Alert
Close

Chat retirement strategies with AARP’s Jean Setzfand today, Oct. 24th, at 2:00 p.m. ET

HIGHLIGHTS

Open
America's Winter Escapes Sweepstakes
Introducing RealPad by AARP
You and Your Town Contest-You could win an AARP RealPad

AUTO BUYING PROGRAM

AARP Auto Buying Program

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Safe Driving in 2014 Sweepstakes

Learn how AARP Driver Safety can help you stay safe—and enter for a chance to win $1,000. See official rules. 

Download the ipad App

AARP-iPad-ePub-app

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP Books

Medicare for Dummies book cover

Get the answers you need, from Patricia Barry, AARP's Ask Ms. Medicare

Most Popular

Viewed

share your Thoughts

Reader stories help us fine-tune our education efforts and strengthen our calls for action on issues that matter most to you. We read and learn from every story and may use yours (with permission) to brief legislators, inspire other readers and more. Please share your story with us. Do

Ask Ms. Medicare

A Right to Know If Medicare Won't Cover Your Skilled Nursing Care

Q. My father-in-law spent two days in the hospital and was then sent to a skilled nursing facility for rehab. Now the facility has billed my mother-in-law, and not Medicare, for the full cost of his care. The hospital did not tell them that Medicare wouldn’t pay. What can we do?

The rules on Medicare coverage for skilled nursing facility (SNF) care are very strict. You must be admitted as a patient to a hospital for three full days consecutively before qualifying for skilled nursing care that Medicare will pay for.

A hospital that refers someone to a skilled nursing facility when the three-day condition is not met is required to inform the patient, in a specific notice, that Medicare will not cover the cost. And the nursing facility is also required to give the same information to an incoming patient.

In this situation, your in-laws should appeal to the quality improvement organization (QIO) in their region, the agency Medicare uses to assess complaints against hospitals and other facilities. If it finds that the hospital (or the skilled nursing facility) was in error, your in-laws will not have to pay the nursing bill. While your appeal is pending, the nursing facility cannot insist that you pay.

To find the phone number and Web address of your regional QIO, go to the “Find Helpful Contacts for Organizations” section of Medicare’s website. Search for a “specific organization” and enter the name of your state.

For information on other rules required to qualify for SNF care, see the official publication “Medicare Coverage of Skilled Nursing Facility Care.”

Patricia Barry is a senior editor at the AARP Bulletin.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Grandson (8-9) whispering to grandfather, close-up

Members can save 20% on hearing aids with the AARP® Hearing Care Program provided by HearUSA.

AARP/Walgreens Wellness Bus Stops in Clarksdale, MS

Members can get exclusive points offers from Walgreens and Duane Reade.

Member Benefits

Join or renew today! AARP members receive exclusive member benefits & affect social change.

Rewards for Good

Your Points Balance:

Learn More

Earn points for completing free online activities designed to enrich your life.

Find more ways to earn points

Redeem your points to save on merchandise, travel, and more.

Find more ways to redeem points