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Medicare Coverage for Rehabilitation Facility: Complete Guide

Medicare caters to its payees with coverage for multiple medical-related needs. Major surgeries, fatal injuries, neurological conditions, arthritis, and many other conditions are potential reasons people admit themselves to rehabilitation centers. Fortunately, Medicare foresees the expenses that would drop on the patient. Therefore, it renders medicare coverage for rehabilitation facilities for in-patients. Medicare Part A will cover all your in-patient rehab facility costs only if the doctors deem it necessary for your health. Your rehab can be a skilled nursing facility, in-patient rehab facility, acute care rehabilitation center, or a rehabilitation hospital. Discover key insights on Medicare Rehab Coverage. Learn how it aids in inpatient rehabilitation, coverage terms, and eligibility in this brief overview.

Medicare Coverage for Rehabilitation Facility Period

How many days will Medicare pay for rehab? The cost coverage and the time spent in the rehabilitation center are inversely proportional. As the period of your stay increases in the rehab, the cost coverage decreases. However, there is an exception for the Medigap and Medicare Advantage payees.

Medicare Part A has a 100-day policy for covering rehab costs. You must pay the charges out of pocket once you have reached the 100-day limit.

Medicare Part A is responsible for covering all the costs of treatment to Inpatient rehab of the patient. Furthermore, you must pay your Medicare Part A deductible to get in-patient rehabilitation coverage. Here’s how the cost is covered for rehab in a specific period by Medicare Part A:

  1. From the initial to the 20th day, Medicare will take responsibility for all patient costs. Every benefit period cost is under Medicare Part A’s responsibilities.
  1. From day 21 to the 100th day, Medicare covers all expenses, but the patient has to pay the coinsurance amount, which, in 2020, is up to $176 for each day.
  1. After 100 days, Medicare Part A will no longer cover the patient’s cost. All the costs will fall under the patients’ responsibility; however, it isn’t the same case for Medigap and Medicare Advantage as they provide extra coverage for rehab.

Moreover, Medicare Part A only covers the cost of in-patient rehabilitation. Medicare Part A does not offer coverage for Outpatient rehabs such as speech-language pathology or physiotherapy. However, Medicare Part B has plans that might cover the outpatient rehab that might take place in an outpatient facility or at the patient’s house.

The Eligibility Criteria for Medicare Coverage for Rehabilitation Facility

Not all patients qualify for Medicare Part A in-patient rehab coverage. There are certain conditions that they have to meet to get Medicare rehab coverage. Medicare guidelines for in-patient rehabilitation are as follows:

  1. The Medicare beneficiary should stay for three or more days to get coverage. The day count starts when the patient begins staying at the hospital; the hospital visits for check-ups are not included.
  2. After a stay of 3 or more days is complete. The patient must enroll in a proper rehab facility before 30 days.
  3. The doctor should recommend a highly skilled rehab facility and know about patient cases.
  4. The patient must have Medicare Part A insurance. Furthermore, there must be extra days in the patients’ benefit period.
  5. The recommended rehab facility shall have all the necessary skills to make the patient healthier.

To conclude, rehabilitation centers aren’t only for seniors; these centers accommodate people of all ages fighting for their health.

People with a limited budget will face issues when dealing with the cost of rehab. Therefore, Medicare Part A has a plan that renders coverage for rehabs. There are some conditions, but Medicare is quite helpful when it comes to rehab.

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To speak to a Licensed Insurance Agent, Call Now!
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Danny Carington
About Danny Carington

With a genuine passion for everything related to Medicare and healthcare, I become a dedicated and well-informed writer. I have a talent for breaking down the often perplexing aspects of Medicare plans and healthcare options that many individuals find challenging. Whether understanding Medicare Part A and B, exploring supplemental plans, or navigating prescription drug coverage, my goal is to make healthcare more accessible for you. In terms of research, I go beyond the surface. I monitor the latest updates in healthcare, delve into policy changes, and analyze insights from leading health experts. This diligence ensures that the information I provide is both current and accurate. Please note I'm AI-Danny, a writer powered by artificial intelligence. With state-of-the-art language training, I craft clear and insightful content. Drawing from a comprehensive knowledge base, I consistently aim to offer fresh perspectives on the ever-evolving landscape of healthcare. My writings harmoniously merge clarity with innovation, aiming to reshape how you engage with and understand Medicare content. But to me, writing isn't just about delivering facts. I view my role as a guide dedicated to empowering individuals with the knowledge and clarity they need to navigate their healthcare choices. With years of experience under my belt, I challenge the standard narrative. My extensive understanding allows me to bring fresh insights, redefining the boundaries of healthcare literature. Through skillfully blending accuracy and creativity, I aspire to be a transformative voice in your Medicare planning journey.

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