What is paid for under Medicare
1. You must have a Medicare card that reads hospital insurance.
2. Your physician must certify that you need skilled care on a continuing basis.
3. You must spend a minimum of three consecutive days (not counting day of discharge) in a hostpital no longer than 30 days prior to entering the skilled nursing facility.
4. Your need for skilled care must relate to your reason for hospitalization.
What is paid for under Medicare Part A while in a skilled nursing facility
Semi - Private Rooms
Nursing & Rehabilitation Services
Supplies and Medical Equipment
What are the Medicare rates if the qualifying criteria are met?
1-20 days: You pay nothing; Medicare pays in full.
21-100 days: Daily co-insurance rate is determined by Medicare.
100+ days: Medicare no longer pays.
Does Medicare pay me directly?
No. Medicare pays the provider of the medical services (the hospital, skilled nursing facility or home health agency). The provider will send the bill to Medicare.
How will I be notified of Medicare status changes?
You will receive a letter explaining your Medicare status when admitted to the skilled nursing facility. If your Medicare status changes before your 100 days are used, you will be notified by another letter.
Medicare Part B
If you have medical coverage under Medicare Part B and are eligible for the services provided, you will be responsible for 20 percent of the total charges of some of the following services:
• Medical Supplies
We will bill Private Insurances as a courtesy based on your plans provisions. However it does not guarantee payment.