Medicare covers therapy services that help you maintain your ability to function, prevent you from getting worse, or slow worsening symptoms. As long as you meet the following requirements, Medicare should cover your outpatient therapy whether or not your condition is temporary or chronic:
1. You need the technical skills of a trained therapist to provide safe and effective treatment;
2 Your doctor or therapist sets up the plan of treatment before you get care; and
3.Your doctor regularly reviews the plan of treatment to see if changes are needed.
If you have Original Medicare, Medicare Part B generally covers 80 percent of the cost of each outpatient therapy service and you or your supplemental insurance is responsible for the remaining 20 percent. In 2014, there is a $1,900 therapy cap for physical and speech therapy combined and a separate $1,900 cap for occupational therapy. However, you may be able to continue receiving therapy past the cap if it is medically necessary. If you have a Medicare Advantage plan, it can set its own cost rules for physical, occupational, and speech therapy.