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Medicare Retirees
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Question/Topic
How does UMP cover services provided at a skilled nursing facility?
Answer/Article

You must receive preauthorization and enroll in UMP's case management program to receive inpatient skilled nursing facility benefits.

UMP covers services and care only if the enrollee meets Medicare guidelines for skilled level nursing care, and only when provided by a facility that is licensed by the state where it is located, and is certified by Medicare.

UMP covers services only if you require medical care from skilled medical or rehabilitation professionals that cannot be provided on an outpatient basis. UMP covers up to 150 days per calendar year (see "Related Items" below for important information affecting Medicare retirees).

UMP does not cover skilled nursing facility confinement for care that is primarily convalescent or custodial in nature.


Related Items
Does UMP cover nursing home services?
What is the limit for skilled nursing facility services for Medicare retirees?
Which services require preauthorization under UMP?
KBID 497
Date Modified 10/7/2008
Date Created 7/17/2006

The Certificate of Coverage (COC) is the source of coverage provisions offered under UMP. If information given here is inconsistent with the UMP COC, the rules in the COC will apply. Also, the COC may have additional information on this subject.

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