New Legislation to Affect Physical, Speech Therapy Benefits for Medicare Recipients

Legislation designed to remove Medicare's annual benefit cap on outpatient rehabilitation services, including physical and speech therapy, could be acted on by Congress later this year.

"This is great for seniors on Medicare," said Alan Weinstock, an insurance broker at website, who indicates that, if passed, the legislation could benefit seniors financially and improve their access to certain types of health care.

The Medicare Access to Rehabilitation Services (MARS) Act is designed to ease health care costs and improve health care access for seniors confronting age-related diseases, such as heart disease, strokes, or Parkinson's. Currently seniors receiving outpatient rehabilitation services have an annual dollar limit of $1,840.00 for care. Once the dollar amount is reached, the care stops for the remaining calendar year, although that dollar amount resets every year on January 1. MARS will repeal the cap on therapy services for Medicare beneficiaries if Congress takes action by December 31, 2009.

Proponents of the cap removal argue that the current process disrupts continuity of health care services for Medicare recipients and requires beneficiaries reaching the therapy cap to choose between stopping their necessary care or continuing with the care and paying 100 percent of the cost. The concern is that the caps can preclude seniors from getting the care they need to maintain a healthy quality of life.

With the cap removed, seniors on Medicare and Medicare supplement insurance plans (also known as Medigap plans) will have far more freedom to continue receiving much needed therapy services.