| Medicare Coverage In A Skilled Nursing Facility |
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The New York State Veterans' Home is a Skilled Nursing Facility that specializes in skilled
care. The facility has staff to provides skilled nursing care within the categories
of rehabilitation services such as Physical Therapy, Occupational Therapy, and Speech Therapy.
- Skilled service for persons 65 years of age or become entitled to health insurance benefits.
- Admission to a hospital, the qualifying hospital stay must be "medically necessary".
- Hospital stay must be 3 (three) consecutive days, not counting day of discharge.
- Admission to a SNF within 30 days after discharge from a hospital stay, which
included at least 3 consecutive days.
Care in an SNF is covered if all of the following factors are met:
- Requires skilled nursing services or skilled rehabilitation services. (i.e.
services must be performed by or under the supervision or a professional or
technical personnel) (See sections 214.1-214.3) and)
- Requires skilled services on a daily basis (see 214.5) Complete Guide to
Medical Coverage Issues, March 2001.
- What if my care is not considered skilled care?
- Medicare A does not pay for services that are custodial. During the Admission process
payment source is determined at that time. Custodial care is primarily for the purpose of
helping with daily living activities or meeting personal needs, provided by staff without
professional skills or training. Therapy may also be provided, however, may be considered
to be maintenance therapy and is not covered by Medicare A.
For further information, please contact Corinne Ray, at (607) 843-3152.
Empire Blue Cross Medicare Services
Beneficiary Inquiry Department
P.O. Box 4846
Syracuse, New York 13221-4846
Medicare - The Official U.S. Government Site for People with Medicare
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