Inpatient Care - Under half A, you furthermore may have a period of time reserve of sixty days for patient medical care. These period of time reserve days could also be used whenever you're within the hospital for over ninety consecutive days. Once a reserve day is employed, half A pay for all lined services apart from insurance of £348 each day in 1994. Again, the insurance is your responsibility. Once used, reserve days don't seem to be revived.
Gaps in Medicare Inpatient Hospital Coverage:
- You pay £696 deductible on first admission to hospital in each benefit period.
- You pay £174 daily coinsurance for days 61 through 90.
- No coverage beyond 90 days in any benefit period unless you have "lifetime reserve" days available and use them.
- You pay £348 daily coinsurance for each lifetime reserve day used.
- No coverage for the first 3 pints of whole blood or units of packed cells used in each year in connection with covered services. To the extent the 3-pint blood deductible is met under Part B, it does not have to be met under PartA.
- No coverage for a private hospital room, unless medically necessary, or for a private duty nurse.
- No coverage for personal convenience items, such as a telephone or television in a hospital room.
- No coverage for care that is not medically necessary or for non-emergency care in a hospital not certified by Medicare.
- No coverage for care received outside the U. S. and its territories, except under limited circumstances in Canada and Mexico.
Skilled Nursing Facility Car
A skilled nursing facility (SNF) is a special kind of facility that primarily furnishes skilled nursing and rehabilitation services. It may be a separate facility or a distinct part of another facility, such as a hospital. Medicare benefits are payable only if you require daily skilled care which, as a practical matter, can only be provided in a skilled nursing facility on an inpatient basis, and the care is provided in a facility certified by Medicare. Medicare will not pay for your stay if the services you receive are primarily personal care or custodial services, such as assistance in walking, getting in and out of bed, eating, dressing, bathing and taking medicine
To qualify for Medicare coverage for skilled nursing facility care, you must have been in a hospital at least three consecutive days (not counting the day of discharge) before entering a skilled nursing facility. You must be admitted to the facility for the same condition for which you were treated in the hospital and the admission generally must be within 30 days of your discharge from the hospital. Your physician must certify that you need, and receive, skilled nursing or skilled rehabilitation services on a daily basis.
Medicare can help pay for up to 100 days of skilled care in a skilled nursing facility during a benefit period. All covered services for the first 20 days of care are fully paid by Medicare. All covered services for the next 80 days are paid by Medicare except for a daily coinsurance amount. The daily coinsurance in 1994 is £87. You are responsible for the coinsurance. If you require more than 100 days of care in a benefit period, you are responsible for all charges beginning with the 101st day.
Gaps in Medicare Skilled Nursing Facility, Coverage:
- You pay £87 daily coinsurance for days 21 through 100 in each benefit period.
- No coverage beyond 100 days in a benefit period.
- No coverage for care in a nursing home, or in a SNF not certified by Medicare, or for just custodial care in a Medicare-certified SNF.
- No coverage for 3-pint blood deductible (see list of gaps under inpatient hospital care).