Medicare A benefits

I want to explain one piece of the Medicare part A program today. One in seven medicare recipients will be in the hospital this year. Many will stay for three days or longer; and therefore be eligible for the part A benefit of rehabilitation. Please keep in mind that these programs do not guarantee a certain number of days for coverage; these benefits are based on progress within a program( or lack of progress) The primary diagnosis will play a role in particular with skilled nursing care on inpatient basis.

Part A covers inpatient hospital care, inpatient care in a skilled nursing facility, home health care services, and hospice care. Medicare Part A provides payment for post-hospital care in a skilled nursing facility. In order for a medicare recipient to receive Medicare benefits, a physician must certify that the resident requires skilled nursing facility care, and the care required by the resident must be available only as inpatient at a skilled nursing facility.
Skilled nursing facility (SNF) care is covered only if it occurs within 30 days of a three-day or longer stay in an acute hospital facility and is certified as being medically necessary. Individuals utilizing the benefits of skilled nursing facilities under Medicare are limited to a 100-day stay AT MOST) facility. Co-payments are required for the 21st through the hundredth day.

Home health care under Medicare Part A has no limitations on length of stay, no co-payments, and no deductibles. To qualify you must need skilled care and be considered home bound. Home bound has different meaning to different agencies- so check with the home health company in your area for clarification on this topic.

Medicare for hospice care: patients are required to relinquish their standard Medicare benefits for treatment of terminal illnesses in order to receive the hospice care benefits (they will no longer be eligible to pursue curative treatments with medicare coverage).

For those with Medicare advantage- the benefits will decrease!! Many will have co pays beiginning on the third or fifth day but at a lesser rate than the traditional medicare co pay. Medicare supplements will usually cover the copayment which begins on the 21st day of care.