How Does Medicare Cover Rehabilitative Care?

There are numerous Medicare recipients who have been in the hospital for an illness or injury and then been released to go home without incident, simply feeling fine, recovering the rest of the way at home and moving forward from there.

Unfortunately, this is not always the case.  Many times an individual returns home only to encounter complications that need further care.  Sometimes this care can come in the form of home health nurses and practitioners, follow up visits to the doctor, help from friends and family or a combination of all of these.  Again, this combination can work well and result in a successful recovery.

What happens if the person’s recovery is not going as well?  What can be done if all of these measures in the examples above have been taken and the person needs more care or more intensive and inclusive care and the are on Medicare?\

If the doctor determines that the individual does not have to be in the hospital but does need to be in a skilled nursing care facility for rehabilitation, there is coverage available through Medicare and Medicare Supplemental Coverage. 

If the doctor has the individual admitted to a skilled nursing facility, Medicare will cover this as long as the doctor shows that the person is being treated for the same issue that they were being treated for previously in the hospital and at home, prior to being admitted into the skilled nursing facility.  To link these things together, the doctor must show that the person was in the hospital for at least three consecutive days before eventually being admitted to the skilled nursing facility, whether they came home in between or not. 

Medicare will cover the first twenty days in the skilled nursing facility in full.  Then, from day 21 to 100 the individual is responsible for a copy of $128 per day.  If the individual has a Medicare Supplement, the copy for days 21 through 100 might be covered.

It is important to explore the Medicare Supplements available and determine which ones are right for you and which ones have premiums that will fit into your budget.  Do this research while you are still healthy if possible so that you can put it into place ahead of time.  If you have your coverage sorted out before you experience a serious illness or injury, you will be able to concentrate on your recovery rather than your coverage when you are trying to get well.