Does Medicare Pay for Inpatient Rehab? We’ve Got the Facts You Need

If you or someone you love needs rehabilitation services from a skilled nursing home, you’re definitely wondering does Medicare pay for inpatient rehabilitation? It can be confusing to determine what Medicare pays for and what it won’t, so we’ve gathered some information you’ll find helpful and useful.

What Is Inpatient Rehabilitation?

Inpatient rehabilitation is needed when someone is recovering from a serious injury, illness or accident. Some cases where you may need rehabilitation include:

  • A stroke
  • Some type of paralysis
  • Injury or accident
  • A vision issue
  • Surgery
  • Knee replacement
  • Hip replacement

There are three main types of rehabilitation offered at Brook Stone:

  • Physical therapy
  • Occupational therapy
  • Speech therapy 

Physical therapy is probably the type of therapy that comes to your mind when you think of rehabilitation. This type of therapy concentrates on physical movement and helps residents learn to walk again or regain their balance, particularly after a joint replacement. This often involves extensive exercises.

Occupational therapy involves helping residents complete tasks of daily living, such as getting dressed or brushing teeth. In many cases, this requires learning new ways to complete the task or using assistive devices.

Speech therapy involves helping with speaking or swallowing problems. It also is used to help assess how residents are doing cognitively.

Medicare: What It Will Pay, What It Won’t

Medicare Part A

This covers care in a rehab unit in a hospital. It may pay for similar care in a skilled nursing facility like Brook Stone in certain cases.

If you’ve been in the hospital for three days, Medicare will pay for up to 100 days of inpatient rehab per benefit period. It pays for the first 20 days at 100 percent. However, the next 80 days usually involve a daily copayment.

Medicare does not pay after 100 days.

What If I Have to Return to the Hospital?

The good news is that if you have to go to the hospital, and you are there at least three days after one benefit period ends, then another benefit period starts.

It is possible to have as many benefit periods as needed.

Medicare covers:

  • Physical, occupational and speech therapies
  • A semi-private room
  • Nursing services
  • Meals
  • Medication
  • Hospital services

Typically, Medicare will NOT cover:

  • A private room (unless there is a reason that it is medically necessary)
  • A television or other such items in the room
  • Private duty nursing
  • Personal items (razors, toothpaste, etc.)

Need More Information? Here Are Some Resources

First, we understand that Medicare can be confusing, and in some cases, the rules are changing and evolving. This is why we encourage you to speak to members of our staff and your Medicare representative to ensure you have the latest up-to-date information.

Other information can be discovered at the Medicare website or call their toll free number at 1-800-638-6833.

How to Get the Most Out of Your Rehabilitation

We understand that rehabilitation is not a sprint—it’s a marathon. Sometimes, it’s easy to get frustrated, and that’s why we have a wonderful team of therapists who are always in your corner and taking this journey with you.

Our experts offer this advice on how to get the most out of your rehabilitation.

1. Realize this is a process.

Success won’t happen overnight. In many cases, such as surgery, your body has undergone extensive changes, and it will take time for it to adjust before you’re at 100 percent again. Don’t get frustrated. Instead, talk to one of our therapists if you’re concerned about how you’re progressing.

2. Be able to provide detailed information.

If you are having pain, be sure to tell us when it started, where the pain is, and if it hurt after doing a certain activity. This will help us identify any problems or issues.

3. Set goals.

What do you want to get out of rehabilitation? Do you want to walk again without pain, or do you need to regain a better sense of balance? When you set goals—and even the “baby steps” that it will take to reach those goals– then you’re able to evaluate not just where you’re going, but how far you’ve come! Seeing progress is a great motivator.

4. Commit to your appointments.

The number of appointments you have a week depends upon your condition or injury. Remember to give 100 percent at each appointment. If you’re not feeling well or you’re in pain that you feel may be hindering your progress, talk to us!

5. Complete your exercises.

In some cases, we may give you “homework” to do outside of our physical therapy appointments. It’s very important to complete those exactly as instructed. This will help you progress toward our goals.

6. Talk to us!

We believe in open and honest communication. If you’re concerned or you have questions, talk to us! At Brook Stone, we consider our residents family, and just like family, we only want what is best for you. We’ll be happy to address any concerns you may have.

Why Brook Stone is the Best Choice for Inpatient Rehabilitation

We have worked with residents who have a wide variety of needs, and we have improved the quality of their lives, whether it is through learning to walk after a knee replacement to teaching them how to bathe and dress themselves again.

It’s one of the most rewarding things we do, and we celebrate these victories with our residents.

We encourage you to ask about our friendly staff and peaceful environment. Contact us today. Hurry, because our spaces typically fill quickly.