Skilled Nursing Facility

A Skilled Nursing Facility (SNF) is a licensed healthcare facility that provides 24-hour skilled nursing care, rehabilitation services, and other medical services for patients who need more care than can be provided at home but do not require acute hospital care. TRICARE covers SNF stays when medically necessary.

TRICARE SNF coverage requirements: • Must be medically necessary and ordered by a physician • Prior authorization is required • The facility must be TRICARE-authorized • Care must require skilled nursing or rehabilitation services • Custodial care alone is not covered

Services provided in SNFs: • Skilled nursing care (wound care, IV therapy, injections) • Physical therapy and rehabilitation • Occupational therapy • Speech-language pathology services • Medical social services • Nutritional management

TRICARE SNF benefit limits: • Coverage is generally limited in duration • Must show continued improvement or medical necessity • Periodic reviews determine ongoing coverage • Transition planning to home or lower level of care

Cost-sharing for SNF care depends on your TRICARE plan and beneficiary category. Network SNFs result in lower costs, and all cost-sharing counts toward the catastrophic cap.