Do Skilled Nursing Facilities Accept Medicaid or Medicare?
Find out your Medicaid and Medicare coverage options for Skilled Nursing Facilities. This guide explains what is covered, and how long for.
One of the most common yet concerning questions we're asked is whether a Skilled Nursing Facility (SNF) accepts either Medicaid or Medicare. These are murky waters to navigate for the person seeking care or those looking to assist loved ones in need. These questions are also especially tough to give simple answers to, because the response may range from “yes”, to “no”, to “sometimes neither” and “sometimes both”.
With the multiple levels of both state and federal programs added to the complexities of private pay, it’s easy to get confused, if not totally lost. We want to make it easy to understand the differences between Medicaid and Medicare coverage options for SNFs and will guide you every step of the way. The answers will be found on a case-by-case basis.
Understanding the Differences
In several of our online guides, we’ve provided more detailed information on the differences between Assisted Living Communities and Skilled Nursing Facilities. You can also learn more about what Skilled Nursing is in our article “What are the Best Skilled Nursing Facilities?” For our conversation here, we will explain the difference between Skilled Nursing and rehab, and how each can affect eligibility under the Medicare or Medicaid programs.
Does Medicaid Pay for Skilled Nursing Facilities?
Medicaid is designed to assist those who don’t have the money to pay for living space. It can cover some Skilled Nursing benefits if you don’t have more than $2,000 in assets. Medicaid would put a lien on your house to get money back, for example.
Does Medicare Cover Skilled Nursing Facilities?
Medicare pays for both your hospital care and short-term medical needs. These are the parts you’ll see specified on your Medicare membership card and denoted as Part A, B, C, D, and F. The various options are what you most often see in TV commercials and email solicitations where you’re able to change your options in what’s called an “Open Enrollment” period.
- As an example, Part A would cover a hospital stay (generally about three days) and doctor visits. After discharge, the patient might go to rehab (with days 1-20 covered under Part A and days 21-100 at 80 percent coverage).
- Part B would cover flu or shingles shots, or a prostate exam, for example.
- Part C offers the benefits of Parts A and B combined in one program. Other services, like dental and vision, may be covered based on the options of the plan and desires of the individual.
- Part D covers prescription drugs.
- Part F is for supplemental coverage.
If you have questions about Medicare, take a look at the card issued to you, and you’ll find a phone number for assistance. You can also find additional information at the Centers for Medicare & Medicaid Services (CMS) and Medicare.gov
How Long Can You Stay in a Skilled Nursing Facility with Medicaid or Medicare?
Referah counselors most often work with “private pay” residents, but even if your case isn’t of this nature, we’d still very much like to help you find the right path. Each situation varies, but generally, you will only be able to stay in a SNF for a certain amount of time before private pay comes into play.
In the case of private pay patients, Referah’s extensive and ever-expanding group of both Assisted Living and Skilled Nursing Communities is where you’ll find a property that meets your unique needs. While the patient or caregiver may think they already know what is needed, the time spent with an experienced Referah counselor almost always reveals better and more efficient means of arriving at a suitable choice.
In some cases, there may be a separate section for Skilled Nursing within the same Assisted Living Community campus where a resident currently lives. This section will operate under its own license and staff, but the patient won’t be inconvenienced by a complete change of residence once their additional needs end.
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