Traditional Medicare plans cover a Skilled Nursing Facility (SNF) stay for up to 100 days per spell of illness. These days do not reset until a 60-day break in skilled care has occurred. A 3-day qualifying inpatient hospital stay is required prior to SNF admission. Additionally, your health care provider must certify that you need daily skilled care under supervision of skilled nursing or therapy staff. Medicare covers the first 20 days at 100%, and assigns a patient coinsurance to days 21 through 100. Custodial care (long-term care) is not covered by Medicare Part A.
Managed Care plans may cover a Skilled Nursing Facility (SNF) stay up to an allowed number of days per benefit period. A hospital stay may not be required under your plan. Most plans assign a patient coinsurance and/or deductible. Coverage varies depending on the plan, however determination of SNF admission coverage will be decided by your insurance provider. Custodial care (long-term care) is not covered by insurance.
Medicaid covers a custodial, or long-term care, Skilled Nursing Facility (SNF) stay for qualified Medicaid recipients. Contact DSHS for further information: Washington State Department of Social and Health Services | Transforming Lives