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I can not find any details about Medicare coverage for therapy (PT, OT, SLP) for a SNF "rehab" stay after the 100 days coverage has ended.


The therapists referred to a "pot of money" that can be used but it is limited and then we would have to pay for therapy ourselves after that runs out.


Currently private pay at SNF after recent hospital stay. They want to do therapy 5 days a week, but say we'd run out of this "pot" pretty quickly.


Anyone familiar with this?

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Therapy non existent if Medicare decided it’s not helping...or patient non cooperative. This happened to my mother..I appealed & lost. Hugs 🤗
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JoAnn29 Dec 2020
This is a post from Aug. The OP never responded and by now probably has their answer. 😊
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I have no idea about a “pot of money” & can’t imagine any professional would say that not knowing specifically what the patients Insurance/supplemental insurance is.
If someone is not progressing in rehab after 100 days, they need SNF placement.
Medicare will not pay 100% of every day after 21 days (I think it’s 21 days) - after that the patient has a larger co-pay for each day.
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Not sure what Pot they are talking about. After 100 days its private pay or Medicaid. Medicaid will require your SS and any pensions to help offset care. After 3 months, maybe the person should not be coming home. You can ask about "in home" therapy.
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I am uncertain for the reason after 100 days that anyone would pay for this care rather than placement? Can you fill me in about what therapy is being done and what the progress is?
Write to Medicare for the handbook, Medicare and You, 2020 edition. This was mailed to most recipients. It explains everything in quite some detail. The address is U S Department of Health and Human Services
7500 Security Building
Baltimore, MD 21244-1850
You can email a request via medicareandyou@CMS.hhs.gov
100 days is very long. There is usually 21 day coverage complete for rehab but I am not familiar with SNF time and rules; 100 days sounds like a lot of time.
Wishing you luck and hope you will find out more. Sounds like there may be a need for placement after SNF medicare time runs out?
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