Does my seniors insurance cover physical therapy and rehabilitation?

by the Editor, SeniorInsider | May 31, 2011

As we get older and injuries become more and more common, it’s important to have seniors insurance in place that covers rehabilitation and physical therapy.  While you may never be in need of these services, it definitely does not hurt to have them at your disposal.  While injuries can happen to people of all ages, they can be more complicated for people over the age of 65.   It is important to find insurance for seniors that provides benefits for physical therapy and rehab in case you need these services.

When is Physical Therapy Necessary?


Physical therapy is a type of rehabilitation services that focuses on restoring health and functionality and is usually used when people are recovering from musculoskeletal injuries.  Sometimes physical therapy will also be used as a way to help people to cope with ailments like arthritis or illnesses like Parkinson’s health care.

If you need physical therapy you will likely have a special program designed to assist you with your recovery.   This will include exercises that have therapeutic effects and assist with your muscle function, coordination and senior mobility.

Seniors Insurance Often Covers Rehabilitation


Many rehabilitation services are covered by insurance for seniors.  For example, Medicare Part B often handles physical therapy, restorative care and even home health care if it becomes necessary.  Medicare Part B works to cover outpatient health care and expenses for doctor visits.  Services like X-rays, braces and medical equipment will also be covered under Medicare Part B seniors insurance.

You will find that Medicare will reimburse you for about 80% of the charges that are allowed.  This means that you must pay 20% and also any charges that Medicare doesn’t allow.  As a result, it is important to stay on top of what your seniors insurance does and does not handle.

Insurance for Seniors Under Medicare Part A


If you are undergoing physical therapy and rehabilitation, Medicare Part A may handle some of the costs as well.  For example, Medicare Part A can cover your stay in a nursing facility if you have recently been admitted to the hospital for more than three days.  If you are trying to get covered for a stay in an inpatient rehabilitation facility, you don’t necessarily need to have been hospitalized.

Stipulations with Medicare Seniors Insurance


Keep in mind that in order to receive these insurance benefits, you need to have at least two different types of rehab prescribed by your doctor.  It is also necessary to get a prescription from a doctor for your physical rehabilitation services.  Further, in order to receive coverage under Medicare Part A seniors insurance, you need to make sure that you are in a “Medicare-certified” rehab facility.  

It’s important to note that you will only receive coverage while you are getting better.  Once your condition is marked as stable, Medicare Part A will no longer provide your inpatient care. Another factor to keep in mind is that while you are receiving coverage, you must receive at least three hours of rehab therapy per day.

Considering Medigap Insurance for Seniors


Medigap is designed to handle any gaps between what Medicare covers and the services that you need.  However, Medigap is a policy that you would need to pay for out of pocket and get from a private insurance company.  The good news is that if you decide to get a Medigap Medicare supplemental plan, you don’t need to panic if you receive treatments that are not covered by your Medicare policy.  Medigap can also cover your Medicare Part B deductibles and co-payments.  

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