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learn about what Medicare covers in intensive care unit

Will Medicare Cover ICU Care?

Intensive care is known as the specialized medical treatment given to people who are acutely sick and need critical medical attention. An intensive care unit (ICU) a department of a hospital or medical facility that provides critical care, medicine, and life support for injured or acutely unwell patients. Unless it’s an emergency admission, you’ll need a referral from your specialist or doctor to be admitted to ICU.

Medicare pays for intensive care units to help beneficiaries recover and start rehab after injury, surgery, or serious illness over the course of the weeks. It applies to those who have spent 3 or more days in ICU.

Who Is Cared for in the ICU?

You or your loved one may be admitted after surgery, suffering a life-threatening injury or illness, or due to sudden and critical health deterioration. Intensive Care Unit teams are multi-disciplinary, which is composed of highly skilled intensive care doctors, nurses, and specialists — trained to provide critical care for those with a variety of surgical, medical, and trauma conditions. 

Some ICU specializes in offering care for certain injuries or health conditions, including:

  • Severe burns
  • Major trauma
  • Organ transplants
  • Respiratory failure
  • Cardiothoracic surgery
  • Complex spinal surgery

Services Covered by Medicare

The services and care received at an Intensive Care Unit include the following:

  • Rehab services like physical therapy, speech pathology, or occupational therapy for your inpatient hospital stay.
  • Meals, which include special diets if it’s deemed medically necessary.
  • A semi-private room with 2 or more beds.
  • Regular nursing services.
  • Treatment, medication, medical supplies, and other appliances like a splint, casts, wheelchair, and so forth.

Medicare will cover 100% percent of the medical expenses for the first 20 days of inpatient hospital care, but you’ll be responsible for copays any day afterward.

Services NOT Covered by Medicare

Is there any service or item Medicare won’t provide coverage for? Yes, the coverage for intensive care doesn’t extend to:

  • Nurses for private duty.
  • Television, radio, telephone, or other personal conveniences.

How Many Days Will Medicare Pay for ICU?

According to medicareinteractive.org, Original Medicare will cover up to 90 days of inpatient hospital care each benefit period. 

Besides that, you can get additional 60 days of coverage, which is known as lifetime reserve days. You can only use these 60 days once, and you’ll be responsible for coinsurance for each day you spend in the hospital. Keep in mind that you don’t have to use up all your lifetime reserve days for the same hospital stay.

If you stay in the hospital as an inpatient for more than 90 days in just one benefit period, your lifetime reserve days will start getting deducted by the hospital. So, if you don’t want to use these 60 days, you can notify the hospital — just remember that you’ll be responsible for the full cost of your medical care after 90 days.

Get Help Today!

For more information about Medicare coverage for care in the ICU, contact Medicare Gurus to speak with a licensed insurance expert.