Summary of Medicare Long-Term Care Benefits 

Care in a Skilled Nursing Facility (SNF)

An SNF is an institution that provides skilled nursing or rehabilitation. Medicare covers room (semi-private) and board, skilled nursing and therapy services, and other medically needed care.

To Qualify:

• The patient must have a hospital admission of at least three days,
• SNF care must be related to that admission,
• SNF admission must occur within 30 days of hospital discharge,
• A physician must certify daily skilled nursing care is needed, and 
• Care must be in a Medicare-approved SNF.

Limits, Deductibles, and Copayments:

• Medicare covers 100 days per benefit period.
• There is no limit on benefit periods in a person’s lifetime.
• Medicare covers 100% for the first 20 days.
• Patients must pay a copayment of $139 per day for days 21 to 100.
• There is no coverage after 100 days.

Home Health Care

Home health care is part-time or intermittent skilled nursing services. It can include physical, speech, or occupational therapy; home health aides if in conjunction with other covered services; durable medical equipment; wound care; and medical social services under the direction of a physician.

To Qualify:

• The patient must be homebound;
• A physician must certify the need for skilled nursing or speech, physical, or occupational therapy;
• A physician must sign a care plan; and 
• Services must be provided by a Medicare-approved home health agency.

Limits, Deductibles, and Copayments:

• Medicare Part A covers up to 100 visits following a hospital stay.
• Medicare Part B covers without a prior hospitalization with no limit on visits.
• Coverage is limited to the time period during which the patient needs skilled care; coverage of skilled nursing and home health aides is limited to “part-time” and “intermittent.”
• There is no copayment for services, but there is a 20 percent copayment for durable medical equipment.

[Back to top]