What Medicare Covers After A Stroke

According to the National Institute of Neurological Disorders and Stroke, over half a million people over the age of 65 suffer from a stroke every year. A stroke can be very serious, and can have long lasting effects on balance, hearing, and vision. It can also cause decreased mobility or even paralysis. Recovery after a stroke can be a long and difficult process, especially if you don’t have the proper insurance coverage. Thankfully, Medicare covers a lot of the aftercare related to recovery from a stroke, including both inpatient and outpatient care, as well as some medical equipment. There are gaps, however, which can be filled by a Medicare Supplement Plan.

illustration of skeletal with the brain colored in red.

Medicare Part A Coverage

If you suffer a stroke, you might need to go to an Inpatient Rehab Facility afterwards to recover and get the therapy that you need. As long as your doctor deems your stay medically necessary, Medicare Part A will cover this inpatient rehabilitation. Medicare will cover the cost of treatment in an inpatient facility for a limited time; if you need to stay longer than 60 days you will have to pay $352 per day for days 61-90. For days 91 and beyond, you will pay $704 in coinsurance per “lifetime reserve day.” You have 60 reserve days over your whole lifetime; after that, you will need to pay the full cost of your stay. 

Medicare Part B Coverage

Medicare Part B will cover any outpatient rehabilitation needed, such as physical therapy, at 80%. You will be responsible for the other 20% coinsurance. As with any service, your doctor must deem your rehab medically necessary in order for it to be covered. If there is any durable medical equipment that is medically necessary, then Part B will also cover the cost of that at 80%. This includes equipment such as wheelchairs, walkers, or canes. Any of this equipment will need a prescription from your doctor.

older mans lower half of body sitting down holding a ball in his hand with a person holding his arm in support

Skilled Nursing Facilities

If you are moved into a skilled nursing facility from the hospital or from an inpatient rehab facility, Medicare will only pay for your stay if you have satisfied the “3-day rule.” This means that you need to have been admitted as an inpatient into the hospital for three days, and not classified as an “observation care” patient. With Medicare, staying at one of these facilities is free to you for the first 20 days, and $176 per day for the next 80 days after that.

Long-Term Care Facilities

Medicare does not cover any long-term care facilities, even if your doctor deems it medically necessary. These services are not covered because care at these facilities includes things like bathing, feeding, and assisting with the bathroom, which Medicare does not consider medical care services.

Medicare Supplement Plans

There are obviously gaps in what Parts A and B cover when it comes to recovery from a stroke. A Medicare Supplement Plan can help to fill those gaps. Most plans will cover your Part A coinsurance and allow you to extend hospitalization days up to 365 days over your lifetime. A Medicare Supplement Plan will cover part or all of your Part A deductible, and approximately 8 out of 10 plans will cover the skilled nursing facilities coinsurance. Some also provide coverage for long-term care. There are 10 different types of plans to choose from, with different coverage and different price points. EZ’s highly trained, licensed agents can help you compare these plans,  and can provide quotes to you within minutes.calculator sitting on top of next to it.

We hope you never need to test the limits of Medicare’s coverage for stroke care. Speak to your doctor about your risk factors, such as high blood pressure, high cholesterol, diabetes, smoking, and drinking, and see if there are ways you might be able to lower your risk through healthy lifestyle changes. Suffering a stroke can be scary and life-changing, but if it does happen to you, Medicare will cover the majority of your costs for treatment and rehabilitation. And whatever it does not cover, you can always count on a Medicare Supplement Plan to help you pay your medical bills. To be better prepared and to save money, compare Medicare Supplement Plan quotes by entering your zip code in the bar above, or to speak directly to an agent call 888-753-7207.

About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

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