Which program would cover skilled nursing facility expenses only if the insured was hospitalized before entering the facility?

• A. HMOs
• B. Medicare
• C. Medicaid
• D. Medicare Supplements

Answer: (B)

Medicare's coverage for skilled nursing facility care is triggered by a hospital stay. After you’re admitted to a hospital as an inpatient for at least three consecutive days for the same condition, Medicare Part A can pay for skilled nursing facility services for up to 100 days, in Medicare-certified facilities. The first 20 days are fully covered, and days 21 through 100 require a daily coinsurance. If there’s no qualifying hospital stay, Medicare won’t cover SNF costs. Other programs don’t hinge on this hospital-stay prerequisite in the same way, making Medicare the program that fits the scenario described.