Does TRICARE cover skilled nursing facility care?

TRICARE covers skilled nursing facility (SNF) care when it is medically necessary for beneficiaries who require a level of care that can only be provided in a skilled nursing setting. This typically occurs following a hospitalization when the patient needs continued skilled nursing services, physical therapy, or other rehabilitation services. Pre-authorization from TRICARE is required before admission to a skilled nursing facility. Coverage is limited to conditions requiring daily skilled nursing care or skilled rehabilitation services that cannot be provided on an outpatient basis. TRICARE does not cover custodial or long-term care in a nursing facility for chronic conditions that do not require daily skilled services. The facility must be a TRICARE-authorized skilled nursing facility, and the treatment plan is reviewed periodically for continued medical necessity. Standard inpatient cost-shares apply based on the beneficiary's plan type, and active duty family members may have different cost-sharing than retirees.