How to Use Medicare Part B with Occupational and Physical Therapy

In this blog, we will cover how to use Medicare Part B with Occupational and Physical Therapy. Medicare is a national health insurance program funded by the U.S. government that provides medical insurance for people aged 65 or older, younger people with disabilities and individuals with end-stage renal disease. There are four major components of Medicare that cover particular aspects of healthcare:

• Medicare Part A refers to hospital insurance which covers inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
• Medicare Part B is medical insurance that helps cover services from doctors and other health care providers, outpatient care, home health care, and durable medical equipment such as wheelchairs, walkers, hospital beds and other equipment. Part B also covers many preventative services such as screenings, shots, vaccines, and yearly wellness visits.
• Medicare Part C (Medicare Advantage) is a Medicare-approved plan that offers an additional alternative to Original Medicare (Parts A, B, and D). Medicare Advantage offers health and drug coverage that is not always included in Original Medicare such as certain vision, hearing and dental services. These out-of-pocket costs vary and may have lower or higher out-of-pocket costs for certain services when compared to Original Medicare.
• Medicare Part D helps cover the cost of prescription drugs, including many recommended shots and vaccines. Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.

According to the National Medicare Handbook, you can sign up for Part A and Part B during the 7-month period that begins three months before the month you turn 65 and ends 3 months after the month you turn 65. While annual enrollment in Parts A and B is automatic for anyone who receives Social Security benefits, Part D coverage is optional, so you must enroll during open enrollment. The Medicare Open Enrollment Period occurs each year from October 15- December 7 and gives you the chance to review or make changes to your current coverage.

Each year Medicare makes changes to the program to widen its reach and become more effective and usable for older adults. This year, Medicare has made the following changes:

• Stretch coverage of telehealth services until the end of 2024.
• Limit the amount that the Medicare drug plan can charge for insulin providing recommended adult vaccines for free.
•  Cover intensive outpatient program services for mental health care.
• Continue to cover the cost of the COVID-19 vaccine.
• Cover monthly services to treat chronic pain if you’ve been living with it for more than three months.

Medicare Part B: How Should I Use It?

The National Medicare Handbook breaks down the components of the Medicare program and explains how to use each part. According to the guide, Medicare Part B, which covers medical insurance, can be used to help cover a wide variety of services such as outpatient care, home health, mental health services, and preventative services. Under part B, services like advance care planning, acupuncture, ambulance services, chemotherapy, and chiropractic services are all covered.

Medicare Part B: Occupational Therapy

In addition to medical insurance and preventative care services, Medicare Part B also covers occupational therapy, which some may consider a crucial part of healthy aging. As we age, the way we perform certain tasks may become more difficult as our mobility declines. Occupational therapy allows older adults to learn how to do basic daily tasks in a safer way. This therapy helps to improve or maintain current capabilities or slow decline when your doctor or other health care provider certifies you need it. When enrolled in Medicare, you pay 20 percent of the approved amount after you meet the deductible.

Occupational therapy helps you regain everyday life and home skills that can become more difficult after injury, illness, or changes in your health. Many older adults benefit from the use of occupational therapy after a hospital stay, stroke or major surgery such as knee and hip replacements. Occupational therapists can also perform home evaluations to make recommendations for adaptive equipment and other tools that help reduce risk of injury and increase independence. According to the American Occupational Therapy Association, occupational therapy can help older adults relearn how to:

• Drive
• Dress and toilet
• Prepare and eat meals
• Manage their medications
• Ambulate safely
• Refine their gross and fine motor skills
• Improve concentration and memory
• Use medical devices such as walkers or prostheses

According to Healthline Magazine, OT can be especially beneficial for people who are experiencing:

• Dementia or Alzheimer’s disease
• Stroke
• Neuromuscular disorders such as Parkinson’s disease
• Traumatic brain injury
• Paralysis
• Mental health concerns
• Chronic muscle, joint or skeletal concerns
• Chronic pain
• Developmental disorders such as autism

Medicare Part B: Physical Therapy

Also covered under Medicare Part B is physical therapy. Physical therapy is crucial for seniors because it helps maintain and improve their physical function and mobility. It can alleviate pain, enhance balance, and reduce the risk of falls, which is a significant concern for older individuals. Additionally, it promotes independence and a higher quality of life by addressing age-related conditions and helping seniors stay active and engaged in daily activities.

Physical therapy (PT) is used for seniors in various situations and conditions, including:

Post-Surgery Rehabilitation: Seniors often require PT after surgeries like joint replacements or orthopedic procedures to regain strength and mobility.

Chronic Pain Management: PT can help manage chronic conditions such as arthritis, back pain, or osteoporosis by improving joint function and reducing pain.

Fall Prevention: Seniors at risk of falls benefit from PT to enhance balance, coordination, and strength, reducing the likelihood of accidents.

Stroke Recovery: PT plays a crucial role in helping seniors regain motor skills and mobility following a stroke.

Neurological Disorders: PT is used for seniors with conditions like Parkinson’s disease or multiple sclerosis to manage symptoms and improve mobility.

Cardiac Rehabilitation: After a heart attack or cardiac surgery, PT can aid in cardiac rehabilitation, focusing on cardiovascular health and exercise tolerance.

Pulmonary Rehabilitation: Seniors with respiratory issues, such as chronic obstructive pulmonary disease (COPD), can benefit from PT to improve lung function and breathing.

Pain Management: PT techniques like manual therapy and exercises can alleviate pain from musculoskeletal conditions.

Balance and Mobility Issues: Seniors with general balance and mobility problems can enhance their physical capabilities through PT.

Aging-Related Conditions: PT can address age-related issues like reduced flexibility, muscle weakness, and posture problems to maintain independence and overall well-being.

The specific application of PT for seniors depends on their individual needs and conditions, but it often plays a vital role in improving their quality of life and functional abilities as they age.

Utilize Medicare Part B Coverage at Maplewood Senior Living
At Maplewood Senior Living, we know how difficult finding high-quality care that works with Medicare can be for older adults and their family members. Our Maplewood Senior Living communities provide long-term care options that are designed to fit the unique needs of each individual. From occupational and physical therapies to care coordination and hospice care, our communities are designed to meet your needs in a warm and welcoming environment. To learn more about our offerings or how to use your Medicare coverage within our communities, please contact us. We’d love to hear from you.