What Does Medicare Cover for Stroke Patients?
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.
Speak with a Medicare Advocate
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 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:
You have Medicare Part A and Part B
You live in a plan's service area
You have one of the
3 SNP eligibility conditions listed here.
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
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
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