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What Does Medicare Cover for Stroke Patients?

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By Daniel Petkevich
Jan 20, 2023

A stroke can cost thousands of dollars. Do you have coverage?

Nearly 800,000 Americans have a stroke each year. And if it happens to you or a loved one, the after-effects can be devastating. With Medicare, you are covered in the event of a stroke. And further, there are some Medicare Advantage plans with more specialized coverage for those with special needs. Read on to find out more about what Medicare covers for stroke patients.

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What's covered in Medicare?

Treatments available to stroke patients may also change over time, so it's important to stay up-to-date on what is included in Medicare coverage. Also, everyone's healthcare needs following a stroke can vary. Here are some examples of different treatment options that might be covered for you:

Examples of inpatient care covered by

Part A

Medicare Part A is also known as Hospital Insurance. For stroke recovery, you may have the following covered:
  • Hospital stays
  • Inpatient rehab
  • 20 days of care in a skilled nursing facility

Examples of outpatient care covered by

Part B

Medicare Part B is also known as Medical Insurance and may include the following:
  • Home health services, including physical therapy, occupational therapy, speech-language pathology
  • Durable medical equipment such as wheelchairs, walkers, hospital beds
  • Certain preventive services that may reduce the risk of a stroke happening in the first place (see more below).
  • Diagnostic tests such as MRI and CT scans
  • Certain prescription drugs to help manage stroke symptoms (some drugs will fall under Part D prescription drug coverage)
It's important to remember that what is covered may vary depending on what type of Medicare coverage you have, so check with your doctor or health plan provider for specific information about what is covered.

Preventive services to reduce the risk of future strokes

Medicare Part B also covers certain preventive services to help reduce the risk of a stroke happening in the first place.
These include:
  • Blood pressure screenings
  • Diabetes screenings and education
  • Vaccinations such as flu shots or shingles vaccines
  • Lifestyle counseling and smoking cessation programs
  • Low-dose aspirin therapy
  • Nutritional counseling
These services are covered once a year, so take advantage of them and talk with your doctor about what is best for you.

The average cost of stroke rehabilitation

The cost of stroke rehabilitation can vary greatly depending on what type of care is needed. That being said,

some estimates put the average cost of the first year after having a stroke at over $17,000

. Medicare Part B typically covers 80% of the cost of approved services such as physical and occupational therapy. The remaining 20% may be covered by supplemental insurance plans or out-of-pocket costs. If you are looking for the best way to combat steep out-of-pocket costs, look no further than

Medicare Supplement Plan G

.

What isn't covered by Medicare?

Medicare has some gaps when it comes to treating people recovering from strokes. Long-term care is currently not covered by Medicare. However, if you also have Medicaid, you might get coverage for long-term care. Speak with your plan provider for information specific to your unique situation.

What about Medicare Advantage?

There are plans available specifically for those who have survived strokes called Special Needs Plans (SNPs). Stroke is one of the chronic conditions that qualify a beneficiary for these plans. You just need to meet the following criteria:

Tips for getting the most out of your coverage

  • Know what type of coverage you have
  • Ask your doctor what is covered
  • Take advantage of preventive services
  • Consider supplemental insurance plans
  • Keep up with changes in Medicare coverage.
Keeping up with

what is and what isn't covered by Medicare

can be a challenge, so it's important to stay informed and speak with your doctor about what's right for you.

Conclusion

Medicare covers a variety of treatments and services for stroke patients, from inpatient care to preventive screenings. Be sure to check what is covered by your specific plan and talk to your doctor about what is best for you. Taking advantage of what Medicare does cover can help ensure that you get the care and support you need after a stroke. If you have questions about what is covered by Medicare or whether your plan is the right fit for you, speak with an expert at

Fair Square Medicare

.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

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