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About Medicare’s “three day rule” for Skilled Nursing Home Coverage

As if Medicare’s various rules regarding healthcare aren’t already complicated enough, the so-called “three day rule” adds yet another level of confusion for those needing skill nursing care. The base rule is this: for Medicare to cover your stay in a skilled nursing facility, that say must be preceded by a three day admittance to a hospital, which is where the tricky part comes in. When you first enter a hospital now, your stay will be classified as either “admitted” or “under observation,” depending on the severity of your condition and the projected duration of your stay. To follow your hospital stay with admission to a skill nursing facility with expenses covered by Medicare, your hospital stay status must have been “admitted” and not “under observation,” a nuance that most patients don’t pay attention to. Although the rule was softened during the COVID-19 pandemic, the base rule is still on the books and can affect your healthcare outcome, as explained in this Forbes article by Gregory Gurbiklan. Click here to read more.

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