How Medicare Part A nursing-home benefits are provided:

Medicare nursing-home benefits are provided under Part A. These benefits are very limited. For each benefit period or “spell of illness,” Medicare will provide benefits for up to 100 days of care in a skilled-nursing community, as long as therapy or nursing care is required.

Days 1-20: Medicare pays 100%

Days 21-100: You pay a daily co-insurance; Medicare pays the rest. The co-insurance amount changes each year. In 2015, the amount you must pay each day is $157.50. If you have supplemental insurance, it may puck up some or all of this co-insurance cost.

Medicare will only provide these benefits under the following conditions:

  • Have Medicaid Part A Coverage
  • Have had a three-day hospital stay
  • Be admitted to the skilled-nursing community within 30 days of your hospital discharge
  • Requires skilled services on a daily basis – seven days a week for skilled-nursing services or at least five days a week if admission is for skilled-rehabilitation services only.
  • Receive skilled treatment that is appropriate for the illness for which you were hospitalized – or a related illness – and is ordered by a physician in writing.
  • Not have used 100 days of skilled-nursing care available per benefit period under Medicare. (If you have already used up 100 days, you must have been out of a hospital or skilled-nursing community for 60 consecutive days before you start a new benefit period and are eligible for more skilled-nursing benefits.

Covered Part A Services:

  • Meals, including special diets
  • Regular nursing services
  • Rehabilitation services
  • Drugs provided by facility to you
  • Medical supplies

Services Not Covered with Medicare Part A:

  • Personal convenience items
  • Private-duty nursing