Final answer:
To be eligible for Medicare coverage in a Skilled Nursing Facility (SNF), patients must have a prior hospital stay of at least three days, require daily skilled care, and have their care deemed medically necessary.
Step-by-step explanation:
The qualifications for Skilled Nursing Facility (SNF) care coverage under Medicare involve several stipulations. A direct answer is: to qualify for SNF coverage, a beneficiary must have been hospitalized for at least three consecutive days and enter an SNF within a short time (typically within 30 days) of hospital discharge. Furthermore, the SNF services must be for a condition treated during the hospital stay or a condition that arose while receiving care in the SNF for a condition treated during the hospital stay.
Medicare provides coverage only if the patient requires daily skilled care that can only be provided in an SNF on an inpatient basis. This can include services such as intravenous injections, and physical therapy, and the services must be ordered by a physician and deemed medically necessary. The coverage for SNF under Medicare Part A typically includes room and board, nursing services, medications, and other medically necessary services and supplies.
Note that Medicare coverage is not provided for long-term or custodial care if these are the only type of care needed. Medicare Part A covers up to 100 days of SNF care per benefit period, with a co-payment required after the first 20 days. It's also essential to choose a Medicare-certified SNF to ensure that the care meets the coverage criteria.