Does Medicare Cover Rehab?
Does Medicare cover rehab? If you're recovering from an injury, here's what you need to know about Medicare's coverage of care.
Medicare does cover physical therapy and other inpatient or outpatient rehab services if they are considered medically necessary by your doctor.
Medicare Supplement Insurance (Medigap) can help cover rehab costs that Medicare doesn't cover, such as deductibles, coinsurance, copays and more.
Medicare Rehab Coverage
While it’s often less expensive than surgery, rehab can still run up big charges.
Medicare Part B covers several forms of outpatient rehab, including:
Treatment in private practitioners’ offices
Care in outpatient hospitals
Service from rehabilitation agencies
Care at skilled nursing facilities
Home care, provided by private practitioners and home health agencies
How Much Does Rehab Cost With Medicare?
It’s important to note that Medicare rehab coverage caps the amount of physical therapy and rehabilitation services you can receive. In 2023, Medicare’s “therapy caps” are set at:
$2,330 for both physical therapy and speech-language pathology services, calculated together
$2,230 for occupational therapy
It is possible to get an exemption from these limits.
In order to gain an exemption, your rehab provider must document your needs in your medical records, and show that your care that exceeds the caps is both reasonable and medically necessary.
Even if Medicare covers your rehabilitation services, Medicare Part B comes with its own out-of-pocket costs, including:
A yearly deductible of $240 (in 2024)
20% coinsurance on any Medicare-approved cost of service
What Are the Benefits of Rehabilitation?
Rehabilitation through physical therapy offers proven health benefits, including:
Maximizing your movement
It’s important that you take care of day-to-day tasks without pain. Physical rehabilitation can increase your ability to lead an independent pain-free life, so you can pick up groceries and do laundry without a worry.
Minimizing the need for surgery
Surgeries, even if minor, can be expensive and have long recovery times. Physical rehabilitation can help you forego these procedures, while still taking care of the pain you’re suffering from.
Some prescription drugs come with major side effects. And with the potential for addiction, opioid pain killers present another set of worries. Physical therapy can reduce pain without relying on medications.
Getting personalized care
Physical therapy is often highly personalized. Your treatment regimen will likely be tailored to your specific needs, and developed together between you and your physical therapist.
These forms of rehabilitation can treat a number of injuries and physical ailments, from tendon pain to vertigo. Since you can avoid surgery with rehab, it’s also often a lower-cost option.
Medigap Plans Can Supplement Medicare Rehab Coverage
Medicare Supplement Insurance (Medigap) helps cover some of your Medicare out-of-pocket costs.
For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient rehab services.
Learn more about common procedures that Medicare covers.
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.