Does Part A cover inpatient care in other facilities?

Page 4 of Medicare Part A (Hospital Insurance): How It Works

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One of the most common mistaken ideas about Medicare is that it pays for long-term nursing home care. It does not. Medicare Part A covers only short-term skilled nursing or rehabilitation facility inpatient care, and only under very limited circumstances. It also covers limited stays in a psychiatric facility.

For patients who require a stay in a skilled nursing or rehabilitation facility, strict rules apply for Part A coverage. For example, within 30 days prior to entering the nursing or rehab facility, a patient must have had a hospital stay of at least three days. A doctor must certify that the patient needs daily, skilled nursing care or rehab services, and, even then, coverage lasts only as long as that daily skilled care is needed to recover. For each hospitalization, there's a maximum of 100 days nursing or rehab facility coverage.

Inpatient care in a psychiatric facility is also limited under Part A. Participants have a lifetime coverage total of only 190 days in a mental health care facility. Care for psychiatric or other cognitive problems for an inpatient in a regular hospital, though, is subject to regular Part A hospital coverage limits, not this special 190-day total.

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3 months ago

Very helpful.Thanks.


10 months ago

Hi adsg, That's a good question. While I don't have the answer, you can post your question to our Ask & Answer section, here: ( http://www.caring.com/ask ). I hope that helps! -- Emily


11 months ago

My mother-in-law is in a skilled nursing facility and her 100 days is about to expire. She still needs PT, 24/7 oxygen, breathing medicine and treatments. I know Medicare will pay again after 60 days - but someone said she had to be out of that facility for 60 days then she could go back. Is this true? Or, could we pay for the 60 days and then Medicare pick back up? Anyone know ?????


about 1 year ago

my 94 year old Grandmother has Medicare as her primary and Tricare as her secondary, so I believe we are good to go, haven't seen any bills from home health care or hospitals, should I be checking????


over 1 year ago

Very informative; clear and concise.


Anonymous said over 1 year ago

Very informative article; simple and clear.


over 1 year ago

clearly explained.


over 1 year ago

A very informative article....much appreciated.


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