Medicare Coverage for Inpatient Physical Rehabilitation

What is rehabilitation?

Rehabilitation (also called rehab) is a treatment program for people who have been ill or injured. It helps you relearn the skills of everyday life. In rehab, you may learn new ways to:

• eat, cook, dress, or bathe
• exercise to improve your strength and balance
• improve your ability to remember things or solve problems
• listen, read, speak, and write.

When is rehab needed?

You may need rehab if you have:

• a stroke or other type of paralysis
• injuries that make it hard to do everyday tasks
• a hand injury or surgery
• joint replacement surgery
• vision problems such as blindness.

What is Medicare?

Medicare is a federal government program. It provides healthcare coverage for people age 65 and older and for people of any age who have certain disabilities.

Medicare is divided into 2 parts: Part A and Part B. Each part covers different services. Both parts pay some of the costs for needed medical services. Rules about what Medicare covers can be confusing. Rules also change from time to time. Your local Social Security office can answer your questions about Medicare.

Does Medicare cover rehabilitation?

Rehabilitation in a hospital rehab unit is covered under Medicare Part A. Medicare may pay for rehab in a skilled nursing facility in some cases.

After you have been in a hospital for at least 3 days, Medicare will pay for inpatient rehab for up to 100 days in a benefit period. A benefit period begins when you go into the hospital. It ends when you have not received any hospital care or skilled nursing care for 60 straight days.

Medicare pays for the first 20 days at 100%. For the next 80 days, you must pay a daily co-payment. Medicare does not pay for rehab after 100 days.

If you go into the hospital (for at least 3 days) after one benefit period has ended, a new benefit period begins. There is no limit to the number of benefit periods you can have.

For information on coverage for outpatient rehabilitation, see:

Occupational Therapy

Physical Therapy

Call Medicare toll-free at 1-800-638-6833.