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Taking the guesswork out of your plan!

Skilled Nursing Home Benefits

Original Medicare offers some benefits for Skilled Nursing Care provided in a skilled Nursing Facility. Unfortunately, few people understand what skilled nursing is.

First, they should know that Skilled Nursing care is not Custodial Care: Nurses that ONLY help them get in and out of bed, feed them, bathe them, help them put on their clothes or use the bathroom are providing custodial care. Medicare does not cover Custodial Care.

What is Skilled Nursing? Skilled Nursing is basically inpatient rehabilitation services like Physical, Occupational, and Speech Therapy are examples of Skilled Nursing Care. Basically, anything that helps treat and manage their post hospitalization rehabilitation fall under this category as long as it takes place at a Skilled Nursing Facility.

The patient must receive a "skilled" level of care in the nursing facility that cannot be provided at home or on an outpatient basis. In order to be considered "skilled," nursing care must be ordered by a physician and delivered by, or under the supervision of, a professional such as a physical therapist, registered nurse or licensed practical nurse. Care must also be delivered on a daily basis.

Original Medicare covers 100% of Skilled Nursing Facility costs for the first 20 days per benefit period, as long as they have met all of the Medicare benefit criteria. The next 80 days they are required to pay a substantial daily co-payment per day equal to one-eighth of the initial hospital deductible.

If they are confined to a Skilled Nursing Facility for more than 100 days they will have to pay for any extra days out of their own pocket.

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