Does Medicare pay for rehab stay following a surgery?

[question everything]

Spouse had an open heart surgery, went OK but will require some rehab before can go home and be self sufficient. I cannot take care of everything. Right now two nurses handle some of the movements.

I kinda remember, when we purchased our long term insurance, that Medicare pays for initial stay if there is a direct transfer from the hospital.

Anyone can shed more info?

I suppose the Social Worker in the hospital should know about it, also what is available around. I think that by now these places are safer than they were last year - Covid wise - and spouse had both vaccines.

Hope to know more tomorrow.

[DemocratSinceBirth]

1. If my memory is correct they pay for one hundred days.

[SharonAnn]

5. Best to verify this. Depends on how long in the hospital, if discharged directly from there, etc.

We mean well, but don't take your advice from us.

[question everything]

7. I certainly will but the comments here are a start on which to ask

Sometimes one does not even know where to start and what to ask.

[Groundhawg]

2. yes they will

[rsdsharp]

3. I have a Medicare Advantage plan.

It paid for 19 days of rehab. After that I would have been responsible for part of the cost.

[question everything]

4. Thanks. This is what we have. And I do hope that stay should be less than 19 days.

[rsdsharp]

6. After I went home it also paid for a daily visit by a nurse

Last edited Tue Mar 2, 2021, 12:25 AM - Edit history (1)

for seven days, and then once or twice a week for several more weeks. I also had in home physical therapy once or twice a week for a couple of months. I had no out of pocket for that. They also paid for consumable medical supplies ( gauze, saline, bandages, etc.)

[PoindexterOglethorpe]

8. Wow. That's amazing.

I'm a senior, recently was hospitalized with a heart attack, but didn't need home physical therapy. Medicare is paying for 36 weeks of cardiac rehab, although I do have a copay. Lucky me, I can afford the copay.

The hospital stay was billed at around $80,000 for three days. That includes the cath lab bill for the stent and everything else connected to it. Medicare paid about $32,000, the rest was written off other than $885 I needed to pay. Which, again, I can easily afford.

Many years ago, around 1974 or so, I had a small medical crisis, and after insurance, I was left with some kind of copay. I wish I could remember what the total was, but it was more than I could imagine being able to pay off, and in a panic I went to the station manager's secretary. She was able, quickly, calmly, and efficiently, to separate the wheat from the chaff and let me know that I owed maybe twenty dollars. Which was still a fair amount of money for me, living as I was from paycheck to paycheck, but it was vastly better than the sixty dollars I remember as being the bill. This was in perhaps 1973, so that sixty dollars was more than $300 today. And again, living paycheck to paycheck as I was then, that was a lot of money.

What we can afford really matters.

[rsdsharp]

11. I got the bill for 16 days of hospitalization,

including five days in ICU, and five surgeries. It was about $190,000. My share was $1770. From there I transferred to a rehab floor in the same hospital for 19 days, followed by the aforementioned home follow up. Didn’t pay a cent; never even saw a bill.

[PoindexterOglethorpe]

13. My. I will ask, did you pay the $1770?

I'm guessing the answer is yes, but you didn't pay anything else.

This is how it should be.

[rsdsharp]

14. Oh yes. I thought it was quite reasonable.

Last edited Tue Mar 2, 2021, 04:43 PM - Edit history (1)

The downside was that a month and a half before I was hospitalized I retired, and my employer’s insurance was gone. I had been hospitalized in March, as well for something else, and had satisfied my out of pocket for the year on that policy. Suddenly, that went POOF, and a new out of pocket applied.

[PoindexterOglethorpe]

15. I'm inclined to agree that it was quite reasonable.

I'll add that I'm one of those amazing and annoyingly healthy people who essentially never get sick. As a consequence, I am not as understanding or sympathetic as I should be to normal people with normal health problems. I will say, in my defense, that I have long advocated some sort of Universal Health Care. If everyone can't be as healthy as I am, they should at the very least pay as little as I do for health care.

[question everything]

16. This will be nice - rehab in the hospital instead of transferred to another place via ambulance, no

doubt.

Thanks, one more bit of information to know.

[question everything]

17. Four years ago spouse had a knee replacement surgery, stayed in the hospital three days

The hospital alone charge was close to $42,000, Medicare paid $13,000, supplemental insurance another $1200 and our co-pay was $200.

I remember even posting here: either the hospital needs $42,000 to survive, or it can do it with $15,000 (Medicare, plus insurance plus our co-pay).

The reality, of course, that hospitals charge different rated depending on the contracts that they have.

Recently the WSJ posted a long story about C-Sections in San Francisco Sutter Health’s California Pacific Medical Center, where price might be $6,241. Or $29,257. Or $38,264. It could even go as high as $60,584.

The rate the hospital charges depends on the insurance plan covering the birth. At the bottom end of the scale is a local health plan that serves largely Medicaid recipients. At the top are prices for women whose plans don’t have the San Francisco hospital in their insurers’ network.

[Trueblue Texan]

9. Medicare pays 100% for first 10 days...

80% for next 80 days. You should have a social worker check this out for you. It’s been 5 years since I worked inpatient rehab

[question everything]

10. I certainly will. Social worker stopped by but was saying so much that it was hard to keep up.

[Trueblue Texan]

12. Home health after discharge from inpatient therapy should be covered 100%

Home health services can include nursing, physical and occupational, as well as speech therapy and even bath aide services. It’s a great value. Remember, just because you could toilet and shower before hospital stay doesn’t mean you can still do those things without great effort or huge fall risk. Home health will make sure you can still take care of yourself safely with your new level of function.

[question everything]

18. This is what I found. First, because we have Medicare Advantage - there is nothing else here

except straight Medicare -

the rehab center has to be in the network and the social worker found one not too far from home.

But.. none of them allow visitors. So decided to look at a few that are close to the hospital. This way, if there is an emergency the hospital will be close by.

Yes, will have to pay for transportation but as costs go, we should be able to handle this. I think.

Will have to wait and see. Thanks to all who made suggestions.