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Caring Senior Service of Tucson

Caring Senior Service of Tucson Blog

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When Medicare Pays for Skilled Rehab for Seniors: Conditions that Meet Eligibility Requirements

Posted by Ruby Cemental on Sep 12, 2017 5:30:00 PM

Rehab_seniors-LR.jpgAs seniors age, they may be more susceptible to illness and injury. Sometimes they may get better with a short hospital stay and outpatient care, but sometimes more intensive therapy may be needed after they leave the hospital. They may need Skilled Rehab/Skilled Nursing services. Sometimes seniors will be sent to Skilled Nursing Facilities (SNF) to recover and receive necessary therapies on an inpatient basis. Unfortunately, this can be very costly and many families are not prepared to cover the cost, as the need for skilled nursing care is often unexpected. Medicare does pay for SNF, but there are several conditions that need to be met for the patient to be eligible for these services.

1. The patient must have Medicare Part A or hospital insurance. He/she must also have days left in their benefit period, which is usually 100 days.

2. A qualifying hospital stay must have occurred. The patient must have received inpatient care for 3 consecutive days or more for the condition(s) for which skilled nursing is needed.

3. A physician must order skilled nursing services to include therapies and services such as occupational therapy, physical therapy, LPN care, speech-language pathology, etc.

4. The required skilled care should be given on a daily basis and can also be provided during an inpatient stay.

5. SNF care must be necessary in order for the patient’s condition to improve and to prevent his/her condition from worsening.

It is important to remember that Medicare will only cover SNF service while the patient’s condition is improving. Once he/she has recovered, Medicare will no longer cover the cost. It is also important to remember that Medicare only covers the cost of SNF care for up to 100 days. Sometimes recovery may take longer than this benefit period so it is crucial to research additional financing options.

At Caring Senior Service, our expert staff is comprised of extremely knowledgeable, friendly, and trusted professionals who take pride in helping your loved one manage their daily activities. Contact us today to learn more!

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Topics: Medicare

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