Part A covers inpatient hospitalizations, care in skilled nursing facilities, palliative care, and some home health care. Medicare pays for inpatient and outpatient rehabilitation care that is medically necessary after a debilitating illness, injury, or surgery. Yes, Part B (health insurance) helps pay for medically necessary outpatient physical therapy, including Senior Care Services near Katy TX. The amount you pay may depend on any other insurance you have and the type of facility you use. Your doctor may also recommend services that Medicare doesn't cover or suggest that you receive them more often than Medicare allows, depending on your condition.
Be sure to ask the questions before starting therapy to be clear about how much you'll have to pay in the future. A previous rule allowed Medicare to deny you coverage for a stay in the IRF if your condition was not expected to improve enough during the stay so that you could return home on your own or regain your previous level of functioning, but this rule is no longer in effect. You don't have to pay a deductible for inpatient rehabilitation care if Medicare already charged you a deductible for care you received in a previous hospitalization within the same benefit period. Before you start getting home health care, the home health agency must tell you how much Medicare will pay.
However, if you are transferred from an intensive care hospital, the deductible you pay for the hospital stay is also considered for the rehabilitation stay. If you receive your Medicare benefits through a Medicare Advantage (Part C) plan or another Medicare health plan, check with your plan for more information about your home health benefits. The benefits of Medicare home health care services will not change, and the pre-application review process should not delay your access to home health care services. The good news is that, for the first 60 days of being hospitalized in an IRF, Part A of health insurance covers everything (after paying the deductible).
Medicare covers a different number of days for an IRF than for skilled nursing, and you pay a higher copay for a rehabilitation center. For Medicare to approve home care, the Medicare beneficiary must have developed a plan of care during an in-person consultation with a doctor. There's no limit to how much Medicare can pay for your outpatient therapy services in a calendar year, as long as your doctor or other health care provider certifies that it's needed since the medical point of view. If a person pays for room and board costs or is not eligible for Part A coverage, Medicare may pay for Part B specialty therapy services instead of Part A.
The agency must also let you know (both verbally and in writing) if Medicare won't pay for the items or services you provide and how much you'll have to pay for them. If you choose Original Medicare (Parts A and B), you may consider buying a separate Medicare supplement plan to help you pay for out-of-pocket expenses, such as deductibles, copays and coinsurance. Based on this demonstration, your home health agency may submit to Medicare a request for a pre-claim review of coverage for services of home health care. Depending on eligibility, both Part A and B may cover medically necessary specialized home therapy provided by a Medicare-approved home health agency.
