Skilled nursing facilities offer care and therapy to help patients recover from injury, illness and hospitalization. In addition to short-term care, long-term care is also available for those who are unable to live independently and need daily medical assistance. While the cost of skilled nursing care varies depending on the facility and geographic location, costs usually start in the thousands per month. The first question many people have when looking for skilled nursing care is whether insurance will pay for it. Here’s what you need to know:

Private insurance coverage for skilled nursing facilities

In the event you need to stay at a skilled nursing facility to recover from a short-term medical condition such as an injury or illness that required hospitalization, most private medical insurance policies will pay all or a significant portion of your stay due to medical necessity. Typically, most private insurance policies do not cover the costs of long-term care at a skilled nursing facility. Fortunately, there are specific long-term care insurance policies that you can add to existing coverage or apply for separately before it is needed. Additionally, many life insurance policies allow policy holders to cash out a portion of their death benefits to pay for long-term care.

Medicare coverage for skilled nursing facilities

Medicare, which is a government-sponsored health insurance program for senior citizens, only covers short-term rehabilitation and recovery at skilled nursing facilities. To qualify, patients must have had a qualifying stay in a hospital and a doctor’s recommendation that daily skilled care is needed. Full cost coverage lasts for the first 20 days at the facility, followed by a daily cost ranging from $170-$185 for days 21-100. Coverage ends as of day 101, at which time all costs become the responsibility of the patient. There is often a misconception that Medicare will pay for long-term care at a skilled nursing facility because the program does cover long-term residency at nursing homes. This is an important distinction to be aware of.

Medicaid coverage for skilled nursing facilities

Medicaid is similar to Medicare, but instead of being offered exclusively to senior citizens, the government-backed health insurance is available to everyone below a certain income level. Unlike Medicare, Medicaid covers long-term care at a wider variety of facilities, including skilled nursing facilities, and there is no time limit to the coverage periods. Medicaid coverage for skilled nursing facilities covers all costs, including room and board, any therapies necessary for regular care (physical therapy, occupational therapy, speech therapy, etc.), medical devices, and personal care items such as incontinence supplies and toiletries. 

Skilled nursing care at Bella Vista Health Center

Whether you need short-term skilled nursing care to recover following hospitalization or long-term care to meet your medical needs and assistance with daily activities, Bella Vista Health Center offers a wide range of services and amenities, along with round-the-clock care from a compassionate staff of medical and therapeutic professionals in our nurturing 5-Star Skilled Nursing Facility. For more information about our short- and long-term care programs, or to schedule a tour, call us at (619) 644-1000.