Final answer:
Skilled Nursing Facility inpatients under Medicare are responsible for full Medicare rates for the first 20 days, a daily co-payment from days 21-100, and all costs after day 100. Medicare Part A coverage involves deductibles and co-payments, with no out-of-pocket maximum.
Step-by-step explanation:
Patients admitted to a Skilled Nursing Facility (SNF) after a required minimum three-day acute hospital stay who meet Medicare's qualified diagnosis and comprehensive treatment plan requirements are mandated to pay the Medicare rate for SNF inpatient care for a specific period. For the initial 20 days, Medicare covers the full cost of SNF care. However, from days 21 through 100, inpatient care requires a daily co-payment, after which Medicare coverage ceases and the patient is responsible for all costs.
Medicare Part A, which handles hospital expenses for patients eligible for Social Security benefits, funds this SNF coverage partially through payroll deductions and employer contributions. Beneficiaries cover various costs such as deductibles and co-payments, but there is no maximum out-of-pocket limit, leading to potentially significant personal expenses. Additionally, Medicaid can cover certain long-term care costs, but eligibility varies widely between states.
The financial responsibilities associated with Medicare and SNF care emphasize the importance of understanding healthcare policies and regulations, which can impact one's financial planning for healthcare needs. Considering the Medicare rate and associated personal costs when entering a Skilled Nursing Facility is therefore crucial for patients and their families.