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Who pays for a nursing home stay right after a hospitalization in Minnesota?

Medicare Part A can cover a limited number of days of medically necessary skilled nursing facility care following a qualifying inpatient hospital stay

Quick answer

Medicare Part A can cover a limited number of days of medically necessary skilled nursing facility care following a qualifying inpatient hospital stay of at least three days, subject to coinsurance after day 20. After Medicare coverage ends, the resident is privately responsible unless they qualify for Medical Assistance, at which point Minnesota's long-term-care Medicaid eligibility and spend-down rules apply.

HomeQuestionsWho pays for a nursing home stay right after a hospi
Answer

Medicare Part A can cover a limited number of days of medically necessary skilled nursing facility care following a qualifying inpatient hospital stay of at least three days, subject to coinsurance after day 20. After Medicare coverage ends, the resident is privately responsible unless they qualify for Medical Assistance, at which point Minnesota's long-term-care Medicaid eligibility and spend-down rules apply.

Inside the discharge window

A lot of confusion during a Twin Cities hospital discharge comes from families assuming Medicare will keep paying for nursing home care indefinitely once it starts, when in reality Medicare's skilled nursing coverage is specifically for short-term, medically necessary rehabilitation following a hospital stay, with coinsurance kicking in partway through and coverage ending once the patient plateaus or the covered days run out. If it becomes clear a parent will need nursing-facility care longer-term, that's the moment to start a Medical Assistance application process, since Minnesota's spend-down eligibility rules and MnCHOICES assessment take time to process and shouldn't be started only after Medicare coverage has already run out.

Related questions

Questions families ask

Who pays for a nursing home stay right after a hospitalization in Minnesota?

Medicare Part A can cover a limited number of days of medically necessary skilled nursing facility care following a qualifying inpatient hospital stay of at least three days, subject to coinsurance after day 20. After Medicare coverage ends, the resident is privately responsible unless they qualify for Medical Assistance, at which point Minnesota's long-term-care Medicaid eligibility and spend-down rules apply.

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