Increase in Medicare Co-Payment for Skilled Nursing Care

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Medicare is not long-term care insurance.  Medicare does not pay for long-term care, other than a portion of the skilled care that an individual may require after a stay in a hospital.

According to the Medicare statute, if a person is in a hospital for at least three days and then goes into a facility for skilled nursing care, then Medicare will pay for the first 20 days and then a portion of the remaining 80 days.  According to the federal regulations, the daily co-payment is equal to one-eighth of the hospital deductible amount.

In 2020, the daily co-payment was $176.00.  Effective January 1, 2021, the Medicare co-payment for skilled care has increased by approximately 5.4%.  The new co-payment for skilled care in a facility is now $185.50.

Based upon the new changes in the Medicare co-payment, an individual who requires skilled care in a facility for at least 100 days but does not have supplemental health insurance to cover the co-payment, will have to pay the Medicare co-payment of $14,840.00.  In other words, that individual will be responsible to pay the facility $14,840.00 for the 80 days of skilled care.