Medicare Coverage For Stroke Patients' Compression Devices

Medicare covers a range of treatments and services for stroke patients, including inpatient and outpatient care, as well as preventive screenings. However, it's important to note that Medicare does not typically cover all the costs associated with stroke recovery, and there may be out-of-pocket expenses. While Medicare does not cover compression stockings, it does provide coverage for pneumatic leg compression devices, also known as leg compression pumps, in certain situations, such as for patients with Lymphedema.

Medicare Part A covers inpatient rehab in hospitals, rehab centres, or skilled nursing facilities

Medicare Part A, also known as Hospital Insurance, covers inpatient rehab in hospitals, rehab centres, or skilled nursing facilities for stroke patients. This coverage is provided if inpatient rehab is deemed medically necessary by a doctor. All the requirements and costs associated with typical skilled-nursing-facility care apply to care for stroke recovery.

Medicare Part A covers 20 days of care in a skilled nursing facility for stroke recovery. This coverage can be extremely beneficial for stroke patients, as the after-effects of a stroke can be devastating and costly. On average, the cost of the first year after a stroke can exceed $17,000.

In addition to inpatient rehab, Medicare Part B covers outpatient rehabilitation services such as physical therapy, occupational therapy, and speech-language pathology if deemed medically necessary by a doctor. Medicare Part B also covers durable medical equipment, such as wheelchairs, walkers, hospital beds, and diagnostic tests like MRI and CT scans.

It is important to note that Medicare coverage for stroke patients may vary depending on the specific plan and individual needs. Staying up-to-date with Medicare coverage and consulting with a doctor or healthcare provider is essential to understanding what is covered. Additionally, Medicare Advantage Plans and Special Needs Plans (SNPs) offer more specialized coverage for individuals with special needs or specific conditions, including stroke survivors.

Medicare Part B covers outpatient rehab, like physical therapy

Medicare Part B, also known as Medical Insurance, covers outpatient rehab like physical therapy. This includes medically necessary physical therapy services provided on an outpatient basis, such as in a doctor's or therapist's office, hospital outpatient department, outpatient rehabilitation facility, skilled nursing facility, or at home under certain conditions. Medicare Part B typically covers 80% of the cost of approved services, with the remaining 20% covered by supplemental insurance plans or out-of-pocket costs.

Medicare Part B covers physical therapy for stroke patients when it is deemed medically necessary by a doctor or healthcare provider. This includes therapy to aid in recovery from a stroke, as well as therapy to improve or maintain current function or slow decline. Medicare Part B also covers occupational therapy and speech-language pathology services, which are often part of stroke rehabilitation.

In addition to therapy services, Medicare Part B may also cover durable medical equipment, such as wheelchairs, walkers, and hospital beds. It is important to note that coverage may vary depending on the specific Medicare plan and individual needs, so it is recommended to consult with a doctor or healthcare provider to understand what is covered.

Medicare Part A, on the other hand, covers inpatient rehabilitation care in facilities such as hospitals, skilled nursing facilities, and some home care. It is important to note that Medicare Part A requires certification from a doctor stating that the patient requires intensive rehabilitation, continued medical supervision, and coordinated care from doctors, healthcare providers, and therapists.

Medicare Part B covers durable medical equipment, like wheelchairs, walkers, lifts, or canes

Medicare Part B covers durable medical equipment (DME) that is deemed medically necessary. This includes equipment that helps with completing daily activities, such as:

• Walkers
• Wheelchairs
• Hospital beds
• Home oxygen equipment
• Nebulizers and nebulizer medications
• Prosthetics and orthotics
• Pressure-reducing beds and mattresses
• Blood sugar test strips

Medicare Part B typically does not cover common medical supplies such as bandages, gauze, and compression stockings. However, in certain situations, Medicare Part B may cover compression stockings if prescribed by a doctor to treat a specific condition, such as a venous stasis ulcer.

To be covered by Medicare Part B, durable medical equipment must meet the following criteria:

• Prescribed by a doctor or healthcare provider
• Used because of an illness or injury
• Able and necessary to be used at home
• Likely to last for three or more years
• Provided by certain medical suppliers approved by Medicare

Medicare Part D plans may cover drugs used to treat deep vein thrombosis

Medicare Part D prescription drug plans may cover drugs used to treat deep vein thrombosis. However, Medicare typically does not cover compression stockings, which are often used to treat deep vein thrombosis, unless they are prescribed by a doctor to treat a venous stasis ulcer.

Medicare Part D plans cover a wide range of prescription drugs, including most drugs in certain protected classes, such as cancer, HIV/AIDS, or depression treatments. Each plan has its own list of covered drugs, known as a "formulary," and these formularies include both brand-name and generic drugs. While Medicare Part D plans must cover at least two drugs per drug category, the specific drugs covered vary depending on the plan. Additionally, drugs are placed into different tiers on the formulary, with drugs in lower tiers generally costing less than those in higher tiers.

It is important to note that Medicare Part D excludes certain types of drugs from coverage by law. For example, drugs used for weight loss or gain, cosmetic purposes, or erectile dysfunction are not covered. However, drugs used to treat physical wasting caused by diseases such as AIDS or cancer may be covered under Part D.

To determine if specific drugs for deep vein thrombosis are covered by Medicare Part D, individuals can compare Part D plans available in their area and consult with their doctor or healthcare provider about their Medicare coverage.

Medicare Advantage plans may include additional coverage for compression stockings

Medicare Advantage plans, also known as Part C, are offered by private insurance companies. These plans must provide at least the same coverage as Original Medicare (Part A and Part B) but may also offer additional benefits.

Dual-eligibles who receive Medicaid assistance may have prescription compression stockings covered under their regular benefits or by a provider's allowance for over-the-counter items.

To confirm whether your Medicare Advantage plan includes coverage for compression stockings, contact a representative from your private insurer.

It is important to note that Original Medicare typically does not cover compression stockings. However, in certain situations, such as for the treatment of lymphedema or venous stasis ulcers, Medicare Part B may provide coverage with a prescription from your doctor.

Frequently asked questions