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Medicare Eligibility in a Skilled Nursing Facility:
(All five criteria must be met.)

  • Must be a hospital inpatient for three or more consecutive days, NOT including the day of discharge.
  • A physician must indicate skilled care is needed on a daily basis.
  • Care in the skilled nursing facility is due to a condition that was treated in the hospital.
  • Care must be provided in a Medicare-certified skilled nursing facility.
  • Coverage for skilled nursing facility days are available (coverage limits have not yet been reached) under Medicare Part A.

Medicare benefits in a Skilled Nursing Facility:

  • First 20 days Medicare pays entire cost.
  • Next 80 days patient pays $137.50 per day and Medicare pays the rest.
  • After 100 days patient pays the entire cost.

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