Medicare covers inpatient rehab in an inpatient rehabilitation facility – also known as an IRF – when it’s considered “medically necessary.” You may need rehab in an IRF after a serious medical event, like a stroke or a spinal cord injury.

What nursing homes does Medicare cover?

Usually, Medicare Part A may pay for up to 100 days in a skilled nursing facility. A skilled nursing facility must admit the person within 30 days after they left the hospital, and they must admit them for the illness or injury the person was receiving hospital care for.

What is the 3-day rule for Medicare?

Medicare inpatients meet the 3-day rule by staying 3 consecutive days in 1 or more hospital(s). Hospitals count the admission day but not the discharge day. Time spent in the ER or outpatient observation before admission doesn’t count toward the 3-day rule.

How Long Does Medicare pay for rehab?

100 days
Medicare will pay for inpatient rehab for up to 100 days in each benefit period, as long as you have been in a hospital for at least three days prior. A benefit period starts when you go into the hospital and ends when you have not received any hospital care or skilled nursing care for 60 days.

What happens after 100 days rehab?

Days 101 and beyond: Medicare provides no rehab coverage after 100 days. Beneficiaries must pay for any additional days completely out of pocket, apply for Medicaid coverage, explore other payment options or risk discharge from the facility.

Can a Medicare Advantage plan pay for rehab?

Many of these privately sold plans may also offer additional benefits not covered by Original Medicare, such as prescription drug coverage. This means that a Medicare Advantage plan will pay for your qualified rehab in the same ways that Medicare Part A and Part B would.

What is the Medicare deductible for inpatient rehab?

If you’re enrolled in original Medicare (Medicare Part A and Part B) in 2020, you’ll pay the following costs during each benefit period: Days 1 through 60. You’ll be responsible for a $1,364 deductible.

When does the inpatient rehab benefit period end?

The period ends 60 consecutive days after your stay without further inpatient care. If you need to return to the hospital and are admitted within 60 days of your previous stay, you’ll still be in that benefit period. However, if you go back to the hospital after the 60 days without care, a new benefit period begins.

Do you pay for rehab in a SNF?

Rehab in an SNF may be needed after an injury or procedure, like a hip or knee replacement. You usually pay nothing for days 1–20 in one benefit period, after the Part A deductible is met. You pay a per-day charge set by Medicare for days 21–100 in a benefit period. You pay 100 percent of the cost for day 101 and beyond in a benefit period.