门诊康复与长期护理保险的关系

The relationship between outpatient rehabilitation and long-term care insurance

I'm Aoi Hashima , an occupational therapist working in Saga Sumai and Fukuoka.

Some people are transferred to the outpatient clinic for rehabilitation after being discharged from the hospital, and receive a long-term care insurance certificate midway.

If bathing at home is a burden, some people may consider using day services, day care, or visiting the bathroom as a service for long-term care insurance.

In this case, we may be asked whether outpatient rehabilitation can continue.

Post-stroke rehabilitation After inpatient treatment, outpatient rehabilitation will be terminated if the patient is enrolled in long-term care insurance after discharge from the hospital.

This time I want to write about the relationship between outpatient rehabilitation and long-term care insurance.

Basic knowledge of outpatient rehabilitation after stroke (2022 medical expenses)

After being discharged from the hospital after a stroke, outpatient rehabilitation is available for 180 days after the onset of the stroke.

After 180 days, the number of rehabilitation sessions is limited to 13 units per month (20 minutes per unit).

However, if you are discharged home from the High Forest Rehabilitation Ward, the 180-day limit will not apply for the first three months after discharge, even if 180 days have passed since the onset of the stroke.

If you do not carry nursing insurance, there is no limit to the number of recoveries within 180 days after the onset of the stroke, but after 180 days, the number of recoveries per month will be limited to 13 units.

If you decide you need some kind of care after you leave the hospital, you usually apply for long-term care insurance while you are in the hospital.

However, those who wish to be discharged early or do not wish to enroll in long-term care insurance when they are hospitalized can apply for long-term care insurance after being discharged from the hospital.

After being identified as requiring long-term care insurance for long-term care, within 180 days of the onset of stroke, rehabilitation under medical insurance (outpatient rehabilitation) and rehabilitation under long-term care insurance (day care, etc.) are limited to two months before the 180th day. can be used together.

However, if you have 180 days after your stroke, recovery can only be done through nursing insurance if you have nursing insurance, you will not be able to recover through Medicare.

▶︎If you do not have long-term care insurance (discharge from convalescent recovery ward home)

Within 3 months after leaving the Haifumu rehabilitation ward: unlimited number of outpatient rehabilitation

More than 3 months after discharge from Haifumu Rehabilitation Ward: 13 credits per month

▶︎If you do not have long-term care insurance (discharge from a hospital other than the Hayford Wood Rehabilitation Ward)

180 days after stroke onset: Unlimited outpatient rehabilitation sessions

Onset 180 days or more after stroke: 13 units per month

▶︎If you have long-term care insurance

If you have long-term care insurance, you must, in principle, transition to recovery with long-term care insurance 180 days after the onset of the stroke.

From April 2019, the transition to recovery under long-term care insurance is a legal decision.

However, even if you have long-term care insurance, you can combine outpatient and home-visit rehabilitation if your doctor thinks you need Medicare rehabilitation.

However, in principle, long-term care insurance takes precedence over rehabilitation covered by Medicare and long-term care insurance, and I think it should.

At the end

This time I write about the relationship with long-term care insurance, and I am often asked about outpatient rehabilitation.

If you have long-term care insurance, talk to your care manager or recovery leader.

,゚.:。+゚Thank you for reading to the end,゚.:。+゚

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This article was reprinted on October 12 , 2022 on Aoi Hashima's blog " Stroke Rehabilitation Longevity Consultation Center " .

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