A Patient’s guide to Medicare and Mobile Therapy Services
Medicare doesn’t have to be complicated
What is Mobile Therapy? Mobile therapy is a cost-effective and efficient service designed to help Medicare patients live more independently in the comfort of their own home whether that’s a house, Assisted Living Facility, Independent Living Facility, Manufactured/mobile home, or even a yacht! You can avoid the hassle of finding transportation and going to crowded Outpatient clinics by having Mobile Therapists come to you instead. Therapy within the home provides therapists the ability to work within the client’s natural environment, instead of trying to simulate it in a clinic. Therapists can also assist in modifying the home environment to increase safety and independence. Mobile Therapy services provide Occupational Therapy, Physical Therapy, and Speech Therapy.
What does Mobile Therapy cost? If you are 65 or are covered under Medicare, Mobile Therapy is covered under Medicare Part B. Medicare Part B will cover 80% and Supplemental plan will cover 20%. Your Mobile Therapy provider must inform you in advance what Medicare will cover or if there are any other services that are not covered and the anticipated cost. Since there are no annual caps, Medicare Part B covers Mobile Therapy services without limitations as long as it’s medically necessary and certified by a Physician, Physician Assistant, or Nurse Practitioner. Mobile Therapy can also be paid for privately without limitations in number of visits. These services can also be covered by Medicare Advantage PPOs, or private insurances.
What is required for coverage? One of the advantages of receiving Mobile Therapy services is that you don’t have to be homebound, and the frequency and duration of therapies are tailored to the client’s needs and goals; unlike, Home Health Part A therapy which requires client’s to be home-bound and is limited on visits and duration of therapy. To start Mobile Therapy, simply call your local Mobile Therapy provider and schedule an evaluation. The provider will assist with verifying your insurance and even connect with your physician to request a referral.
What can you expect? Mobile Therapy, whether it’s PT, OT, ST or all three, is a proven way for older adults of all levels of physical ability to build confidence, improve function, and stay active. Therapists will develop and implement a personalized plan tailored to meet your goals. They will work within your pain and activity thresholds to restore and improve mobility – all in the comfort of your home.
What is Medicare and who is eligible? Original Medicare (your Red, White and Blue card) is made up of two components:
Part A, helps pay for inpatient care at a hospital or skilled nursing facility, hospice care and home healthcare.
- You are eligible for Part A when you turn 65, if you or your spouse has paid a designated amount of Medicare taxes while working. *You may still be eligible to purchase Part A if you or your spouse did not pay Medicare taxes.
Part B, requires a monthly premium, deductible if applicable. It covers:
- services from doctors and other health care providers
- Outpatient care
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
With Original Medicare, you can use any doctor or hospital that takes Medicare, anywhere in the U.S. To help pay your out-of-pocket costs in Original Medicate (like your 20% coinsurance), you can also buy supplemental coverage.
What doesn’t Medicare cover?
- 24-hour care at home
- Meals delivered to the home
- Homecare services (cleaning, shopping, laundry, etc.)
- Personal care (bathing) from home health aides if this is the only care needed
To learn more about Medicare, call 800-MEDICARE or visit www.medicare.gov