Vicki Gilbert

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Vicki Gilbert
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Director of Finance
Appleton
Senior Care
St. Paul Elder Services Inc.
316 E. Fourteenth St.
Kaukauna
WI
54130

I have been told that under Medicare A I am guaranteed 100 days of coverage in a skilled nursing facility for rehab. Is that true?


No. “ Medicare A” gives you up to 100 days of coverage. You have to meet certain criteria to qualify. You must have a three night hospital stay. This doesn’t include swing bed or observation. You must have a skilled nursing need and / or make progress in therapy. A skilled nursing need is anything that requires the care of an RN. An example would be an IV antibiotic. You can also qualify by progressing in therapy. Once you have met your prior level of functioning, then you would no longer qualify under Medicare A for therapy.

 

Do Medicare Replacement or Medicare Advantage insurance plans have the same benefits and requirements as standard Medicare?


No. When you purchase a Medicare Replacement or Advantage plan, you no longer have Medicare benefits as these plans take the place of Medicare. Each Medicare Replacement plan or Medicare Advantage plan has its own requirements and benefits and they differ from that of traditional Medicare. Review carefully the benefits and co-payments that are important to you.  

Vicki Gilbert
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Vicki Gilbert
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