Medicare & Medicaid

Medicare: The following requirements must be met to establish and maintain eligibility for skilled nursing facility coverage under Medicare:

• - Medicare Part A insurance coverage indicated on the Medicare card
• - Physician certification that skilled rehabilitation or nursing services are medically necessary
• - Hospital stay over 3 consecutive midnights within the past 30 days

Medicare pay 100% of the entire cost of a skilled nursing facility stay for the first 20 days, including room and board, nursing care, therapies, medications and supplies. If one continues to meet the above criteria, Medicare will continue to pay the cost of the stay, minus $133.50 per day coinsurance on days 21-100. The resident is responsible for paying the coinsurance amount if there is no Medicare supplemental insurance or Medicaid. A predetermined number of Medicare covered days is never guaranteed but only conditional on the eligibility criteria listed above, as well as participation and progress in the treatment plan.

Medicaid: Medicaid is a medical assistance program for individuals below a certain income and asset levels. The resident is responsible for the estimated patient payment upon admission. Medicaid usually calculates this amount as income minus $50.00 monthly personal needs allowance. The patient payment is calculated differently when a spouse still lives in the community. Our social worker will assist your family with applying for Medicaid.

Cripple Creek Rehab & Wellness Center
Phone: 719.689.2931 ♦ Fax: 719.689.3702

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E Kjelland