Nursing home care
Medicare Coverage Information
Overview
Medicare provides limited coverage for skilled nursing facility care following a qualifying hospital stay. Beneficiaries can receive short-term rehabilitative care and medical services under specific conditions, typically for a limited duration.
- Covers skilled nursing care after a qualifying 3-day hospital inpatient stay
- Limited to 100 days of care per benefit period
- Requires medical necessity and ongoing skilled care needs
- Covers semi-private rooms, meals, nursing care, and therapy services
- Does not cover long-term custodial care or permanent nursing home residence
- Medicare Part A beneficiaries
- Patients discharged from hospital after minimum 3-day inpatient stay
- Must require skilled nursing or rehabilitation services
- No cost for first 20 days of skilled nursing facility care
- $204.50 daily coinsurance for days 21-100
- Full costs apply after 100 days in benefit period
- Must be directly related to treatment of a medical condition
- Requires continued medical improvement
- Limited to short-term rehabilitative care
- Specific documentation and physician certification required
- Confirm coverage details with your specific Medicare plan
- Obtain physician certification of medical necessity
- Check with Medicare representative about current benefit periods
- Review detailed coverage requirements before facility admission
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare nursing home careskilled nursing facilityMedicare Part Along-term care coveragenursing home benefits
Related Coverage Topics
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