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Medicare and Rehabilitation Care

Rehabilitation hospitals are specialty hospitals or parts of acute care hospitals that offer intensive inpatient rehabilitation therapy. This kind of care is intended for patients recovering from a serious illness, surgery, or injury and requires a high level of specialized care that generally cannot be provided in another setting.







Common conditions which may qualify for care in a rehabilitation hospital include ;
  • stroke
  • spinal cord injury
  • brain injury. 
Hip or knee replacement is not covered by Medicare, especially if you have no other complicating condition.


Medicare-covered services offered by rehabilitation hospitals include:
  • Medical care and rehabilitation nursing
  • Physical, occupational, and speech therapy
  • Social worker assistance
  • Psychological services
  • Orthotic and prosthetic services
To qualify for a Medicare-covered stay in a rehabilitation hospital, your doctor must state that this care is medically necessary, meaning you must require all of the following services to ensure safe and effective treatment:
  • 24-hour access to a doctor which means you require frequent, direct doctor involvement, at least every 2-3 days
  • 24-hour access to a registered nurse with specialized training or experience in rehabilitation
  • Intensive therapy, which generally means at least three hours of therapy per day. You may still qualify if you are not healthy enough to withstand three hours of therapy per day)
  • And, a coordinated team of providers including, at minimum, a doctor, a rehabilitation nurse, and one therapist
Your doctor must also expect that your condition will improve. That after a rehabilitation hospital stay, you will be able to function more independently.  Such as, therapy may help you regain the ability to eat, bathe, and dress on your own, live at home, and/or live with family rather than in a living facility.
If you qualify for Medicare-covered care in a rehabilitation hospital, your out-of-pocket costs will be the same as for any other inpatient hospital stay

Also keep in mind that if you enter a rehabilitation hospital after being an inpatient at a different facility, you will still be in the same benefit period. If you do not qualify for a Medicare-covered stay in an inpatient rehabilitation hospital, you may still qualify for rehabilitation care from a skilled nursing facility, a home health agency, or in an outpatient setting.

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NCOV -19 and MEDICARE 2020

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Cardiovascular Disease Risk Reduction

Cardiovascular disease generally refers to conditions that can lead to a heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease. How to know if I am Eligible? Medicare   Part B  covers an annual cardiovascular disease risk reduction visit with your primary care  provider . You do not need to show any signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided.  During the screening, your provider may; Encourage aspirin use if the benefits outweigh the risks You are a man  of age 45-79 Or a woman of age 55-79 Screen for high blood pressure if you are age 18+ Provide behavioral counseling and tips to encourage a healthy diet Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease. How much will it cost? If you are eligible,  Original Medicare  will cover your cardiovascular disease risk red

Lifetime Reserve Days

There are  90 days of  inpatient  hospital care coverage on Original Medicare for each  benefit period , In addition, you also have an additional 60 days of coverag e , called LIFETIME RESERVE DAYS .   These Lifetime Reserved Days  can be used only ONCE, and you will pay a  coinsurance  for each of it. To have a better understanding of it, let’s imagine an individual who had a 120-day  Medicare -covered inpatient stay, this means that they used 30 lifetime reserve days. After they have been out of the hospital for 60 days in a row, they will be eligible for another 90 days of hospital coverage because they will be in a new  benefit period . However, if they need  inpatient care  beyond the benefit period maximum, they will only have 30 of their 60 lifetime reserve days remaining. The above example illustrates that lifetime reserve days do not have to be applied to the same hospital stay. If you need to stay in the hospital twice for 120 days each time during different benefit