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Medicare and Rehabilitation Therapies

Medicare covers important types of services at home to help with Alzheimer’s. These are called skilled rehabilitation therapies. These services can help you keep or improve your ability to function. They are covered as a part of Medicare’s home health care benefit. They include:

  • Physical therapy to help you move, walk, or get around your home, and
  • Speech-language therapy services to help you talk or swallow, and
  • Occupational therapy to help you do your daily activities.

Only trained professionals can give you these services. You only qualify if you need trained professionals to give you this kind of treatment safely and effectively.

What will rehabilitation therapies do for someone with Alzheimer’s?

This skilled care can be very helpful. It can help prevent or delay your symptoms. This is especially true for people with early or moderate Alzheimer’s symptoms.

Skilled rehabilitation therapies can help in these ways:

  • Physical therapy: These treatments help strengthen a body part. They help you move again, or do daily tasks. For example, physical therapists can teach you how to get in and out of a wheelchair or bathtub safely. They also can help you walk better, get you moving after a fall, or help you keep your ability to function.
  • Speech-language therapy: People with Alzheimer’s often have problems with speaking and swallowing. This type of therapy can help you with both. Speech therapy can help you to restore or maintain your speech or hearing. It can also help you listen, read, and remember things.
  • Occupational therapy: This helps you learn how to do common daily activities that become harder to do as your Alzheimer’s progresses. You can learn new ways to eat, put on clothes, brush your teeth, and do other daily activities.

Note: You cannot qualify for home health care if the only skilled service you need is occupational therapy. But you can keep getting this kind of treatment and home health aide care even when you stop needing other skilled care.

Does Medicare cover rehabilitation therapy?

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.

NEXT: Medicare Drug Coverage and Alzheimer’s

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