There is a Medicare “rule” or “qualification” for Skilled Nursing Facility Care that is explained on page 41 in the “Medicare and You 2016” handbook. The following is important information regarding this rule:

1.) Medicare covers semi-private rooms, meals, skilled nursing and rehabilitation services, and other services and supplies that are medically necessary after a 3-day minimum medically-necessary inpatient hospital stay for related illness or injury. An inpatient hospital stay begins the day you are formally admitted with a doctor’s order and doesn’t include the day you are discharged. You must stay 3 days past mid-night to qualify.

2.) Until there has been a diagnosis, your loved one may be in “observation” and not formally admitted into an inpatient hospital stay. It is important to check with hospital staff to understand if your loved one has been formally admitted into an inpatient stay.

3.) To qualify for Skilled Nursing, your doctor must certify that you need daily skilled care like intravenous injections, physical, occupational, or speech therapy.

4.) You pay nothing for the first 20 days and a co-pay per day for days 21-100 for a benefit period.

5.) Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) for more information.