|  | Healthcare Industry | Medicare

Medicare Rehabilitation Benefits

Most hospital stays are covered by Medicare under Part A. However, for many, the recovery from a major illness or injury does not end once they are discharged. Many people require extensive therapies and rehabilitation. Fortunately, Medicare offers many coverage options for those requiring rehabilitation.

  1. Inpatient Rehabilitation Hospital Stays

    • Medicare will cover inpatient rehabilitation hospital stays under Part A if a physician orders daily physical rehabilitation. The daily physical rehabilitation must follow within 30 days of a three-day inpatient stay at a hospital, and the rehabilitation facility must be Medicare-certified. Medicare will pay for 80 percent of the bill for the first 20 days, and after 20 days, Medicare pays 80 percent plus a $133.50 daily co-payment. After an additional 10 days, the beneficiary is responsible for the entire cost.

    Skilled Nursing Facility Stays

    • Skilled nursing facilities offer care performed by registered nurses, therapists, audiologists, speech-language pathologists and other skilled care professionals. Any highly skilled treatment not performed by typical health care professionals may be found at a skilled nursing facility. There are two requirements for having a skilled nursing stay covered by Medicare: The beneficiary must require skilled care at least seven days a week as ordered by a physician or, the beneficiary must have been in the hospital for at least three days as an inpatient. The beneficiary also must check into the skilled nursing facility within 30 days of hospital discharge in order to qualify for coverage.

    Home Health Care

    • Those who require rehabilitative skilled nursing services and who are homebound can qualify for the Medicare home health benefit. Homebound means that the beneficiary cannot leave his home without considerable effort. This may mean the beneficiary requires the use of a wheelchair or a walker. The beneficiary must require skilled nursing care part-time or irregularly, or the beneficiary must require skilled therapy such as physical, speech or occupational therapy; however, if the beneficiary only requires occupational therapy, that is not enough to qualify for the home health care benefit. If the beneficiary requires occupational therapy and an additional therapy, he can receive the occupational therapy under the benefit. Finally, a doctor must approve the home health care and the care must be received from a Medicare-certified home health agency.

Medicare - Related Articles