Bcbs skilled nursing facility 2025

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Blue Cross Blue Shields Coverage for Skilled Nursing Medicare Part A specifically covers inpatient care in hospitals or skilled nursing facilities, home health care, and hospice care.
Individuals who require ongoing medical care after an injury, rehabilitation or other highly effective medical treatment qualify for skilled nursing care. Those recovering from a stroke, a surgery, an accident or significant illness are typical skilled nursing facility patients.
3-Day Prior Hospitalization Before SNF Admission Patients meet the 3-day rule by staying 3 consecutive days in 1 or more hospitals. Hospitals count the admission day but not the discharge day. Time spent in the ED or outpatient observation before admission doesnt count toward the 3-day rule.
A skilled nursing facility is a temporary residence for patients undergoing medically necessary rehabilitation treatment, while a nursing home is more of a permanent residence for people in need of 24/7 care. These services may be under the same physical roof.
First, the patients physician must write an admission order for placement in a skilled nursing facility. The patient must have a need, based on their medical diagnoses, for 24 hour nursing care. And finally, the patient must have a payer source for the care needed.
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Many people who qualify for skilled nursing or nursing homes are older adults who are at a higher risk of falls, have chronic conditions, and other health problems that may qualify them. Older adults often benefit from services that can improve their quality of life and ability to carry out activities of daily living.

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