Medicare Outpatient Observation Notice (MOON), the . Medicaid only covers stays at Long Term Care facilities. Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week. Once a benefit period begins, a beneficiary must then have a qualifying three-day inpatient hospital stay in order be eligible for any coverage of rehab care in a skilled nursing facility. If you believe rehabilitation and Medicare coverage is ending too soon, you can request an appeal. If you qualify for Medicare-covered care in a rehabilitation hospital, your out-of-pocket costs will be the same as for any other inpatient hospital stay. Facilities can use the . Hospitals can count the admission day (April 16), but not the discharge day (April 18). You will find that what is expected of you, as a patient, is much different in the short term rehab environment as compared to the typical acute care hospital stay. Medicare pays 100% of the bill for the first 20 days. where they remain for 14 days with no symptoms (instead of integrating as usual on short-term rehab floor, or returning to long-stay original room).” Medicare Skilled Coverage Eligibility During COVID-19 At-a-Glance & FAQs – DRAFT April 5, 2020 New Fact Sheet Available – Medicare Inpatient Rehabilitation Hospital/Facility Coverage In Light of Jimmo v. Sebelius April 11, 2019; CMS Clarifies 3-Hour “Rule” Should Not Preclude Medicare-Covered Inpatient Rehabilitation Hospital Care March 15, 2018; Value of Inpatient Rehabilitation Hospital Care Reaffirmed May 18, 2016 Contact the Medicare plan directly. Medicare covers inpatient rehab in an inpatient rehabilitation facility – also known as an IRF – when it’s considered “medically necessary.” You may need rehab in an IRF after a serious medical event, like a stroke or a spinal cord injury. For more information, see our article on Medicare coverage of inpatient rehab facility stays. Contact a licensed insurance agency such as eHealth, which runs Medicare.com as a non-government website. You must be ADMITTED into the hospital and stay for three midnights to qualify for the 100 days of paid insurance. Skilled nursing facilities are sometimes called post-acute rehabilitation centers, but the rules for a stay in an acute care rehabilitation center, or inpatient rehab facility (IRF), are different. If you or a loved one may need to transition to long-term nursing home care, there are options outside of Medicare that may help offset some costs. (You can find more detailed information about how Medicare distinguishes inpatient status from outpatient status and related costs at Medicare.gov.) Keep in mind that if you enter a rehabilitation hospital after being an inpatient at a different facility, you will still be in the same benefit period. Medicare 100-day rule: Medicare pays for post care for 100 days per hospital case (stay). Information on how to request this appeal is included in the Notice of Medicare Non-Coverage. Don’t be caught off-guard by assuming your loved one will receive the full 100 days of Medicare. In the hospital, care is largely centered on treating the illness, injury or condition that made medical care necessary, getting you stabilized and on the road to recovery. How Long Will Medicare Cover Rehab in an Inpatient Rehabilitation Facility? Learn More To learn about Medicare plans you may be eligible for, you can:. In this case, the beneficiary did not stay in the hospital long enough to satisfy the 3-day rule. These include: Long-term care insurance.