If you fall or become otherwise injured and need rehabilitative services in a skilled nursing facility (SNF) after a hospitalization, here’s what Medicare will cover:
- Semi-private room
- Meals
- Skilled nursing care
- Physical therapy
- Occupational therapy
- Medical social services
- Medications
- Medical supplies and equipment used in the facility
- Ambulance transportation (when other transportation endangers health)
- Dietary counseling
Coverage
Medicare will cover your rehab if you meet all of these conditions:
- You have Medicare Part A
- You have a qualifying hospital stay of at least 3 days
- Your doctor has decided that you need skilled nursing care
- The SNF has been approved by Medicare
Observation status
It’s important to note that you need to be formally admitted to the hospital as an inpatient in order for Medicare to pay for rehab after you’re discharged. If you are not an inpatient for at least three days, Medicare will not cover your rehab. Your doctor may hold you under observation status while deciding if you need to be admitted or treated with outpatient services, which are covered by Part B. This means, if you spend three days in the hospital but you weren’t formally admitted until the third day, Medicare will not pay for rehab. In order for Medicare to pay for your rehab after you’re discharged, you need to have spent at least three days in the hospital as an inpatient.
Cost
Medicare will cover the full cost of services for the first 20 days of skilled nursing care. From days 21-100, you will pay a coinsurance of $167.50 per day. After that, you are responsible for the full cost of services rendered to you.
