Rehabilitative Care: What does Medicare Part B cover?

Posted by Lexington Square

Whether due to illness, injury or both, rehabilitative care is often a necessary step in the process of recovery. For many seniors, concerns about medical expenses weigh heavily on their minds as they attempt to regain good health and a sense of normalcy. Supplemental Medical Insurance (SMI) – known as Medicare Part B – provided by the government to seniors and others who qualify can help with those expenses.

In 2010, the Census Bureau reports 43.8 million people – nearly 37 million of whom were seniors – were enrolled in Medicare Part B. This optional benefit helps cover medically necessary expenses like doctors’ services, outpatient treatments, and other medical services not covered under Medicare Part A. Part B also covers some preventive services including exams, lab tests and screening shots to help prevent, find, or manage a medical problem.

Monthly premiums and yearly deductibles

In 2015, citizens with a yearly income of $85,000 or less will pay a monthly premium of $104.90 for Medicare Part B. Individuals with yearly incomes greater than $85,000 will pay premiums that range between $146.90 and $335.70.

The deductible for the year is $147. After the deductible is met, enrollees typically pay 20% of the Medicare-approved amount for service.

Therapy cap limits

While Medicare B helps pay for medically necessary outpatient physical and occupational therapy and speech-language pathology services, there are limits on these services. Known as therapy caps, the 2015 therapy cap limits are:

  • $1,940 for a combination of physical therapy and speech-language pathology services
  • $1,940 for occupational therapy

Although therapy caps are in place, therapy providers can advise clients in need of additional services on how to submit a Medicare review that will sometimes allow recipients to go above their cap.

Information on health care professionals

It is critical for seniors to become familiar with the many requirements and restrictions of Medicare Part B. It is equally important for seniors to understand what health care providers are enrolled in Medicare.

The government-operated website medicare.gov provides a wealth of comprehensive and up-to-date information including a full lists of medical specialties covered under benefit and information on specific medical providers.