Dear Cassie:
My father will be having hip replacement surgery later this month. I’m trying to figure out how much a nursing and rehab center will cost and how much of it his Medicare will pay for? He lives in Central Ohio just outside Columbus.
Can you help? It all seems so confusing!
Renee
Dear Renee:
You aren’t alone in having trouble understanding the Medicare skilled nursing and rehab benefit! It can indeed be very confusing.
Cost of Skilled Nursing Care in Central Ohio
Let’s start with the costs. Skilled nursing and rehab centers bill patients according to a daily rate. In Ohio and in the Columbus area the costs are a bit lower than the national average of $220 per day.
According to Genworth Financial’s 2015 Cost of Care Survey:
- The average daily rate for a semi-private room in an Ohio skilled nursing & rehab center is $210.
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For Columbus area seniors, the average daily rate is $197.
Keep in mind, there may be medication costs, therapy expenses, and durable medical equipment charges in addition to the daily rate. Those expenses will vary according to the services each patient requires.
Paying for Short-Term Rehab in Columbus
The good news for your father is that if he meets Medicare’s requirement that he stay three nights in a hospital prior to transitioning to a rehab center, his Medicare benefit will pay for the majority of these expenses.
Here’s how the Medicare Skilled Nursing Benefit works in 2015:
- Days 1 – 20: His expenses will be covered in full
- Days 21 – 100: He will be charged a $157.50/day co-insurance rate.
- After Day 100: Your father will be responsible for all of his expenses
Check with your father to see if he has a secondary insurance of any kind. In many cases, it will cover some or all the expenses Medicare doesn’t.
Be aware, though, that most insurance companies have a network of preferred providers. Coverage can vary widely depending upon whether the provider he chooses is in network or not.
Our best advice if your father has a secondary insurance is to check with them before your father’s surgery to see which central Ohio providers are in their network.
