How Long Will Medicare Pay for Rehab

How Long Will Medicare Pay for Rehab? 

Rehabilitation often plays a key role in recovering after an injury. Whether an injury is physical, such as after surgery or an accident, or the injury is mental or emotional, such as after suffering due to addiction, rehab is often an important step in being made whole again. Thankfully, for Medicare recipients, rehab is provided in a number of different ways depending on the need.

How Does Medicare Cover Rehab?

If you need rehab after an injury, Medicare benefits cover inpatient care through Medicare Part A. This part of the program is designed to address costs associated with hospital admittance or admittance to a skilled nursing facility. Skilled nursing facilities may be needed during a rehabilitation period when hospital care would be too intensive and unnecessary.

If rehabilitation is provided on an outpatient basis, Medicare Part B would provide benefits. Outpatient rehabilitation is often used when things like physical therapy are required after an injury or while recovering from surgery.

Medicare Part D does not specifically address rehabilitation, but it may cover medications that are prescribed for home use as part of a rehab protocol. Medications that are administered by a physician or nurse would be either covered by Medicare Part A if administered while staying in a hospital setting or Medicare Part B if administered while being treated on an outpatient basis.

While the above is true for rehabilitation after a physical injury, it is also true when recovering from an addiction or when dealing with mental distress that requires rehabilitation. The same parts of your Medicare benefits will provide coverage for costs associated with physical rehab as long as the services are covered by your plan.

How Long Will Medicare Pay for Rehab?

In discussing how long Medicare will pay for rehab, inpatient and outpatient services needed to be addressed separately. Outpatient rehab services often have no limit in most cases unless a plan specifies a certain number of visits. Inpatient rehab, on the other hand, does have limits.

If you require inpatient rehab in a skilled nursing facility, Medicare will provide coverage for up to 100 days, after which you will be responsible for all costs. It’s important to note that this 100-day period is covered on a sliding scale that changes the longer you are receiving services.

Medicare covers your first 20 days at a skilled nursing facility at 100%. From day 21 through day 100, you pay a per-day charge that is outlined in your plan. After day 100, you pay all costs.

This may be different, however, if you require rehab in a hospital. In those situations, you may receive full coverage for the first 60 days. From day 61 through day 90, you pay a per-day charge as outlined in your plan. From day 91, you can use lifetime reserve days up to 60 days, bringing you to day 150. During these days, you would pay the per-day lifetime reserve rate. After day 150, you would be responsible for all costs.

Note that all plans are different, and Medicare Advantage plan may offer additional benefits. As such, it would be a good idea to work closely with your doctor and with your Medicare plan manager to discuss your rehabilitation needs and expectations prior to entering rehab if possible in order to avoid surprise charges.