Should Medicare or Medicaid have paid for my mother to enter a rehab facility after brain surgery?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

My mother has medicare part B and medicaid, and we were told she does not get to go to a rehab center after her brain tumor surgery. We had to bring her home and her recovery is extremely slow now because she only gets physical therapy twice a week for one hour each time. Should she have been sent to a rehab center? How do I find out if someone made a mistake or gave us wrong advice? Please help. Thank you.

Expert Answers

The decision about whether your mother should have gone into a rehabilitation facility following surgery is a medical one, made by her doctors rather than by Medicare or Medicaid. If the doctors had decided that she needed to be in a rehabilitation facility and had prescribed it, Medicaidwould have paid for it. Medicaid Part B is for outpatient care and doctors' services, so it would not have paid for inpatient rehabilitation. But if your mother has Medicare Part A, that, too, would have covered her stay in a rehabilitation facility.

Now that she's at home, you may be able to get home health care covered by Medicare Part B and by Medicaid, in addition to your mother's physical therapy. Again, the key to getting home health care for your mother is her doctors -- ask her doctors if they will prescribe home health care for her while she recovers. If the doctors prescribe it, Medicare Part B and Medicaid will almost certainly cover it, at least for awhile. If the doctor prescribes it and Medicare or Medicaid covers it, home health care can provide regular visits by the staff of a home health care agency, including nurses and certified home care aides. They can provide nursing and comfort care for your mother, and give you and other family members a much needed break from caregiving.