People With Medicare
Rehabilitation Therapies Coverage
If your doctor thinks therapy can help you, Medicare should pay for it. Your doctor must follow the Medicare rules for ordering this therapy. Make sure you understand Medicare’s rules.
Will Medicare continue to cover rehabilitation therapy if my condition does not improve?
Yes. Many people think that Medicare will only pay for rehabilitation therapy as long as the patient improves. This is not true.
Medicare will cover therapy when it can help a person keep functioning, or keep the condition from getting worse. Medicare will pay as long as the patient needs skilled care and meets other coverage rules.
What would Medicare NOT cover?
Medicare only covers services that you need a skilled rehabilitative therapist to do. For example, you may not need a therapist to do repetitive motion exercises for you.
What if my Medicare home health care benefits are ending?
Sometimes home health agencies tell patients with Alzheimer’s that Medicare will stop covering these services. The agencies may claim that the patient will not improve, or benefit from continued therapy. But rehabilitative therapy can help people with Alzheimer’s. Medicare does cover rehabilitative services if they can help prevent or slow decline, or keep you functioning.
If Medicare refuses to pay, talk with your doctor and therapist. A home health agency that often cares for patients with Alzheimer’s or dementia can be of most help. It is best to pick one of these agencies from the start. If your doctor or therapist thinks therapy can help you, then you can appeal Medicare’s decision. To find out how, get personal help.