so this is important talking about medicare and skilled nursing coverage i had a call yesterday
from a woman whose mother broke her arm and they took her to the hospital and obviously
medicare covers hospital costs she was there for about three days and then she was discharged to a
skilled nursing facility for rehab so obviously medicare would cover skilled nursing correct
well she was quite shocked when she got a bill from that skilled nursing facility
for about four thousand dollars so certainly very important understand when medicare covers
skilled nursing and when it does not you might be surprised i'm gonna go over right now stay tuned
so let's talk about medicare and skilled nursing coverage so it's important to understand this
because we don't want any surprises if we're in a position where we need skilled nursing care
basically rehab or physical therapy we want to make sure that medicare covers it so i'm going to
go through it real quick and show you exactly what you need to know so you don't have any surprises
and when we're talking about skilled nursing care you know what is it first of all a lot of people
think about long-term care and long-term care might take place in a skilled nursing facility
but skilled nursing care especially as it's related to medicare is really related to rehab
so physical therapy things of that nature and it happens at a skilled nursing facility so they
generally evaluate they manage they treat and they observe and it's generally done by registered
nurses or practical nurses physical therapists speech therapists occupational therapists things
of that nature kind of putting you back to where you were before you got there so it's important
to understand how they function because it can be crazy expensive if it's not done correctly so
we want to make sure again going in we don't have any surprises so if you're admitted or
discharged into a skilled nursing facility you're likely going to have a semi-private room so you
probably have a roommate they're going to provide the medications they're going to have nursing care
meals and then therapy so whether it's physical speech occupational whatever therapy it may be
generally going to take how take place in the skilled nursing facility so where can it be a
problem like i alluded to in the beginning of the video i had somebody call me recently and
her mother had broken her arm and she went to the hospital they set the arm she was there for almost
three days and then she was discharged into a skilled nursing facility for rehab to help it
get better to get back to where she can manage things on her own and weeks later the daughter
received a bill for almost four thousand dollars from skilled nursing so how can that happen
when the mother has medicare so some things medicare does not cover with skilled nursing
number one long-term care and that's a big big deal and a whole different subject so it does
not cover long-term care also doesn't cover custodial care where there's no improvement
in a situation but this woman had improvement so how could it possibly be that she got such a large
bill well there's two ways that you can actually be admitted into the hospital and the first one
is obvious inpatient admission so if you're going to hospital and you're overnight you're in patient
admission correct well not so much and not so much as it used to be now they have admitted for
observation so if you're admitted for observation it's not the same as an inpatient admission even
though she was there for almost three days they coded it as observation and medicare will not
pay for skilled nursing if you're coming off a observation admission into a hospital so in
order to get medicare to pay for skilled nursing you have to have three or more days in patient
admission in the hospital before medicare is going to take care of the skilled nursing costs so very
important understand that because skilled nursing can run three or four hundred dollars a night
and if you think medicare is paying for it and they're not it can obviously create some problem
so when medicare does pay for it so if you've had three or more inpatient hospital admission days
and you're discharged with skilled nursing this is how medicare covers it so the day one through 20
they pay right off the bat so there's no cost to day one through 20 with the exception of your
part b deductible so it'd be considered outpatient care at a skilled nursing facility
days 21 through 100 medicare a and b pays all of it except 485.50 a day so your responsibility
would be 185.50 per day from day 21 to 100. now good news is if you have a medicare supplement
it's going to cover that 185.50 so there's really no out of pocket cost to you up into
a hundred days in a skilled nursing facility now you likely don't wanna stay there that
long but if god forbid you had that happen then at least you won't have a big out of pocket expense
day 100 plus no coverage so it's whatever the going rate is at that skilled nursing facility
on day 100 plus so that kind of turns into long-term care so certainly important to
understand that before it actually gets there and again if you have a medicare supplement plan
it's going to kick in and cover that gap of 185.50 so it keeps you kind of out of the
out of pocket range all the way up to day 100 in skilled nursing so certainly good to understand
on how it works so obviously if you have any questions we're here to help with any medicare
related items not just skilled nursing if you have any questions give me a call send me an email
obviously visit medicareonvideo.com i have videos on just about everything
we'd love to help you with your medicare supplement plan that's how i make my living
and there's no cost you to let me help you so hopefully you'll take advantage of everything we
have and we'll make sure we get all your pieces in the right places so i hope you found this helpful
and share it with your friends because it's important information have a fantastic day