Inpatient rehabilitation is one of the most crucial branches of medicine. If it wasn’t for the ability to help those who needed specialized care even after a hospital stay, then many conditions wouldn’t be cured at all.
That is why having a Medicare plan that covers you for inpatient rehabilitation is quite necessary. To help you find a suitable plan, here is all the information you need on inpatient rehabilitation and its functionality with Medicare.
Inpatient rehabilitation refers to the care provided during a patient’s stay at a rehab or skilled nursing facility (SNF). This particular care includes but is not limited to physician services, as well as any other medical and supportive services that are required for you to get better.
Inpatient rehabilitation applies when you are recovering from injury, surgery, or illness. It is used when you need a dedicated rehab program. Since the costs can get extensive, Medicare and rehab often go hand in hand. That is why it is important to know about Medicare rehab coverage and Medicare rehab days on your policy.
Generally speaking, Medicare has four types of coverage plans:
• Part A, which gives you coverage against inpatient rehab at a hospital or skilled nursing facility. • Part B, which gives you coverage for outpatient procedures and services. • Part C, which allows you different ways to get Medicare through Medicare Advantage Plan. But these Medicare private health plans, which usually consist of Part A and Part B, could vary in their benefits. • Part D, which allows you to get coverage for prescription drugs.
Given these details, when it comes to Medicare and rehab, you need Medicare Part A coverage by default. This covers your rehab services such as physical or occupational therapy.
Part B covers your physician costs, even if they are working with your therapist. Part C could also benefit you, but it depends on the plan that you are enrolled in. The Medicare rehab coverage applies in cases where you are formally admitted to rehab to receive care.
If you have a holistic Medicare plan in both Part A and B, or Part C that has both aspects in check, you can benefit from the following advantages.
As mentioned above, the coverage in certain cases such as Medicare private health plans may differ. With that, the number of Medicare rehab days that are included in the Original Medicare (Part A) or Medicare Advantage Plan (Part C) may also be different.
In original Medicare, the number of Medicare rehab days that you can get coverage for is distributed into benefit periods. Your benefit period begins when you are admitted to the hospital or skilled nursing facility. It ends 60 days after you have been discharged from the hospital or the nursing facility.
If you come back home from the hospital on the seventh day of your stay, but go back and get admitted to rehab five days later, then it would count during the same benefit period.
There is no limit to how many benefit periods you can have. With that being said, you need to pay a deductible for each benefit period. This means that if you were transferred to your rehab or nursing facility directly from the hospital, then you won’t need to pay another deductible for rehab (there is another advantage to being admitted to an SNF, which is described below).
Once you have used all of your lifetime reserve days, you need to bear all the costs for the hospital stay.
Medicare also allows you to take benefit from a 100 Days Reset. Generally, Medicare covers up to 100 days of care at an SNF, with some coinsurance applying after a certain period in those days. After these days have passed, you generally have to pay all costs out of pocket.
But this can get reset if you get discharged from the rehab or nursing facility and stay at home for 60 days. Then, if you go back again, you will need to pay your deductible, have a three-day stay at an inpatient facility, and reset your coverage.
The cost for the deductible for each benefit period is $1,364. At a rehab center, the costs look like this: • The period of 1-60 days goes with $0 coinsurance.
But at a nursing facility, the costs change:
To avail this benefit of being at a nursing facility, you also need to have a qualifying hospital for at least 3 days. Only after being admitted to the hospital for 3 days could you qualify for this specialized approach to Medicare rehab coverage.
The payment options could come from:
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