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I think Medicare limits the number of days for rehab,if you need more days,you have to pay yourself.
Some nursing homes,like the one we have in Houston,has a special building where you can stay after returning from hospital,before you go back to your apt within the nursing home facility.
I would assume this is how you can stretch your rehab
I think Medicare limits the number of days for rehab,if you need more days,you have to pay yourself.
Some nursing homes,like the one we have in Houston,has a special building where you can stay after returning from hospital,before you go back to your apt within the nursing home facility.
I would assume this is how you can stretch your rehab
Under Part A this is called Skilled Nursing Home assuming it is medically necessary. Need to have had a 3 day hospital stay & discharge.
With the move to Home Care there may be another item to bring in a Nurse.
For Skilled Nursing Home days 1-20 pay $0 For days 21-100 pay $200/day. For days 101 on pay full cost.
Under Part B there may be other charges for the Doctor. You may be responsible for the 20% Medicare does not cover.
Depending on your Medigap plan may cover all these costs.
Under a Advantage plan pay a co-pay for 20 days then more days 21-100 & the most days 101 7 on. Prices may be higher.
Sounds like Houston may have a facility like Vanderbilt Stallworth rehab where you can go after surgery then get therapy so you can take care of yourself. Still have nurses 24/7 but go to dining room when you are able.
sorry to disillusion you but medicare is def a gate keeper. if it doesnt approve of any test, any treatment etc etc it doesnt pay! been there and done that and I have the symptoms that may kill me thanks to that crappy govt ins.
I'm not going to keep arguing with you. There are no gatekeepers determining how long you can get rehab, period. It is nothing like an Advantage plan where you have to get re-approved week by week. I'm not talking about anything but rehab.
Speaking of pitfalls of Advantage plans, my brother's ex-wife had a cancer scare. She had lung cancer removed years ago, but a recent scan showed something suspicious. It turned out to be just inflammation, false alarm. She said "Thank God, because I can't afford radiation", because her Advantage plan only covers 80% of it. That's when you find out the nuts and bolts of the plans, when you're really sick. When you're healthy they seem great.
FYI, I say all this knowing full well I will most likely end up on Advantage plan, because I probably won't be able to afford a supplement. But I know full well it'll probably bankrupt me when I start needing multiple joint replacements, etc (I have a lot of arthritis already and my spine is a mess).
I think Medicare limits the number of days for rehab,if you need more days,you have to pay yourself.
Some nursing homes,like the one we have in Houston,has a special building where you can stay after returning from hospital,before you go back to your apt within the nursing home facility.
I would assume this is how you can stretch your rehab
Medicare pays 100% of the first 20 days, then 80% of days 21-100 (there is a dollar amount but it generally works out to 80/20). The supplemental insurance plan that really is a requirement if you opt for traditional, pays the other 20%.
That unit in the building is the sub-acute rehab unit, all patients who are under Medicare A due to a 3-day hospitalization go to that unit. When rehab is done and there is no more need for skilled care, they go back to the long term unit. These units are certified by the state as being for subacute or long term.
Long term patients can still get therapy under Medicare B too though, but usually 3 days a week vs 5-7.
FYI, I say all this knowing full well I will most likely end up on Advantage plan, because I probably won't be able to afford a supplement. But I know full well it'll probably bankrupt me when I start needing multiple joint replacements, etc (I have a lot of arthritis already and my spine is a mess).
You can have your cake and eat it too with a high-deductible Medigap at a fraction of the cost. Ex: Plan G in WI for me $330 or Plan N $240 v. $68 for a high deductible plan.
HDs provide all the flexibility, coverage and protections of a full Medigap, Medicare pays its 80%, you pay 20% up the deductible - $2,700 for 2023. Thereafter, coverage is 100% between Medicare/Medigap.
Many here are choosing the HD as they are realizing the cost-effectiveness of these plans. They may experience a bad year when the deductible is met, but most find they rarely incur anywhere near the deductible in their 20% copay on any consistent basis. You save thousands in premiums over the years, meanwhile the coverage is there should disaster befall.
You can have your cake and eat it too with a high-deductible Medigap at a fraction of the cost. Ex: Plan G in WI for me $330 or Plan N $240 v. $68 for a high deductible plan.
HDs provide all the flexibility, coverage and protections of a full Medigap, Medicare pays its 80%, you pay 20% up the deductible - $2,700 for 2023. Thereafter, coverage is 100% between Medicare/Medigap.
Many here are choosing the HD as they are realizing the cost-effectiveness of these plans. They may experience a bad year when the deductible is met, but most find they rarely incur anywhere near the deductible in their 20% copay on any consistent basis. You save thousands in premiums over the years, meanwhile the coverage is there should disaster befall.
My wife had cataract surgery this morning and she has regular Medicare and a plan N supplement. So when she checked in nothing needed to be paid up front because everything would be covered.
While I was waiting for her, another very elderly lady came in for cataract surgery. When she checked in, she was told that with her insurance, she had a copay of $1100 that would need to be paid up front. She said that she didn't have that much money, so they worked it out to pay 1/2 down and the rest in payments.
Makes me really appreciate the Medicare insurance we have.
What a tragedy, and the administration seems intent on making Medicare advantage our only option. I was just reading an article today about how medicare advantage plans can now use "step therapy". In case anyone doesn't know what that is, it goes like this. There are 4 drugs for a given disease, and medicare advantage requires that the physician try each drug in order of cost, starting with the cheapest. So if you have stage 4 cancer and your oncologist suggests starting with drug D (the most expensive) because you have a short life expectancy if the cancer isn't controlled, medicare advantage won't pay until drugs A, B, and C are tried and fail...too bad for you if you die before you are allowed the drug that might help you https://www.medscape.com/viewarticle/900503
Not only that, but there are politicians who want EVERYONE to have Medicare! They think that's a great idea! Notice, that those politicians are not on Medicare. They're on top-notch Congressional health insurance.
To avoid confusion, it should be noted the post you elected to comment on -- referring to "the administration" -- was from 2019. So, it's not referring to the current administration.
The current administration seems to be taking at least some steps to try to rein in the misleading marketing practices of insurance companies selling Medicare Advantage policies. More action is needed, but at least it's a start (and certainly more than what the prior administration ever attempted).
Not only that, but there are politicians who want EVERYONE to have Medicare! They think that's a great idea! Notice, that those politicians are not on Medicare. They're on top-notch Congressional health insurance.
They want everyone to have access to it, not required to get it. It's much better than most worker's employer-provided insurance. It was just a way to try to get Universal health care going, which we sorely need IMO.
The politicians who want everyone on Medicare to be on an Advantage plan, are the opposite end of that spectrum. They just want to cut Medicare budget and give a gift to corporate insurance entities, and even Wall Street (yes, Medicare might end up in the hands of investment funds and hedge funds if these politicians get their way)
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Notice, that those politicians are not on Medicare. They're on top-notch Congressional health insurance.
