Did you know Medicare never extends coverage to a patient who needs custodial
care only? The custodial care may be provided as part of the Medicare skilled
nursing home coverage that is partially provided by Medicare Part A. There are
many restrictions, however, that apply to Medicare coverage for skilled nursing
What you may not realize is that nursing care requires that the care must be
provided by or requires the supervision of skilled nursing personnel or other skilled
rehabilitation services. As a practical matter, this can only be provided in a skilled
nursing home facility on an inpatient basis.
For each spell of illness in 2019, Medicare Part A will pay all the costs for a covered
skilled nursing home stay for the first 20 days. After that, it will cover all but $170.50
per day for up to an additional 80 days as long as all of the following conditions are
1. The individual was a patient in a hospital for three consecutive days, not including
the day of discharge. In addition, the patient must be admitted to the skilled nursing
facility within 30 days of discharge from the hospital. However, there are a few
limited exceptions to the requirement that the admission must occur within 30 days
of discharge from the hospital.
2. A doctor must certify that the patient needs skilled nursing home care.
3. The services are provided by or under the supervision of a trained individual.
4. The services are received on a daily basis, which means therapy services at least
5 days per week and/or nursing care 7 days per week.
5. The services are provided by a Medicare-certified skilled nursing facility.
6. The skilled services must be provided on an inpatient basis.
Remember, a Medicare beneficiary is entitled to receive coverage for all the skilled
care in a nursing home for 20 days. A Medicare beneficiary is entitled to receive
$170.50 of the cost of coverage for the next 20 days of skilled care in a nursing
home. The Medicare beneficiary is not entitled to any coverage for long term care in a
nursing home beyond 100 days.
We know this raises questions for you. How will you be able to afford the skilled
nursing facility bill? Where do you turn to for help? Should you ask your children to
help? We want you to know that we are here to answer these questions. We work
with Florida seniors and their loved ones each day as they handle these issues. Do
not wait to contact our law office to schedule a meeting and find the answers you