Medicare Part A covers inpatient hospital, limited skilled nursing facility, and some home health care services.
The Medicare Part A inpatient hospital deductible is $1,484 in 2021. It covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2021, beneficiaries must pay a coinsurance of $371 per day for the 61st through 90th day of a hospitalization in a benefit period and $742 per day for lifetime reserve days. Medicare stops covering the costs once you exhaust your lifetime reserve days. For beneficiaries in skilled nursing facilities, the daily coinsurance is $0 for days 1-20, and $185.50 per day for days 21 through 100 of extended care services in a benefit period.
Medicare only pays for Skilled Nursing Facilities (SNF) for a short time under specific requirements:
- You must be an inpatient at an approved hospital for at least three days. This means being admitted, not “under observation”. Note: During the COVID-19 pandemic, some people may be able to get renewed SNF coverage without first having to start a new benefit period. If you’re not able to be in your home during the COVID-19 pandemic or are otherwise affected by the pandemic, you can get SNF care without a 3-day qualifying hospital stay.
- You must be admitted to a Medicare-certified nursing facility within 30 days of your 3-day inpatient hospital visit
- You must require additional therapy such as physical or occupational
- Your condition medically demands skilled nursing services
Medicare long term eligibility starts after meeting these requirements and pays for a maximum of 100 days during each benefit period.
Hospital charitable programs and Medicaid may be available to you, check with the Social Worker at the hospital or nursing home. MMAP recommends you plan ahead by consulting with a financial planner or an elder law attorney.