When I moved mom from Kentucky to Florida, she had been in a rehab post acute facility for about a month. So, Medicare paid for the first 20 days.

Four days ago mom fell and broke her leg, so she is in the hospital now, and had surgery this morning. I am guessing that she will be released in a few days to a rehab facility.

Can someone tell me if my memory serves me correct, and that Medicare will not pay for the first 20 days of rehab, because mom was in rehab about seven weeks ago? I thought that I remembered that Medicare will not pay for rehab, if they have previously paid the first 20 days of rehab, within 90 days.

I hope that I am wrong, because I feel like I’m in such a pickle right now. If mom has to be in rehab for one week to four weeks, and her long-term care insurance is paying for the assisted living facility, then that means I’m gonna have to pay what is due at the rehab facility daily. Ugh. :-(

Thanks everyone. I found out that she had to be living outside of a hospital or rehab for 60 days in order for the clock to reset on Medicare. But, she still has 64 days left for them to pay 80%, so that’s what we will have to go with. :-/
Helpful Answer (2)
Reply to NekkidFish
JoAnn29 Apr 27, 2019
Medicare does not pay 80% towards rehab after the first 20 days. Its 50%. Is her suppliment picking up the 30 %?
According to website:

Does Going into a Hospital from Rehab Restart Medicare's 100-Day Payment Period?
The hospitalization may extend the resident’s skilled nursing facility (SNF) coverage by a few days because the time spent in the hospital should not count towards the 100 days. However, The resident will not receive a new 100-day allotment until he has been out of the hospital and the SNF (in other words, not receiving any Rehab PT or OT) for at least 60 days.

Beginning on day 21 of the SNF/Rehab PT & OT stay, there is a significant copayment equal to one-eighth of the initial hospital deductible ($170.50 a day in 2019). This copayment is usually be covered by a Medigap insurance policy, provided the patient/resident has one.
Helpful Answer (1)
Reply to DeeAnna

Speak with the Social Worker at the hospital. She has already done 30 days. She has 60 more to go. She may just pick up will she left off paying the 50%. How did she do the last time in rehab? Therapy is hard on someone with Dementia. They can't follow directions nor can they remember the exercises.

If Mom does not have the money to pay the 50%, tell them. You r not responsible for it.
Helpful Answer (0)
Reply to JoAnn29

Thank you Barb!
Helpful Answer (1)
Reply to NekkidFish

I believe mom would have to have been out of the hospital and rehab for 60 days for the clock to " reset".

Have you talked to the social workers at the hospital? They should know the answers, or be able to find out.

MOM may need to pay for rehab. Not you.
Helpful Answer (1)
Reply to BarbBrooklyn

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