Details available on 2018 FEP skilled nursing facility benefit

The chart below describes the Federal Employee Program^® skilled nursing facility benefit coverage for both the Basic and Standard options.

FEP benefit coverage	SNF benefit
Basic Option	There’s no benefit for inpatient SNF care.
Standard Option with primary Medicare Part A	Limited to coverage of the first through 30th day for each benefit period as defined by Medicare. Medicare covers days 1-20 in full. For days 21-30, Medicare covers the stay except for the copayment, which FEP covers. There’s no FEP benefits beyond 30 days. (Members can’t use a Flexible Benefit Option to cover an SNF stay.) FEP considers medical necessity met when Medicare Part A has made a payment for the stay.
Standard Option without primary Medicare Part A Member doesn’t have Medicare Part A or has secondary Medicare Part A.	FEP covers SNF admission for a maximum of 30 days annually. The benefit is also available to overseas members. Requires precertification for medical necessity for the SNF setting. Before admission, the member must provide signed consent for case management services enrollment and participate in case management throughout his or her SNF stay.

If you have benefit questions, contact the FEP Customer Service line at 1-800-482-3600. If you have facility precertification questions, contact Precertification at 1-800-572-3413. If you have questions about case management services, call 1-800-325-6278.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.