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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 111678
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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My brother is eligible for tricare for life if he went to a

Customer Question

My brother is eligible for tricare for life if he went to a hospital for more than three days and if he is admitted to a skilled nursing facility within 30 days of that hospitalization. Then he is eligible for skilled nursing care for an unlimited time. Will he still be eligible if he is moved to another skilled nursing facility? They are trying to push him out. He had a series of strokes and seizures that sent him to Overlook Hospital. After stabilization he was sent to Kessler Institute for Rehab, which is considered to be a hospital. He had another series of strokes and seizures, which sent him to St Barnabas Hospital. After about 3 or 4 days he returned to Kessler. After about 20 days they said his acute status was over and he had to go to sub acute. So we transferred him to Cranes Mill which is a skilled nursing facility. On the 10th they say he will have spent 30 days there and must be transferred elsewhere. They have only Medicare and private pay. They want him to go to a place that accepts both Medicare and Medicaid. We are not eligible for Medicaid but we are eligible for Tricare for Life. Will moving to a new skilled nursing facility affect his eligibility for Tricare For Life?
Submitted: 1 month ago.
Category: Legal
Expert:  Law Educator, Esq. replied 1 month ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
Yes, he would remain eligible for coverage even if he goes to another facility. The fact he was sent to the hospital and then back to the facility. Tricare does not have a limit on the number of days, here is the page from Tricare that tells you that and you need to tell the ignorant staff at the facility that he is not on medicare but tricare and they need to learn the rules. See: http://www.tricare.mil/CoveredServices/IsItCovered/SkilledNursingFacilityCare
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