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How long does Medicare cover my SNF (Skilled Nursing Facility) care?
Medicare uses a period of time called a benefit period to keep track of how many days of SNF benefits you use, and how many are still available. A benefit period begins on the day you start using hospital or SNF benefits under Part A of Medicare. You can get up to 100 days of SNF coverage in a SNF benefit period. Once you use those 100 days, your current benefit period must end before you can renew your SNF benefits.
Your benefit period ends - when you have not been in a SNF or a hospital for at least 60 days in a row, OR
- if you remain in a SNF, when you haven't received
skilled care there for at least 60 days in a row. There is no limit to the number of benefit periods you can have. However, once a benefit period ends, you must have another 3-day qualifying hospital stay and meet the Medicare requirements as listed on page 11 before you can get another 100 days of SNF benefits.
What if I stop getting skilled care in the SNF (Skilled Nursing Facility), or leave the SNF altogether? How does this affect Medicare SNF coverage if I need more skilled care in a SNF later on?
This depends on how long your break in SNF care lasts. If your break in SNF care lasts for
Less than 30 days
At least 30 but less than 60 days
At least 60 days - You don't need a new 3-day hospital stay to qualify for coverage of additional SNF care.
- Since your break in SNF care lasted for less than 60 days in a row, your current benefit period would continue. This means that the maximum coverage available would be the number of unused SNF benefit days remaining in your current benefit period.
- Medicare won't cover additional SNF care unless you have a new 3-day hospital stay.
The new hospital stay need not be for the same condition that you were treated for during your previous stay. - Since your break in SNF care lasted for less than 60 days in a row, your current benefit period would continue. This means that the maximum coverage available would be the number of unused SNF benefit days remaining in your current benefit period.
- Medicare won't cover additional SNF care unless you have a new 3-day hospital stay.
The new hospital stay need not be for the same condition that you were treated for during your previous stay. - Since your break in skilled care lasted for at least 60 days in a row, this would end your current benefit period and renew your SNF benefits. This means that the maximum coverage available would be 100 days of SNF benefits.
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