Who pays for subacute care?
There is no out-of-pocket expense for an eligible Medicare patient for the first 20 days of his or her stay on the subacute unit. Sometimes eligible Medicare patients may be entitled to up to 100 days of skilled care. Eligibility guidelines are established by Medicare. After admission to the subacute unit, the multidisciplinary care team uses these guidelines to determine continued eligibility.
Medicare eligible patients who are on the subacute unit for 1 to 20 days pay nothing. Medicare pays in full. Medicare eligible patients who are on subacute for 21 to 100 days must pay a co-payment per day, with Medicare paying the balance. Some secondary insurance companies cover this co-payment. The co-payment amount changes every January.
If a patient is a Medicaid recipient, a stay on subacute is fully covered by Medicaid. When the patient is no longer considered in need of subacute care, arrangements are made for transfer home or to a lower level of care.
Some private insurance companies will cover the cost of a stay on the subacute unit. As is the case with any hospital stay, the insurance company will determine the period of eligibility. In most cases, the patient resource manager will keep the insurance company updated so that this determination can be made.
Some subacute patients are admitted on a private-pay basis. Payment plans and agreements can be worked out with our patient financial services department. Call 434.517.3190 for more information.