What is a Skilled Nursing Facility (SNF) benefit and under which Medicare program is it paid?

• A. A benefit for skilled nursing facility paid under Part B after a qualifying hospital stay.
• B. A home health benefit paid under Part A.
• C. A hospice benefit paid under Part C.
• D. A Skilled Nursing Facility benefit paid under Part A after a qualifying hospital stay, with coverage and coinsurance rules.

Answer: (D)

The key concept is that the Skilled Nursing Facility benefit is a Part A Medicare benefit that kicks in after an inpatient hospital stay and covers skilled nursing or rehabilitation services in a Medicare-certified SNF. To be eligible, you must have a qualifying hospital stay of at least three days, and the SNF care must be for skilled nursing or therapy services prescribed by a doctor.

You can receive this benefit for up to 100 days per benefit period. The first 20 days are fully covered. From day 21 through day 100, you pay a daily coinsurance amount. After day 100, coverage ends unless a new qualifying hospital stay starts a new benefit period. A new benefit period begins with a new inpatient hospital admission and ends after you haven’t received hospital or SNF care for 60 days.

This benefit is specifically under Medicare Part A; it does not apply under Part B, Part C, or as a home health benefit. It is also distinct from hospice care, which has its own coverage, and from home health services, which are a different Medicare component.