If a person requires skilled care after a hospital stay of at least three days, then Medicare will cover a portion of that person’s care in a facility. According to the applicable federal law, Medicare will provide payment in full for the first 20 days. After the first 20 days of skilled care then it is possible to obtain additional Medicare coverage.
If a person requires skilled care for more than 20 days then Medicare may pay a portion of this care for up to 80 days. Many individuals have supplemental health insurance coverage that will pay for the portion that is not covered by Medicare. For those individuals who do not have satisfactory supplemental health insurance coverage, they will have to privately pay the co-payment for the 80 days of skilled care.
Prior to 2024, the daily co-payment was $200.00 per day. Effective January 1, 2024, the daily co-payment has increased slightly. The new daily co-payment is now $204.00. Therefore, if an individual requires skilled care and does not have supplemental health insurance that will pay for the skilled care for the first 100 days of Medicare coverage, then that individual will be responsible to pay the facility a total of $16,320.00. This is based upon the new daily co-payment obligation of $204.00.
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