Are you currently hospitalized and receiving Medicare benefits? Did the hospital staff tell you that you are physically unsafe to return home? Did they make a recommendation to consider rehab in a skilled nursing facility (SNF)? Should you say yes?
SNFs offer skilled rehab services that include physical, occupational, and speech therapy. They also provide close monitoring of your medical condition by specialty trained medical providers and nursing staff.
It may sound like a good idea to transfer to a skilled nursing facility for rehab, but you should consider your options.. Before agreeing to a transfer to a skilled nursing facility you need to make sure you’re not putting yourself in financial jeopardy.
If you’ve been in the hospital and are heading to skilled rehab, you need to make sure your rehab stay is going to be covered under your Medicare benefits.
In order for Medicare to cover the expense of rehab you need to consider the following:
- Were you admitted as an inpatient? To be considered an inpatient in the hospital you need a qualifying medical reason to be admitted. You might think you have a valid reason, only to find out you were in the hospital under observation status. If you transfer to rehab after being on observation status you will be responsible for the entire cost of your stay.
- Have you spent 3 midnights in the hospital? The 3 to-midnight rule is required to qualify for Medicare coverage in an SNF. Again, Medicare will not pay for your rehab stay if you have not been an inpatient in the hospital for 3 consecutive days.
- Do you have a Medicare Advantage plan? These types of plans can be more flexible with the rule. They may defer this rule in an effort to reduce hospital costs. This will make it possible to transfer sooner and have your plan pay for all expenses during your first 20 days of rehab care.
Once again, the best time to plan for your discharge is on the day you arrive at the hospital. You need to ask the case manager or social worker right away what your current Medicare plan requires for you to qualify for reimbursed post-hospital care.
Never assume that just because you’re sleeping in a hospital bed and wearing a hospital gown you’ve been admitted to the hospital. If you don’t take the time to decipher your plans coverage you might be in for a huge surprise when you discover that you’re responsible for the entire cost of your rehab stay.
Each day you stay in rehab without Medicare coverage will cost you approximately $400!
A one-month uncovered stay will set you back $12,000!
Getting sick is complicated! Being in the hospital and needing post-hospital care is also complicated.
Make sure you have a knowledgeable family member or an independent health advocate in your corner if you need to be transferred to a skilled nursing facility for rehab services. Severino Health Advisors offers 15-minute free phone consultations to help you navigate the challenges of our healthcare system.