Inpatient rehabilitation care
Part A (Hospital Insurance) Medically necessary
Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.
Your costs in Original Medicare
You pay this for each Benefit period
The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you're admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven't gotten any inpatient hospital care (or up to 100 days of skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There's no limit to the number of benefit periods.
- Days 1-60: $1,676 deductible.*
- Days 61-90: $419 each day.
- Days 91 and beyond: $838 each day while using your 60 “lifetime reserve days.”
Lifetime reserve days
In Original Medicare, these are additional days that Medicare will pay for when you're in a hospital for more than 90 days. You have a total of 60 reserve days that can be used during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance. - Each day after you use all of your lifetime reserve days: All costs.
*You don’t have to pay a deductible for inpatient rehabilitation care if Medicare already charged you a deductible for care you got in a prior hospitalization within the same benefit period. This is because your benefit period starts on day one of your prior hospital stay, and that stay counts towards your deductible. For example, you won’t have to pay a deductible for inpatient rehabilitation care if:
- You’re transferred to an inpatient rehabilitation facility directly from an acute care hospital.
- You’re admitted to an inpatient rehabilitation facility within 60 days of being discharged from a hospital.
What it is
Inpatient rehabilitation can help if you’re recovering from a serious surgery, illness, or injury and need an intensive rehabilitation therapy program, physician supervision, and coordinated care from your doctors and therapists.
Medicare-covered inpatient rehabilitation care includes:
- Rehabilitation services, including physical therapy, occupational therapy, and speech-language pathology
- A semi-private room
- Meals
- Nursing services
- Prescription drugs
- Other hospital services and supplies
Medicare doesn’t cover:
- Private duty nursing
- A phone or television in your room (if there’s a separate charge for these items)
- Personal items, like toothpaste, socks, or razors (except when a hospital gives them as part of your hospital admission pack)
- A private room, unless medically necessary
Things to know
Part B (Medical Insurance)
Covers certain doctors’ services, outpatient care, medical supplies, and preventive services.