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NFT: Rehabilitation facility insurance coverage

Hammer : 6/7/2023 7:36 am
Hey folks,

I am in trouble and was wondering if anyone has had a similar experience or expertise in the area.

My wife suffers from dementia and has been living in an assisted living facility for the past six months. I am paying out of pocket for her accommodations.

Yesterday, she was admitted to the hospital because a bed sore has become necrotic. Surgery is scheduled for today.

My understanding is that when she recovers she will not go back to the assisted living facility and must be admitted to a rehabilitation facility until the wound heals.

My question is, will her stay in the rehab be covered by insurance, Medicare Part A, or both?

She has Federal Employee's Horizon Blue Cross Blue Shield coverage for both doctors and hospitals and Medicare Part A. She does not have Medicare Part B because she is not yet 65 and I declined to sign her up when she received her SSI award six years ago. (I did this because we are covered by BC/BS).

Any information or suggestions on where I can get answers would be greatly appreciated.
call the number  
Giantsfan79 : 6/7/2023 7:41 am : link
On her insurance card
Hilary : 6/7/2023 8:00 am : link
your wife will likely qualify for sub acute rehabilitation which is rehabilitation in a skilled nursing facility. Medicare covers 100 days. The first 20 days are covered in full there is a copay for the remainder.
For problems like dementia Medicare does not cover long term care.Only Medicaid or long term care insurance policies cover that

All hospitals have case managers or social workers to help you
rehab - ( New Window )
Came here with an actual answer as a medical social worker  
j_rud : 6/7/2023 9:43 am : link
And Hilary covered all the bases lol
g56blue10 : 6/7/2023 10:07 am : link
Will need to have stayed in the hospital 3 days to qualify for medA. There was a Covid waiver in place that eliminated that requirement but it recently expired.

She is correct in medA will cover 100 days with the first 20 fully covered. If you have a secondary that could cover the co pay
Thanks to everyone for the information  
Hammer : 6/7/2023 9:33 pm : link
I hope to be able to return the favor at some point or another.
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