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. There is a condition or two for availing of the coverage that we will discuss later in this article.

This article will mainly state the period of rehab that Medicare covers and the conditions that make you eligible for it.

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 days policy for covering the costs of rehab. Once you have reached the 100 days limit, you will have to pay the further charges from your pocket.

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 the 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 day to the 20th day, Medicare will take responsibility for all the patient’s costs. Every benefit period cost is under Medicare Part A’s responsibilities.

2. 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.

3. After 100 days, Medicare part A will no longer be responsible for covering the patient’s cost. All the costs will fall under 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 in a row to get coverage. The day count starts when the patient begins staying at the hospital; the hospital visits for check-up are not included.
2. After a stay of 3 or more days is complete. The patient must enrol in a proper rehab facility before 30 days.
3. The doctor should recommend a highly skilled rehab facility and know about the patients’ 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.