Strokes are prevalent for Medicare beneficiaries. More than 790,000 Americans have a stroke annually, and the chances of strokes for individuals on Medicare increase annually. More than 62% of all strokes take place in people over the age of 65.

Medicare will cover treatment for beneficiaries that experience a stroke. We’ll cover what a stroke is and what causes them. Next, we’ll learn about coverage for stroke victims using different Medicare coverages. Finally, we’ll discuss ways to help prevent strokes, answer some frequent questions, and show how to get supplemental Medicare coverage for strokes.

Medicare Coverage for Stroke and Rehabilitation

Original Medicare covers treatment for stroke victims. The treatment type and location will determine the costs and how Medicare covers the treatment. Medicare Part A would cover treatment such as inpatient rehab in an inpatient hospital, skilled nursing, or hospice.

Medicare Part B would cover home health care, outpatient rehabilitation services, durable medical equipment, physical therapy, and occupational therapy services. Stroke recovery can be a long, hard road, but with proper treatment, recovery can be possible for some people.

Costs of Medicare Covered Stroke Treatments

Treatments covered under Medicare Part A would be subject to the Part A deductible. This deductible covers a 90-day benefit period for the occurrence. Depending on the length of the inpatient stay, whether it’s a hospital stay, inpatient stroke rehabilitation center, or SNF, you could be responsible for a daily copay.

For treatments covered under Medicare Part B, such as physical or occupational therapy in an outpatient setting, Medicare pays 80% of the Medicare-approved amount once you’ve met your annual Part B deductible. You’ll be responsible for the remaining 20% coinsurance and any excess charges.

Medicare Supplement Insurance for Strokes

Medicare Supplement plans will help offset some or all of your portion of the bill from Original Medicare. These plans are secondary insurance that works together with Medicare Parts A and B. They’re also referred to as Medigap plans because of the nature of the coverage to fill in the cost gaps left over. The top Medicare Supplement plans give the most comprehensive coverage for strokes.

Medicare Part C Coverage for Strokes

Medicare Part C plans to combine your Original Medicare benefits into one plan. In addition to covering the same services as Medicare Parts A and B, these Medicare Advantage plans will usually include Medicare prescription drug coverage. These plans typically have additional benefits that aren’t included in Original Medicare.

Medicare Part D Coverage for Strokes

This part of Medicare is your standalone prescription drug coverage for prescriptions filled at the pharmacy. This coverage combines with Medicare Part A, Medicare Part B, and Medicare Supplement Insurance coverage to provide comprehensive health insurance for Medicare beneficiaries. Stroke victims take different medications that help to prevent blood clots from causing strokes. Some common medication types include blood thinners, blood pressure, and beta blockers. Be sure to review the available Part D drug plans to cover the prescriptions you need.

Medicare Coverage for Stroke Rehabilitation

Most stroke patients will see the most improvement within the first three months. Recovery will vary depending on the severity of the stroke. About 25% of stroke patients recover with only minor impairments such as minimal vision or memory loss.

If you have paralysis from a stroke, it’s possible to have some recovery. Unless it results in damaged brain cells, you could recover to a point. If the cells die, the damage is permanent in most cases.

Stroke recovery can be a long-fought road. Medicare will cover physical, speech, and occupational therapy to help regain motor functions and help to aid in recovery. The sooner the rehabilitation begins, the better the stroke victim’s chance of full recovery.

FAQs

Does Medicare cover stroke patients?

Medicare covers treatment for stroke patients. How you receive your Medicare benefits and supplemental Medicare plans will determine your costs for treatment.

How long after a stroke can you qualify for Medicare?

Medicare doesn’t have waiting periods for health conditions. You can receive Medicare if you are 65+ or have a qualifying medical condition. If you are under 65 and start receiving SSDI benefits due to your stroke, you’ll begin Medicare on the 25th month of receiving Medicare benefits.

Medicare Supplements will deny you coverage if you have had a stroke within the last two years for most insurance carriers.

Does Medicare Supplement insurance cover stroke?

Yes, you will be covered if you have a stroke and are enrolled in a Medigap plan. Medicare will pay their portion, and the Medicare Supplement will pick up the costs based on your chosen plan letter.

What is the cost of a stroke with Medicare?

The cost of stroke rehabilitation and treatment will usually be more than $17,000 for the first year. Rehabilitation services can run about $11,000, with the prescription cost approximately $5,000.

Finding Affordable Stroke Coverage with Medicare

Strokes are one of the leading causes of death and disability among beneficiaries. It’s essential to have coverage to help cover the cost of your healthcare needs. Our licensed insurance agents specialize in Medicare and are experts in the area.

We’ll help educate you on your choices and verify your drugs and doctors are covered. Give us a call for free personalized assistance, or fill out our online request form.

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by Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.