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.
