How Long Does Medicare Take to Pay for Rehab After A Hospital Stay?

Most people are sceptical if staying in a hospital for a whole night or more for treatment would be covered by their medicare insurance. However, Medicare (part A and part B) may pay the required share in certain rehabilitation services in different ways. Medicare health insurance covers elderly persons above the age of 65 or the individuals who are disabled for the last 10 years. This is health insurance that also covers rehabilitation care at little or no cost to the patient. An individual needs rehabilitation service if they are recovering from any serious injury, surgery, or disease and also needs specialized care that is not be offered by any other setting like home. Medicare pays the amount for the rehabilitation services that seem reasonable and important according to a health condition, age, weight, the complexity of operation of the patient.  

For how long does Medicare pay for rehabilitation services?

Medicare part A provides coverage for both initial treatment and payment for rehabilitation services from the date of admission of the patient in the hospital. However, to avail payment for rehab services, a patient needs to pay their deductible. The benefit of such a service starts with the admission date in the hospital to the first 60 days of the patient’s admission in the hospital. Part A of Medicare usually covers the first sixty days of nursing facilities including coinsurance costs. After completing these days, the patient is responsible for all the expenses of the hospital’s stay. In some cases, medicare part A will also cover some coinsurance costs to meet the deductible. 

Does Medicare also pay for outpatient rehabilitation?

Some types of rehabilitation services like occupational therapy, physical therapy, and speech-language pathology are performed at home or other setting centers. These services are initially covered by Medicare part B. After an individual meets Medicare Part B, they need to pay 20% of the amount approved by Medicare for rehab services. However, there is no limit for these services as long as these services are considered important by a healthcare provider, as long as rehab will be paid.

Does Medicare also pay for drug abuse?

Yes, Medicare also provides coverage for drug or alcohol-related abuse. In outpatient services, these services are considered as a part of a partial hospitalization program, if recommended by a doctor that the patient needs at least 20 hours of therapeutic services as part of the hospitalization program. Medicare insurance may also cover the counseling sessions of drug abuse performed by clinical psychologists, doctors, and nurses. Parts C and D of Medicare also provide coverage for medicines that are prescribed by doctors for alcohol or drug abuse. However, the amount of coverage depends on the individual plan.

How does Medicare work to pay for rehab?

For availing the benefit of the Medicare rehab plan for a stay in the hospital, care must be given by a licensed physician, nurse, or any health care professionals. Medicare only pays the amount for skilled care if needed. Doing an exercise or walking without professional medical help will not be counted as skilled care. Medicare formulary checks the number of hours needed for the patient’s rehabilitation and these hours will be considered if a person needs to go to the hospital for an acute care hospital or long-term care facility.

Some of the key points related to Medicare pay for rehab include:

Rehabilitation days are a single event of staying in a hospital that is paid for by Medicare.

Rehabilitation days include:

• If you have to stay for many days in hospital but are discharged due to a post-acute facility after seven days of stay that means you have still some days left of Medicare payment for the stay.
• If you are readmitted to the hospital and then again discharged after some days then you still have some days left of the original 60 calendar days.
• People face trouble if they are readmitted for the same service many times, suddenly they realize that they do not have enough days left to go back to the rehab facility.