Part A And Skilled Nursing Care

​In past blogs, we’ve been going over each of these Medicare parts and what they generally cover. Today, let's look closely at Medicare Part A to start seniors thinking about what they need in terms of Medicare and supplemental Medicare plans.
 
First of all, Part A is the part of Medicare coverage that covers in-facility treatments.
 
That can mean hospital or hospice stays, or a stint in a skilled nursing care facility. So how are these elements covered under Medicare? Knowing more will help you to navigate this system in a better way.
 
Coverage Deductible
 
One of the first things that's important to understand is that although Part A covers skilled nursing care, it doesn't cover it long-term.
 
Here, the word “covers” can seem deceptive, because of the way that the coverage is structured.
 
Here's, essentially, how it works: for the first number of days, Medicare pays all costs in a skilled nursing facility.
 
After that number of days, coinsurance applies which is set at over $100 per day.
 
After about 100 days, Medicare Part A stops paying completely, and the customer is on the hook for the rest of the costs for that year. So if someone stays in a skilled nursing facility year-round, they are paying about 260 days out of the year out-of-pocket.
 
Daily Skilled Nursing Costs
 
Now, Google average daily skilled nursing facility costs, and you come up with a number – $275.
 
That's over $9000 per month, so for the additional six or seven months, you're paying over $50,000 for the year.
 
Of course, Medicare Part A did pay a significant component of all of the skilled nursing costs, but patients who thought they had very little financial responsibility are sadly surprised when they exceed the stay limitations.
 
Now, it's important to clarify here that people don't choose how long they are in skilled nursing care. It's a clinical determination. Let's also add that most patients don't suddenly stop needing skilled nursing care. When they are deteriorated to the point where they have limited range of motion and mobility, they often need skilled nursing care year-round. That’s not an unreasonable care need! But then there can be significant logistical problems with how that works.
 
Medicare Advantage and Supplemental Plans
 
Here's where supplemental Medicare plans come in. Patients have to choose additional coverage to limit their financial responsibility. We can help make those decisions! Do your research to come up with a plan that will make you feel financially secure in a rapidly changing world.