no cost patient responsibility)
    2. Days 21-100 $185.50 per day Coinsurance in 2021 (patient responsibility)
    3. Days 101 and beyond all costs (all costs are the responsibility of the patient)

Does Medicare cover Long Term Care Facilities?

No, Medicare does not cover care in a Long-Term Care Facility.