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Medicare is a federal health insurance program that covers a range of healthcare services for individuals who are 65 or older, as well as those with certain disabilities or chronic conditions. One of the benefits of Medicare is coverage for inpatient skilled nursing and rehabilitation (rehab) or physical therapy (PT) services if you have an injury.
When an individual suffers an injury that requires inpatient skilled nursing care, Medicare Part A may cover the cost of a stay in a skilled nursing facility (SNF). In order to qualify for coverage, a hospital stay of at least three days is typically required. Medicare will cover up to 100 days of care in a SNF, but it’s important to note that coverage is not automatic after the first 20 days. After the first 20 days, there may be a daily copayment that the patient is responsible for.
Additionally, Medicare Part B covers outpatient rehabilitation services, including PT, for those who have an injury. This coverage includes services provided in a hospital outpatient setting, a rehab facility, or a clinic. In order to qualify for coverage, the services must be deemed medically necessary and be provided by a qualified healthcare professional.
Physical therapy is often necessary after an injury to help individuals regain strength, flexibility, and range of motion. Medicare Part B covers physical therapy services, including evaluation, treatment, and education. There is typically a limit on the number of PT visits that will be covered in a given year, so it’s important to check with Medicare to understand your coverage.
It’s important to note that Medicare does not cover custodial care or long-term care in a nursing home or assisted living facility. Medicare coverage is focused on providing necessary medical care, rather than non-medical care.
In summary, Medicare provides coverage for inpatient skilled nursing and rehab/PT services if you have an injury. Medicare Part A covers the cost of a stay in a skilled nursing facility, while Part B covers outpatient rehabilitation services, including PT. Coverage is typically limited and services must be deemed medically necessary. If you have questions about your coverage or eligibility for Medicare, speak with your healthcare provider or contact Medicare directly.
