Did you know that recuperation (and therapy) in a skilled nursing facility, following a hospital stay is a huge expense if you don’t have the proper insurance coverage in place? There is a trend happening where a patient in the hospital is in observation status, instead of as an inpatient. A senior on Medicare can be in the hospital but admitted on an outpatient basis. This causes problems because you can be in the hospital for days, but not considered an inpatient.

So, what does this means for a Medicare recipient? Medicare isn’t going to pay for rehabilitation in a skilled nursing facility following an observation stay. It must be an inpatient stay. If Medicare does not approve and pay for the first 20 days of skilled care, then the senior’s Medicare Supplement will not pay for days 21-100.

Why is this important for me or my family member? Because the national average of a semi-private room in a nursing facility is $263 a day (or $7,989 per month). You want to make sure that you are aware and don’t get caught off guard.

What can I do? Make sure to ask when admitted to the hospital and see if you are in observation status or as an inpatient. If you have been admitted in observation, ask if there is any way that you can be admitted as an inpatient. If you are admitted to the hospital then Medicare Part A will pick up days 1-20, and your Medicare Supplement will pick up days 21-100.

There is a second solution. There are recovery care plans that will help cover the cost of care in a nursing facility. A rider can be added that would allow someone to come care for your in your own home as well.