Your Medicare Benefit

To make your transition to BRIA as easy as possible, we’d like to share some basic information about Medicare and the benefits provided to you based on your upcoming stay with us.

What is Medicare?

Medicare is a health insurance program for those 65 And older; or for those under 65 with end stage renal Disease, ALS disease or for those under 65 who have Been on disability for 2+ years.

What does Medicare cover?

Medicare is broken into 2 parts; Part A & Part B.

Medicare Part A

  • Covers inpatient care in hospitals and skilled nursing locations such as BRIA and will cover you inpatient stay, meals, regular nursing services and medications
  • Covers Hospice Care & some Home Health Care
  • Most people DO NOT have monthly premiums
  • Medicare card identifies whether you have Part A benefits “Hospital Part A Effective”

Part B

There is a monthly premium based on the income (the standard premium for 2016 is $99.90);
Covers services by outside provides such as:

  • Physician services
  • Outpatient hospital care
  • Some services of physical, occupational and Speech therapy
  • Diagnostic lab and X-ray services
  • Certain ambulance service fees
  • Medical supplies and drugs administered by a physician
  • Home Health Care

How do I qualify to use my Medicare benefits?

  • Currently enrolled and eligible for Part A
  • Qualifying hospital stay of 3 consecutive midnights
  • Requires skilled nursing or post-acute rehabilitative services for the condition which the patient was Undergoing treatment for in the hospital
  • Requires a skilled level of care within 30 days of leaving the hospital, after a stay of 3 consecutive midnights, or after any stay at a skilled nursing facility using Medicare Part A with less than 1000 Medicare days remaining and
  • A physician certifies the patient has a skilled need

Coverage of Medicare charges

Days 1-20 at the facility:
100% of covered charges

Days 21-100 at the facility:
Medicare pays covered charges, except the daily co-payment (for 2016 the daily co-payment amount is $144.50 per day). To qualify, the patient must have a skilled need.

Days 101 and after at the facility:
Medicare does not cover

More information can be found by visiting the Medicare website: www.medicare.gov