Did you know that Medicare has coverage for rehabilitation and therapy in a skilled nursing facility? This article covers a few basic things you should know as a Medicare beneficiary about Medicare and your Medicare supplement as it pertains to rehabilitation and therapy after an accident, illness or surgery. If you are interested in knowing why your doctor may recommend you for a short a short-term stay in an inpatient rehabilitation center like Fair Haven in Birmingham, you can access that article here.
WHAT WILL MEDICARE COVER?
Medicare pays for a rehabilitation stay under Medicare Part A in a skilled nursing facility, and only under certain conditions. There are specific requirements to get Medicare Part A to pay for an inpatient rehabilitation stay like at Fair Haven’s Rehabilitation Center:
1) The patient must have spent 3 consecutive midnights on inpatient status in an acute hospital setting (inpatient status, not observation status).
2) The patient must have a physician’s order to admit the patient to a skilled nursing facility for rehabilitation.
3) The patient must need daily skilled nursing facility services during the rehabilitation stay, such as rehabilitation and therapy, intravenous injections, wound care, etc.
4) Medicare offers a 30-day window from the date of discharge from the hospital setting if the patient goes home to enter a skilled nursing facility for rehabilitation.
HOW MUCH WILL MEDICARE PAY?
The next thing you should know is how much Medicare will pay. Medicare will pay for up to 100 days in a skilled nursing facility, and the days break down like this:
Day 1 thru Day 20 – Medicare pays 100% of the rehab stay, and the patient pays $0.
Day 21 thru Day 100 – Medicare pays all except a daily copay rate, which is currently $167.50 per day as of October 2018. This daily copay will increase in 2019 to $170.50 per day.
HOW CAN I COVER THE COST OF COPAYS?
The next thing you need to know is how you can pay for the copays during Day 21 thru Day 100, if continuing rehabilitation and therapy are needed. There are three ways:
#1 – Some Medicare supplements specifically state that they cover Medicare copays. It is VITAL for you to understand your Medicare supplement policy, and whether or not copay days are covered by your supplement plan. At Fair Haven, a business manager will help families verify whether or not their Medicare supplement covers the cost of the copays. Every year you have the option to UPGRADE or CHANGE your Medicare supplement during open enrollment, which for 2018 is October 15, 2018 through December 7, 2018.
#2 – If you are already on Medicaid in Alabama, Medicaid could cover the copays. At Fair Haven, a business manager will help families verify whether or not Medicaid will cover the cost of the copays.
#3 – Out of pocket for the copays.
YOUR NEW MEDICARE CARD
And by the way, by now every Medicare beneficiary in Alabama should have received a new Medicare card. The new Medicare card was issued to each qualified person in order to get away from the use of social security numbers, which were part of the old Medicare card numbers. The number on the new Medicare card is the number that will need to be given to health care providers in Alabama.
If you’ve not yet received your card, you can log on to your MyMedicare.gov account and, if your card has been mailed, you can see your new number or print an official copy. If you don’t have an account, visit MyMedicare.gov to create one, or you can call Medicare at 1-800-633-4227.
For more information about life at Fair Haven, including details on our how to make Fair Haven your or your loved one’s new home, contact our admissions team at 205-956-4150, or send an email to Traci Kennedy at [email protected]