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Does TRICARE cover skilled nursing facilities?
Verified by TRICARE.com Editorial Team
Updated 2024-12-01
AI-assisted (gemini)
Quick Answer
TRICARE covers skilled nursing facility care for short-term rehabilitation after hospitalization, with authorization and medical necessity requirements.
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Key Takeaways
- Short-term rehab coverage
- Up to 60 days typically
- Authorization required
- Long-term custodial not covered
Detailed Answer
Skilled nursing facility (SNF) care is covered for short-term rehabilitation needs.
When Covered
- Following hospitalization
- Need skilled nursing or therapy
- Cannot be treated at home
- Expected to improve
Coverage Limits
- Up to 60 days per admission
- Can be extended if needed
- Must show continued improvement
- Long-term custodial care not covered
Authorization
- Prior authorization required
- Hospital coordinates transfer
- Medical necessity reviewed
- Continued stay authorization needed
Cost Shares
- TRICARE Prime: Low daily copay
- TRICARE Select: Cost share applies
- After 60 days: higher cost share
- Subject to catastrophic cap
What's Provided
- Skilled nursing care
- Physical therapy
- Occupational therapy
- Speech therapy
- Medications and supplies
Related Questions
What services does TRICARE cover?
TRICARE covers preventive care, doctor visits, hospitalization, surgery, mental health, maternity, prescriptions, and more with some requiring authorization.
What services require prior authorization?
Prior authorization is needed for many inpatient stays, some surgeries, specialty services, DME, and certain high-cost procedures regardless of plan.
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