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My Medicare days ran out while I was receiving physical therapy for paralysis from the waist down. The facility transferred me to their long care unit, to sit out the 60 days needed to replenish my 100 days, which are up soon. Someone is telling me that I might not get a restart to my physical therapy, because I do not have a new diagnosis.
Does anyone have any knowledge or personal experience in this area? Thanks in advance.

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It was my understanding that the 100 day provision was a one-time only event. My father exhausted his several years ago, and we've been reminded by therapists of that every time we get PT.

I am aware though that if a doctor states that a patient is in need of further therapy and therapy will benefit him/her, Medicare MAY consider paying for an extension of therapy. If your paralysis was of a recent event, that may be the case.

I don't know who the "someone" is, but you might want to contact Medicare for advice straight from the horse's mouth, or ask the physician who scripted for you to get PT. His/her staff may have been involved in a situation like this before.

I'm concerned though about letting the 100 day extension run out. The first SNF we dealt with tried to pull that with my mother, and once we figured out what they were doing we took her home. They just wanted more Medicare money, as her orthopedic doctor had said she was ready for home - it was the SNF that wanted her to stay and run out on her 100 days.

Who at the facility told you that the 100 day period is "replenished"?
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My partner has had his PT extended one time so far. And, I was told if he had additional pain, that our Doctor could extend it again. Of course he is at home and I don't know if that makes a difference.
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You better contact Medicare. I don't think that 100 days is a one time thing. Can he continue at home? According to my daughter the home therapy can stop and start again if the doctor feels the patient needs it. Did u check with the supplemental to see how much they will cover now Medicare isn't. If he is in the nursing section waiting for the 60 days, is he paying out of pocket?
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Thank God for Supplimental Insurance. I realize it is expensive and we have the best plan, I think it is the F plan. Is the 100 days only when they go to the hospital? This is so new to me...
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Please, I'm not trying to be rude but Medicare dos put out a booklet every year. It gives u basic info. Anything in more detail u can call them. In rehab the first 20days r paid. 21 to a hundred are paid 50%. At that time ur supplimental picks up what they feel is ok. Mom owed 152 at that time.
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JoAnn, thanks for the reminder about the yearly "Medicare & You" booklet. I just pulled this booklet out to read since I never had looked at it before now. Oh my gosh, what a complex maze of information, thank goodness there is no pop quiz at the end. I was looking for information for myself as I will need physical therapy for a recent injury.
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Imagine the Government spending SO MUCH money on these booklets they send out to us. No wonder they are broke.
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Yes, I heard that you need a new diagnosis. Is that crazy??? But, then he was renewed. Hang in there.
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