What Retirees Should Know About Skilled Nursing and Rehabilitation Coverage

As people age, healthcare needs often change. For some retirees, skilled nursing and rehabilitation services become an important part of recovery after illness, injury, or surgery. Understanding how these services are covered—and where gaps may exist—can help retirees prepare for future needs.

What Is Skilled Nursing and Rehabilitation Care?

Skilled nursing care refers to medical services provided by licensed nurses in a facility, such as a skilled nursing facility or a rehabilitation center. Rehabilitation care focuses on therapy services, including physical therapy, occupational therapy, and speech therapy, to help restore function and independence after injury or illness.

These services are often needed after hospital stays or surgeries, especially for conditions that require ongoing monitoring, specialized treatment, or support with daily living activities.

How Coverage Typically Works

Coverage for skilled nursing and rehabilitation care depends on the healthcare plan in place. Many retirement healthcare programs provide some coverage for these services, but the amount and duration can vary. Coverage is generally limited to a certain number of days or a specific type of therapy.

Important Considerations for Retirees

1. Length of Coverage
   Most retirement healthcare plans have limits on how long they will cover skilled nursing or rehabilitation care. After these limits are reached, additional care may need to be paid out-of-pocket or covered by supplemental insurance.

2. Eligibility Requirements
   Coverage often requires a prior hospital stay of a certain length or a physician’s order. Understanding these requirements ahead of time can help avoid surprises when care is needed.

3. Facility Choice
   Coverage can depend on whether the skilled nursing or rehabilitation facility is in-network or approved under the retiree’s healthcare plan. Choosing an eligible facility is important to ensure coverage.

4. Cost Considerations
   Even with coverage, retirees may be responsible for copayments, coinsurance, or other costs. Planning for these expenses is an important part of healthcare preparation.

Planning Ahead

Since skilled nursing and rehabilitation care can be a significant expense, retirees should consider including this potential need in their healthcare planning. This might involve reviewing plan details, considering supplemental coverage, or setting aside savings for these services.