Medicare does cover rehabilitation after strokes in aging adults, but the extent and type of coverage depend on the setting, the intensity of care needed, and meeting specific eligibility criteria. Rehabilitation after a stroke often involves physical therapy, occupational therapy, and speech therapy to help patients regain function and independence. Medicare’s coverage is designed to support these needs, but it comes with rules about where and how the care is delivered.
When an aging adult has a stroke, they may require inpatient rehabilitation in a specialized facility known as an Inpatient Rehabilitation Facility (IRF). Medicare Part A covers inpatient rehabilitation if the patient meets certain conditions. The patient must need a hospital-level care setting because of the intensity of therapy required—typically, this means at least three hours of therapy per day, five days a week. The care must be reasonable and necessary, and the patient must require a multidisciplinary team approach to improve their functional abilities. This setting is for patients who need intensive rehabilitation to recover quickly and safely enough to return home. Medicare covers a semi-private room, meals, nursing services, and all required therapies during the inpatient stay. There is no 3-day hospital stay requirement before admission to an IRF, unlike skilled nursing facilities[3][6].
If the patient does not qualify for inpatient rehabilitation or after discharge from an IRF, they may receive care in a Skilled Nursing Facility (SNF). Medicare Part A covers skilled nursing facility care for up to 100 days per benefit period, but only after the patient has had a qualifying hospital stay of at least three days (not counting the day of discharge). The first 20 days in a SNF are covered 100%, and days 21 to 100 require a daily coinsurance payment from the patient. The care in a SNF is less intensive than in an IRF, usually involving 1 to 2 hours of therapy per day. Medicare covers skilled nursing care, therapy services, meals, and room and board in this setting. The patient must need daily skilled care that can only be provided in a SNF, such as physical therapy or intravenous medications. Medicare does not cover long-term custodial care in nursing homes[2][3][5].
For stroke rehabilitation, the therapies covered include physical therapy to improve movement and strength, occupational therapy to help with daily activities like dressing and eating, and speech therapy to address communication or swallowing difficulties. These therapies can be provided in inpatient rehabilitation facilities, skilled nursing facilitie
