Is Medicare state specific?

[Anonymous]

I have an elderly relative who lives in MD. She was visiting family in VA when she fell, and now she's in a VA hospital. She qualifies for rehab, based on loss of mobility due to the fall, but she really doesn't want to go. My VA relative who she is staying with is happy to have her back there, and to have PT come in and other services coming in. Going there, where there are adults around constantly, seems like a much better idea than going home where there is less support.

But how does that work across state lines? Can she get PT home care if she's out of state? Anyone know?

[Anonymous]

Original Medicare is not state-specific. Medicare Advantage may have a restricted list of providers that make it hard or impossible to be served out of state.

[Anonymous]

Medicare, depends on the plan. Medicaid, yes.

[Anonymous]

She can go to rehab, but I *think* in order to get home PT she needs a PCP licensed in the state where she’s receiving services, to write orders and follow her in the community. So she might not be able to get home PT at a relative’s home, in a different state than she resides. Check with the discharge planner, though (usually a social worker or nurse case manager).

But rehab benefits are the same across every state (unless has Medicare advantage, as PP said - if that’s the case, her rehab stay will need to be approved and authorized by the insurance company and she would have to go to a rehab that participated with her insurance).