Understanding your Medicare therapy benefits

Happy New Year from Therapy and Recovery at Wesley Towers!

Some of the most frequent questions and the most confusing aspects of Medicare Part B services is "How much do I have?" "How long is this benefit good for?" "What does Medicare Part B cover?" We know that Medicare can be very confusing and difficult to understand what benefits are covered, so hopefully this article will help. 

Medicare Part B services are utilized for outpatient related services, such as Physical, Occupational and Speech Therapy. It does not matter where these services are delivered, whether in a private outpatient clinic, a hospital or in a long-term care facility, as long as they are billed as Medicare Part B. 

When Therapeutic services are provided, Medicare Part B will pay for (approximately) 80% of the services provided. There will be a remaining (approximately) 20% of the balance remaining, which can be picked up one of two ways. Either a secondary insurance, if available, or private pay. When you come to Therapy and Recovery at Wesley Towers, we will check your available benefits prior to treating you properly to determine if you have Medicare Part B, a secondary insurance, or if you will be responsible for any costs. We want to help you any way we can to assure you get the benefits and the help you need. 

If you have a Medicare part b plan, then you are entitled to $3,000 each year. A breakdown of how the money is divided is as follows: 

Physical Therapy/Speech Therapy combine for $3,000 every year
Occupational Therapy is allotted for its own $3,000 every year
Part B dollars are tracked through any of the qualifying services billed through Medicare regardless of where they were delivered. So, if you received Medicare Part B Physical Therapy at one outpatient clinic for $1,000 and Medicare Part B Speech Therapy services in total of $1,000 at a different outpatient clinic, then you have used $2,000 of your Medicare Part B Physical Therapy/Speech Therapy services combined for the year. You are allowed to go over the $3,000 if it is medically necessary. 
Again, this money is tracked through Medicare and we can check the amount you have used prior to receiving services at Wesley Towers. This all can be confusing, but we would be happy to explain it further if you request our therapy services. 
We wish you a safe and healthy 2019, and although we hope you don't require any therapy services, please let us know if we can help you to either stay healthy or recovery after an illness or injury. 
your Therapy and Recovery team at Wesley Towers
(620) 694-1266



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