Medicare is a government provision that millions of seniors take advantage of. But coverage isn't as simple as feeling the need for care, choosing a doctor or facility, and having Medicare pay for it. For any service that is acquired, specific conditions must be met. Here are the conditions under which Medicare will pay for skilled rehabilitation services.
- You still have days left in your benefit period. This is the period that starts the day you are admitted as an inpatient to a hospital or skilled nursing facility (SNF). It ends when you haven't received inpatient care for 60 days in a row.
- You were an inpatient in a hospital for at least 3 days. Time spent as an outpatient or 'under observation' doesn't count.
- Your doctor decided that you need services given daily in an SNF environment. It is fine if rehab isn't provided every single day in the facility, as long as you need it and get it each day that it is offered.
- The SNF must be certified by Medicare. Unfortunately, this may not be the facility located closest to your home or your family members.
- You must need these services because of a condition that was treated in a hospital, or a condition that started while you were an inpatient in a hospital or SNF. It doesn't have to be the condition for which you were originally admitted.
The Medicare website provides more details, including out-of-pocket costs. Be sure to speak to a social worker if you are unsure of your rights to coverage.
Caring Senior Service has the experience, compassion, and training necessary for comprehensive home care, and we also offer a wide range of home care services that are all designed to make life easier for seniors and their families. To learn more about the services we provide, contact us today!