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What will Medicare cover at the nursing home?

Most people think that Medicare will pay the entire bill at the nursing home or will at least pay the entire bill for the first 90 or 100 days.

This is NOT true. 

Medicare will pay the entire bill at the nursing home for the first 20 days. 

For the next 80 days, Medicare will pay the entire bill except for $176 per day, (increased each year for inflation). You are responsible for the $176 per day. This is called the “Medicare co-pay.”

You will receive Medicare benefits for up to 100 days only for so long as you continue to meet the third part of the Medicare qualifying requirement that you are being restored to a higher functioning level. 

Once you are at the nursing home, the nursing home will give you advance notice of when they expect that you will no longer be eligible for continued Medicare benefits. After 100 days, you will no longer receive Medicare benefits at the nursing home. 

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