Benefit Period (as it applies to Medicare)


A benefit period is a defined period of time in which the services a Medicare beneficiary uses are measured. It is also called a “spell of illness”.  A benefit period:

  • starts the day a beneficiary goes into a hospital or skilled nursing facility (SNF)
  • ends when the beneficiary has not received any hospital or SNF care (skilled or unskilled) for 60 days in a row
  • After a benefit period ends, another benefit period begins again when a beneficiary goes into a hospital or SNF.
  • There is no cap on the number of benefit periods for a beneficiary.

Posted in: Definitions

Leave a Comment (0) ↓