If a person who is on Medicare requires therapy, rehabilitation or skilled care in a facility, then Medicare may pay a portion of that person’s care in the facility. According to federal law, that individual must have been in a hospital for at least three days immediately prior to his or her admission into a skilled nursing care facility. Medicare will then provide payment in full for that person’s care for the first 20 days and then a portion of the remaining 80 days. According to applicable federal law, the daily co-payment for the 80 days of skilled care is based upon the hospital deductible amount. In 2022 the daily co-payment was $194.50 for the 80 day period. That resulted in an out-of-pocket cost for skilled care of $15,560.00.
The daily co-pay for Medicare beneficiaries has increased in 2023. The daily co-payment for the 80 day Medicare period of time is $200.00. Therefore, the out-of-pocket cost for the 80 days is $16,000.00.
In summary, if a person requires skilled care and is covered by Medicare, then the first 20 days should be covered in full by Medicare. Medicare will pay a portion of the next 80 days but there will be a co-payment of $200.00 each day for a total of $16,000.00.
Law Office of Donald B. Mark 