The benefit period ends when you haven't received any type of hospital care (or up to 100 days of specialized care in an SNF) for 60 consecutive days. If you enter a specialty care facility for at least 60 consecutive days, this ends your current benefit period and renews your SNF benefits. This means that the maximum coverage available would be up to 100 days of SNF benefits. Understanding these aspects of Medicare rehabilitation coverage, including options for Home Care near Darien CT, can help you manage your options and make informed decisions about your care. Whether it's inpatient or outpatient rehabilitation, knowing what Medicare covers and for how long can ease stress and help you focus on recovery.
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. These two parts of Medicare provide different types of coverage for rehabilitation services, whether you're staying in a facility or coming for outpatient therapy. If this happens, there's no guarantee that a bed will be available to you in the same SNF if you need more specialized care after your hospital stay. Inpatient rehabilitation can help if you are recovering from serious surgery, illness or injury and need an intensive rehabilitation therapy program, the supervision of a doctor and the coordinated care of your doctors, other health professionals and therapists. The benefit period begins when you are admitted to a hospital and ends when you haven't received any type of hospital care for 60 days.
Understanding Medicare rehabilitation coverage for outpatient services can help you make informed decisions about your care. The benefit period begins the day you are admitted to a hospital or inpatient rehabilitation center (IRF) and ends when you haven't received any type of hospital care for 60 consecutive days. You don't have to pay a deductible for inpatient rehabilitation if Medicare already charged you a deductible for care you received at a hospital during the same benefit period. If you don't have a 3-day hospital stay that meets the requirements for hospitalization and you need care after being discharged from the hospital, ask if you can receive care in other settings (such as home health care) or if any other programs (such as Medicaid or veterans benefits) can cover the care you receive in the SNF. Your doctor must certify that you have a condition that requires ongoing medical supervision, intensive rehabilitation and coordinated care so that Medicare can cover the rehabilitation of patients hospitalized.
If your break in specialized care lasts longer than 30 days, you will need a new 3-day hospitalization to qualify for additional care from the SNF. Medicare Part A (hospital insurance) covers medically necessary care you receive in an inpatient rehabilitation center or unit (sometimes referred to as a “rehabilitation center,” IRF, intensive care rehabilitation center, or inpatient rehabilitation hospital). You may not need a minimum 3-day hospital stay if your doctor is involved in a responsible care organization or other type of Medicare initiative that has approved an exemption from the three-day rule in a skilled nursing facility. If you stop receiving specialized care in the SNF or leave it completely, your SNF coverage may be affected depending on the length of the interruption of SNF care.
Your doctor must certify that you have a medical condition that requires intensive rehabilitation, ongoing medical supervision, and coordinated care from your doctors, other health care providers, and therapists. The new hospitalization doesn't have to be for the same condition you were treated for during your previous stay.
