Helping Michigan Seniors Understand the Medicare Rehab Benefit

Dear Donna:

My mother will be undergoing hip replacement surgery at a hospital in Saginaw, Michigan in late June. Her surgeon has advised us that she will likely need to go to a rehab center for a few weeks of therapy after she leaves the hospital. We are trying to figure out if Medicare will pay for that and how to choose the best one for her recovery. Can you help us understand what this means?

Diane in Adrian, Michigan

Diane:

It is a definitely a good idea to tackle all of this before your mother’s surgery. That will help her make a smooth transition to the skilled nursing and rehab center and then, eventually, back home.

Here is how the Medicare Skilled Nursing & Rehab Benefit works:

• Your mother will qualify for the benefit if she spends three nights at an inpatient level of care in the hospital.
• Once she transitions to the skilled rehab center, Medicare will pay for the first 20 days in full.
• Beginning on the 21^st day, she will be liable for a co-payment amount. In 2014, that is $152 per day. If she has a secondary insurance, it may cover this amount.
• If she still isn’t back on her feet after day 100, she will be liable for the entire cost of the stay. But don’t worry. Most seniors are back on their feet and home long before this!

As far as finding the best provider, Medicare has a few tools that can help. One is the Nursing Home Compare rating system on Medicare.gov. It allows you to review each provider’s state survey results and (if applicable) complaint surveys from residents and their family members. Medicare also has a Skilled Nursing Facility Checklist you can download to help you compare one community with another.

Finally, our best piece of advice is to tour every community you are considering for your mother. It would probably be a good idea to have a list of 2 or 3 options. That way if one or two of them are full, you still have another option that your family has already visited and approved of to turn to for rehab.

I hope this helps, Diane! Best of luck to your mother in her surgery and rehab.

Donna