What Is a Skilled Nursing Facility? Medicare Coverage Made Simple
When you’re hurt, sick, or need extra help getting better after a hospital stay, you might need care in a place called a Skilled Nursing Facility (SNF). This isn’t just any nursing home, it’s a place with trained nurses and therapists who help you heal and get strong again.
It’s important to know exactly what a Skilled Nursing Facility is, how it’s covered by Original Medicare, Medicare Advantage, or a Medicare Supplement, and why having proper coverage matters so much.
3 Key Points Before We Dive In:
A Skilled Nursing Facility (SNF) helps you recover after a hospital stay with medical care you can’t get at home.
Medicare does help pay for SNF care, but rules, costs, and coverage limits differ between plans.
Choosing the right Medicare plan can save you thousands and make sure you get the care you need.
What Is a Skilled Nursing Facility (SNF)?
Here’s what you get in a SNF:
Help from licensed nurses, doctors, and therapists.
Wound care, IV treatments, or rehab (like physical therapy).
Meals, medications, and personal care while you recover.
Example: Imagine breaking your hip and have surgery in the hospital. After surgery, you might need 24/7 nursing care and therapy to learn to walk again. That’s what a Skilled Nursing Facility does.
Background: Why Do People Go to a SNF?
People go to a SNF when they need skilled medical care that can’t be done at home. It’s not for long-term living. It’s short-term help to get strong and safe enough to go home.
Some reasons include:
Recovery after surgery (like hip or knee replacement).
Stroke rehabilitation.
Managing serious wounds or infections.
IV medications that need monitoring.
How Is a Skilled Nursing Facility Covered by Original Medicare?
Original Medicare (Part A and Part B) covers SNF care if you meet certain rules:
· You must have a qualifying hospital stay (at least 3 days in a row as an inpatient).
· Your doctor says you need daily skilled nursing or therapy.
· The SNF is Medicare-certified.
What You Pay with Original Medicare:
Medicare Part A limits SNF coverage to 100 days in each benefit period.
Important: Medicare doesn’t pay for long-term or custodial care in a nursing home.
How Is Skilled Nursing Facility Care Covered by Medicare Advantage (Part C)?
Medicare Advantage Plans are private plans that replace Original Medicare.
· They must cover at least what Original Medicare covers for SNF.
· Many plans have different copays, rules, or prior authorization requirements.
Key Things to Know:
Some plans may have lower daily copays than Original Medicare.
Others may limit which facilities you can use (network restrictions).
Always check your plan’s Summary of Benefits to know the exact costs.
How Is Skilled Nursing Facility Care Covered by a Medicare Supplement (Medigap)?
Medicare Supplement Plans help pay your Original Medicare out-of-pocket costs.
· Medigap doesn’t pay for extra days beyond 100—but it covers your Part A coinsurance for days 21–100.
Example:
If Original Medicare says you owe $204/day for days 21–100, Medigap can cover that for you (depending on the plan letter).
You pay little or nothing out of pocket during that time.
Why Is Having Proper Skilled Nursing Facility Coverage So Important?
Without good coverage, SNF care can be very expensive.
Recent data shows that in 2025, the median daily cost for a skilled nursing facility (private room) is $361/day, which comes out to approximately $10,965/month.
This translates to around $11,000/month, and with a multi-week stay, total costs can easily reach $10,000–$20,000, even before factoring in insurance. Without coverage, families often pay out of pocket. Having the right plan means you get the care you need without going broke.
Conclusion: Get the Help You Need with the Right Medicare Plan
Choosing the right Medicare coverage for Skilled Nursing Facility care isn’t just about saving money, it’s about making sure you get the help you need when you need it most.
It can be confusing, but you don’t have to figure it out alone.
Senior Help And You is here to help you review your options, understand your costs, and choose the plan that truly protects you and your family.
Call us today to get personal, friendly, professional help—at no cost to you. We’re ready to help you get peace of mind.
3 Takeaways to Remember:
Skilled Nursing Facilities offer short-term medical care after hospital stays.
Coverage and costs differ between Original Medicare, Medicare Advantage, and Medigap.
The right plan can save you thousands and make sure you get the care you need.
Author:
Albert Ferrin, Medicare Coach and Founder of Senior Help And You LLC
Source: Medicare.gov
