How to arrange therapy after a hospital discharge

Before you leave, ask the discharge planner which therapy you need, where, who has accepted you, and when care starts. A hospital in Medicare or Medicaid must plan your discharge with you, let you choose among available agencies and facilities, and send the next provider your medical information. This guide is for adults, their families, and parents of children.⁠^1,2,3,4

What does the hospital have to do to plan your discharge?

It must run a discharge planning process built around your goals and treatment preferences, with you and your caregivers or support people as active partners.⁠¹ The rule binds hospitals in Medicare, hospitals paid by Medicaid must meet the same conditions, and critical access hospitals follow a matching rule.⁠^4,19 Its wording covers the hospital’s patients in general, with no limit to Medicare patients or to adults.⁠¹

• Planning starts early. The hospital must identify, early in the stay, the patients likely to be harmed by leaving without a plan, evaluate them in time for arrangements to be made before discharge, and evaluate anyone else who asks.⁠¹
• It looks at need and access. The evaluation covers the services you are likely to need afterward, such as a nursing facility, home health or community services, and whether they are available and within your reach; the results must be discussed with you or your representative.⁠¹
• Your information travels with you. At discharge, the hospital must send information on your illness, treatment, goals and treatment preferences to the facility, agency or outpatient provider responsible for your follow-up care.⁠³

Medicare’s discharge checklist tells patients that they and their caregivers are important members of the planning team.⁠¹⁷ The plan can change: the hospital must keep re-evaluating your condition and update the plan as needed.⁠¹

Can you ask the hospital for a discharge planning evaluation?

Yes. The rule requires an evaluation for any patient who asks, or whose representative or physician asks, and your physician can ask the hospital to develop a discharge plan and start carrying it out.⁠¹ A registered nurse, social worker or other qualified staff member does it or supervises it, and Medicare’s checklist names the discharge planner, social worker and nurse among the staff to talk to.⁠^1,17 Ask early in the stay, not on the morning you leave.

Which therapist does what after a hospital stay?

Each therapy covers different ground, and a plan may call for one, two or all three.⁠^8,20,21

• Physical therapy helps restore or improve movement after an injury, illness or surgery; physical therapists are licensed providers who evaluate, diagnose and manage movement problems at any age.⁠^8,22
• Occupational therapy helps with daily activities such as dressing and bathing; occupational therapists also recommend adaptive equipment such as shower chairs, train family caregivers, and work on falls prevention and home safety.⁠^20,23
• Speech-language pathology evaluates and treats speech and language, including cognitive and swallowing skills; ASHA calls speech-language pathologists the preferred providers for swallowing disorders (dysphagia).⁠^21,24

A referral for one discipline does not set up the others, so ask what each recommended therapy is meant to address. Keep following any swallowing or eating instructions from the hospital until a speech-language pathologist or your doctor changes them. If speech is affected and a communication device may help, see AAC device funding.

Where can therapy continue after you leave the hospital?

In an inpatient rehabilitation facility, a skilled nursing facility, your home through a home health agency, or an outpatient clinic, and Medicare covers physical, occupational and speech therapy in each when you qualify.⁠^{5,6,7,8,20,21} A long-term care hospital is a fifth option, typically for patients with more than one serious medical condition.⁠²⁵ The hospital’s required list covers home health agencies, nursing facilities, rehabilitation facilities and long-term care hospitals, not outpatient clinics.⁠²

Medicare Advantage, Medicaid and private plans set their own cost sharing and approvals, covered below; the Medicare therapy coverage guide has the Medicare detail.

Who can go to an inpatient rehabilitation facility after a hospital stay?

Someone whose provider certifies a need for intensive rehabilitation, continued medical supervision and coordinated care.⁠⁵ Medicare’s criteria add that at admission you should need active therapy from more than one discipline, one of them physical or occupational therapy; be expected to take part in an intensive program, generally at least 3 hours a day at least 5 days a week, or at least 15 hours a week in some well-documented cases; and be stable enough to do it.⁠²⁶ A rehabilitation physician must see you face to face at least 3 days a week, and the ordered therapy must begin within 36 hours from midnight on the day you arrive.⁠²⁶

In 2026 you pay a $1,736 deductible, then $0 a day for days 1–60, $434 a day for days 61–90 and $868 a day for days 91–150 while you use lifetime reserve days; there is no second deductible when you transfer directly from an acute care hospital.⁠⁵ If the team says you cannot manage 3 hours a day yet, ask what would change that and which setting fits meanwhile.

When does Medicare pay for a nursing facility stay after the hospital?

After a medically necessary inpatient stay of at least 3 days in a row, counting the day you were admitted as an inpatient but not the day you leave; time under observation or in the emergency room before admission does not count, even overnight.⁠⁶ You generally enter within 30 days of leaving, and your doctor or other provider must decide you need daily skilled care, such as physical therapy.⁠⁶

You pay $0 a day for days 1–20 after the $1,736 deductible, none if you paid it for the hospital stay in the same benefit period, then $217 a day for days 21–100 in 2026, and all costs after that.⁠⁶ Medicare Advantage plans may waive the 3-day rule and may charge copayments in the first 20 days.⁠⁶ Without a qualifying stay, Medicare.gov suggests asking about other settings, such as home health, or programs such as Medicaid or veterans’ benefits.⁠⁶

When can therapy come to your home through a home health agency?

When you are homebound and need part-time or intermittent skilled care. Homebound means leaving home is not recommended for your condition, or you need help such as a walker, special transportation or another person to leave, and leaving normally takes a lot of effort.⁠⁷ A doctor or other provider, such as a nurse practitioner, must see you in person and order the care from a Medicare-certified agency; that visit must relate to the main reason for home health and fall within the 90 days before care starts or the 30 days after.⁠^7,28 Ask whether a visit during your hospital stay is the one being used.

Occupational therapy cannot open home health on its own: it must first be ordered with nursing, physical therapy or speech-language pathology, and can then continue alone.⁠^7,28 Covered visits cost nothing, though you pay 20 percent for medical equipment after the Part B deductible, and personal care alone, such as help bathing or dressing, is not covered.⁠⁷ Your provider should give you a list of agencies serving your area and must tell you about any financial interest in them.⁠⁷

How does outpatient therapy start once you are discharged?

With an evaluation at a clinic and a plan of care, the written treatment plan your therapist and doctor sign. Part B pays when a physician, nurse practitioner, clinical nurse specialist or physician assistant who knows your case certifies the plan, recertified at least every 90 days; the regulation does not require an order or referral.⁠²⁷ You pay 20 percent of the approved amount after the $283 deductible in 2026, and a Medicare Advantage or private plan may want a referral or approval first.⁠^8,9,29,30 The Medicare therapy coverage guide explains plans of care and maintenance therapy in detail.

How does observation status change what Medicare pays afterward?

It can decide whether Medicare pays for a skilled nursing facility, because only inpatient days count toward the 3-day stay.⁠^6,31 You are an inpatient only from a formal admission with a doctor’s order; observation is outpatient care while your doctor decides whether to admit you, and you can be an outpatient even after a night in a hospital bed.⁠³¹ Medicare.gov suggests asking every day which you are, and the hospital must give you a Medicare Outpatient Observation Notice (MOON) after more than 24 hours of observation.⁠³¹

Since February 14, 2025, if you were admitted and the hospital changed you to outpatient observation, you can ask for a fast appeal; you should get a Medicare Change of Status Notice (CMS-10868) before you leave, and the reviewer decides about 2 days after you file.⁠³² The reviewer is the BFCC-QIO (Beneficiary and Family Centered Care Quality Improvement Organization), an independent reviewer under contract with Medicare.⁠¹⁷ File while still in the hospital if you can; if your status should not have changed, you may qualify for a covered nursing facility stay within 30 days of discharge.⁠³²

Can you choose the rehabilitation facility, nursing facility or agency?

Yes. If you need home health, a skilled nursing facility, an inpatient rehabilitation facility or a long-term care hospital, the hospital must give you a list of those available to you that take part in Medicare and serve your area, or the area you ask for in the case of a facility, and record that you received it.⁠² It must tell you that you are free to choose, respect your goals and preferences when possible, and not specify or limit which qualified providers are open to you.⁠²

The list shows what is available, not a ranking: home health agencies appear by asking to be listed, and the plan must identify any agency or nursing facility you are referred to in which the hospital has a disclosable financial interest.⁠² The hospital must also share quality and resource-use data relevant to your goals, and Medicare’s Care Compare tool compares home health agencies, nursing homes and rehabilitation facilities.⁠^1,17 If you are in a managed care plan, such as Medicare Advantage, the hospital must tell you to check your plan’s network and share what it knows about it.⁠²

DrSensory is not that list. It is a free directory families use to find occupational, physical and speech therapy clinics for children and adults by location; it lists clinics, not individual therapists, does not list inpatient rehabilitation facilities, and does not verify clinical quality or rank clinics by payment. It fits the outpatient step, once the hospital’s plan says a clinic is the right setting.

What if you think the hospital is discharging you too soon?

If you have Medicare, ask the BFCC-QIO named on your Important Message from Medicare for a fast appeal no later than the day you are due to leave.⁠^10,11 Hospitals must give this notice to every Medicare inpatient, in Original Medicare or Medicare Advantage, within 2 calendar days of admission, and present a copy again no more than 2 calendar days before discharge.⁠^33,34 It lists your right to the services you need after you leave; if you do not get it, ask for it.⁠¹⁰

1. Ask by the discharge day. Call or write to the reviewer no later than the day of discharge.⁠¹¹
2. The hospital explains itself. It carries the burden of showing discharge is correct, and must give you a detailed notice of its reasons by noon of the day after the reviewer contacts it.⁠^11,33
3. The reviewer decides quickly. The decision is due within one calendar day after the reviewer has the information it asked for.⁠¹¹
4. You can stay while it decides. If the reviewer sides with the hospital, you are not charged for the stay, beyond coinsurance and deductibles, before noon of the calendar day after you hear the decision.⁠^10,11

Miss the deadline and you can still ask for review, up to 30 calendar days after discharge or later for good cause, but without that protection from the bill.⁠¹¹ Tell the reviewer about the therapy side: whether the setting you are being sent to meets your needs and has accepted you. When covered care later ends in a nursing facility or home health, the notice is the Notice of Medicare Non-Coverage, given at least 2 days before services end; the Medicare therapy coverage guide covers that appeal.⁠¹⁰

Does the fast appeal work the same in a Medicare Advantage plan?

Largely, yes: plan members get the same notice, ask the reviewer no later than the day of discharge, and get a decision within one calendar day of the information.⁠^33,35 If the reviewer finds you are leaving too soon, coverage continues as long as medically necessary when the plan authorized the admission or it was for emergency or urgently needed care.⁠¹⁰

How do you challenge a discharge without Medicare?

Through your health plan’s urgent or expedited appeal, because the Important Message and the BFCC-QIO review are Medicare’s.⁠^33,34 A job-based plan must decide an urgent claim within 72 hours and treat as urgent a claim a physician who knows your condition calls urgent; a Medicaid managed care plan must offer an expedited appeal when the standard timeline could seriously jeopardize your ability to attain, maintain or regain maximum function.⁠^36,37 Ask the discharge planner to call the plan with you, and see what to do when insurance denies therapy for the appeal steps.

How do Medicare Advantage plans approve rehab after a hospital stay?

Through prior authorization, under rules that tie the plan to Original Medicare’s criteria. A plan must cover all Part A and Part B services and follow Traditional Medicare’s coverage conditions, which the regulation says include the payment requirements for nursing facility care, home health and inpatient rehabilitation facilities, so the facility criteria above are its test too.⁠^12,26 Prior authorization may only confirm a diagnosis or other medical criteria or check medical necessity under those standards, and once a plan approves a service it cannot later deny it as not medically necessary.⁠³⁸ You may need to use providers in the plan’s network.⁠²⁹

The plan’s decision is an organization determination, and refusing a service or cutting short an approved course of care counts as one; you, your representative or a provider can ask for one.⁠³⁹ When a physician says the standard timeline could seriously jeopardize your life, health or ability to regain maximum function, the plan must expedite, and an expedited decision is due within 72 hours.⁠^13,40 If the plan turns down a rehabilitation or nursing facility, ask the hospital physician to make that request, and ask the team what interim plan is safe.

What changes with Medicaid, a job-based plan or paying yourself?

The plan’s own documents decide what it pays, so ask for its Summary of Benefits and Coverage, the plain summary for comparing a plan’s costs and coverage.⁠⁴¹

• Medicaid managed care. Your plan must name a person or entity to coordinate your care, give you their contact details, and coordinate services between settings, including discharge planning.⁠⁴² If you are moving into managed care or between plans, the state’s transition-of-care policy must let you keep your current provider for a period, even out of network, when losing services would seriously harm your health.⁠⁴³
• Medicaid for adults. States must cover home health, but physical therapy, occupational therapy and speech, hearing and language services are optional; where covered, physical and occupational therapy are prescribed, and speech services referred, by a physician or other licensed practitioner.⁠^44,45
• Medicaid for children. Under EPSDT, children under 21 enrolled in Medicaid get the medically necessary services the program can cover, even when the state plan does not list them.⁠⁴⁶
• Job-based and Marketplace plans. Marketplace plans cover rehabilitative and habilitative services and devices, with details that vary by state, and a plan may require preauthorization, which HealthCare.gov notes is not a promise to pay.⁠^30,47
• Paying yourself. If you are uninsured or choose not to bill your plan, a clinic must give you a good faith estimate within 3 business days of your request, or of booking a visit at least 10 business days ahead.⁠⁴⁸ See adult therapy without insurance.

If your plan has no clinic that can see you, see no in-network therapist available.

How is the handoff different when a child leaves the hospital?

The hospital’s duties are the same, but the routes afterward differ. The discharge planning rule covers the hospital’s patients without an age limit, so a child’s evaluation, plan and records transfer follow it too.⁠^1,3 As a parent you are usually your child’s personal representative under HIPAA, though HHS names three exceptions, such as care a minor may consent to alone under state law.⁠⁴⁹

A child’s therapy can come through three separate routes: medical therapy paid by the family’s plan or Medicaid, early intervention for children under 3, and school services.⁠^14,16,46 Each has its own referral, so ask which ones the hospital has started. See insurance and therapy for children and the therapy guides by age.

Can the hospital refer a baby or toddler to early intervention?

Yes. Hospitals are primary referral sources for early intervention under Part C of IDEA, and state procedures must provide for referring a child under 3 as soon as possible and no more than seven days after the child is identified; parents can refer too.⁠¹⁴ Services include occupational therapy, physical therapy and speech-language pathology, are chosen with the parents, are free except where federal or state law sets family payments such as sliding fees, and are given in natural environments where appropriate.⁠⁵⁰ Ask whether the referral has gone, to which program, and who is expected to call you.

How does a child get therapy at school after a hospital stay?

Through the school’s own process. Under IDEA, speech-language pathology, physical therapy and occupational therapy can be related services, the support a child needs to benefit from special education, and a parent can request an initial evaluation, due within 60 days of consent or the state’s own timeline.⁠^15,16 Section 504 requires a public school program to provide a free appropriate public education, which can include related aids and services.⁠⁵¹ These laws bind the school, not the hospital or a clinic, and because school therapy serves the child’s education, it may sit alongside outpatient therapy rather than replace it.⁠¹⁶ Send the school the discharge summary with your request.

What should you have in hand when you leave the hospital?

Written instructions you can understand, a summary of your health, your updated medication list, equipment arranged and follow-up appointments, which is what Medicare’s checklist tells patients to ask for.⁠¹⁷ Your hospital record must also include a discharge summary with the outcome of the stay and the plans for follow-up care.⁠⁵²

Medicare’s checklist suggests having staff show you and your caregiver any task that needs special skills, then practicing it, and asking who arranges equipment delivery.⁠¹⁷ Part B covers equipment such as walkers, wheelchairs, commode chairs and hospital beds that your doctor or other provider orders for home, only from Medicare-enrolled suppliers; you pay 20 percent after the deductible if the supplier accepts assignment.⁠⁵³

How do you get copies of hospital records for the next therapist?

Ask the hospital’s medical records office. HIPAA gives you, with few exceptions, the right to a copy of your medical and billing records; the hospital must act within 30 days, extendable by up to 30 more, may charge reasonable copying and mailing costs but no search or retrieval fee, and cannot refuse over an unpaid bill.⁠^18,54 The hospital also has to send necessary information to your next provider itself, so ask whether it went.⁠³

A relative can help: providers may talk with a family member involved in your care unless you object, but need not share with anyone except your personal representative, who for an adult is someone with legal authority over health care decisions, such as through a health care power of attorney.⁠^49,55

How do you book outpatient therapy once you are home?

Start from the discharge plan: confirm the discipline recommended, then check that a clinic treats your condition, bills your coverage and can see you soon. Medicare does not require a referral, but a Medicare Advantage or private plan may require a referral or prior authorization, so call the plan first.⁠^27,29,30

When you are ready to look, the DrSensory directory is free for families and helps you find occupational, physical and speech therapy clinics for children and adults by location. It lists clinics, not individual therapists, and does not verify clinical quality, rank clinics by payment or sell leads, so confirm with the clinic what it treats and accepts. A message you send through DrSensory is read by the clinic in its portal.

How do you keep track of appointments and catch gaps in care?

Keep one log, started before discharge, with a line for every service and item in the plan and the day each one actually starts. A gap is any service without a confirmed first visit, equipment not delivered, or a call not returned by the day promised. Medicare’s checklist has room for appointments and the names and numbers of people to call.⁠¹⁷

When a line stalls, call the agency, facility or clinic first to ask what is missing, then the hospital’s discharge contact, then your plan’s member services or care coordinator; a Medicaid managed care plan must name one.⁠⁴² Check the log on a fixed rhythm, such as every other weekday. For new symptoms or a safety concern, call your doctor, or 911 in an emergency.

What might the handoff look like for an adult and for a child?

Both situations are invented; the names, days and choices are inputs, not predictions.

Sources

1. Electronic Code of Federal Regulations. 42 CFR 482.43, Condition of participation: Discharge planning (Medicare hospital conditions of participation, as amended through 89 FR 94592, November 27, 2024). Checked October 24, 2026.
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   Paragraph (a), the discharge planning process: “The hospital must have an effective discharge planning process that focuses on the patient’s goals and treatment preferences and includes the patient and his or her caregivers/support person(s) as active partners in the discharge planning for post-discharge care.”; “The hospital’s discharge planning process must identify, at an early stage of hospitalization, those patients who are likely to suffer adverse health consequences upon discharge in the absence of adequate discharge planning and must provide a discharge planning evaluation for those patients so identified as well as for other patients upon the request of the patient, patient’s representative, or patient’s physician.”; “A discharge planning evaluation must include an evaluation of a patient’s likely need for appropriate post-hospital services, including, but not limited to, hospice care services, post-hospital extended care services, home health services, and non-health care services and community based care providers, and must also include a determination of the availability of the appropriate services as well as of the patient’s access to those services.”; “the results of the evaluation must be discussed with the patient (or the patient’s representative)”; “Any discharge planning evaluation must be made on a timely basis to ensure that appropriate arrangements for post-hospital care will be made before discharge and to avoid unnecessary delays in discharge.”; “Upon the request of a patient’s physician, the hospital must arrange for the development and initial implementation of a discharge plan for the patient.”; “must be developed by, or under the supervision of, a registered nurse, social worker, or other appropriately qualified personnel”; “The hospital’s discharge planning process must require regular re-evaluation of the patient’s condition to identify changes that require modification of the discharge plan.”; “The discharge plan must be updated, as needed, to reflect these changes.”; “The hospital must assist patients, their families, or the patient’s representative in selecting a post-acute care provider by using and sharing data that includes, but is not limited to, HHA, SNF, IRF, or LTCH data on quality measures and data on resource use measures.”
2. Electronic Code of Federal Regulations. 42 CFR 482.43(d), Requirements related to post-acute care services (Medicare hospital conditions of participation; applies to patients referred for home health or transferred to a skilled nursing facility, inpatient rehabilitation facility or long-term care hospital). Checked October 24, 2026.
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   “The hospital must include in the discharge plan a list of HHAs, SNFs, IRFs, or LTCHs that are available to the patient, that are participating in the Medicare program, and that serve the geographic area (as defined by the HHA) in which the patient resides, or in the case of a SNF, IRF, or LTCH, in the geographic area requested by the patient.”; “HHAs must request to be listed by the hospital as available.”; “This list must only be presented to patients for whom home health care post-hospital extended care services, SNF, IRF, or LTCH services are indicated and appropriate as determined by the discharge planning evaluation.”; “For patients enrolled in managed care organizations, the hospital must make the patient aware of the need to verify with their managed care organization which practitioners, providers or certified suppliers are in the managed care organization’s network.”; “If the hospital has information on which practitioners, providers or certified supplies are in the network of the patient’s managed care organization, it must share this with the patient or the patient’s representative.”; “The hospital must document in the patient’s medical record that the list was presented to the patient or to the patient’s representative.”; “must inform the patient or the patient’s representative of their freedom to choose among participating Medicare providers and suppliers of post-discharge services and must, when possible, respect the patient’s or the patient’s representative’s goals of care and treatment preferences, as well as other preferences they express. The hospital must not specify or otherwise limit the qualified providers or suppliers that are available to the patient.”; “The discharge plan must identify any HHA or SNF to which the patient is referred in which the hospital has a disclosable financial interest”.
3. Electronic Code of Federal Regulations. 42 CFR 482.43(b), Discharge of the patient and provision and transmission of the patient’s necessary medical information (Medicare hospital conditions of participation). Checked October 24, 2026.
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   “The hospital must discharge the patient, and also transfer or refer the patient where applicable, along with all necessary medical information pertaining to the patient’s current course of illness and treatment, post-discharge goals of care, and treatment preferences, at the time of discharge, to the appropriate post-acute care service providers and suppliers, facilities, agencies, and other outpatient service providers and practitioners responsible for the patient’s follow-up or ancillary care.”
4. Electronic Code of Federal Regulations. 42 CFR 482.1, Basis and scope (hospital conditions of participation) (Medicare and Medicaid). “Hospitals participating in Medicare must meet certain specified requirements”; “hospitals receiving payment under Medicaid must meet the requirements for participation in Medicare”. Checked October 24, 2026.
5. Centers for Medicare & Medicaid Services (Medicare.gov). Inpatient rehabilitation care (Your Medicare coverage; 2026 costs). Checked October 24, 2026.
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   “Inpatient rehabilitation can help if you’re recovering from a serious surgery, illness, or injury and need an intensive rehabilitation therapy program, physician supervision, and coordinated care from your doctors and other health care providers (including therapists).”; “Rehabilitation services, including physical therapy, occupational therapy, and speech-language pathology”; “Your health care provider must certify that you have a medical condition requiring intensive rehabilitation, continued medical supervision, and coordinated care from your providers.”; “Days 1-60: After you pay the $1,736 deductible you pay $0 each day.”; “Days 61-90: You pay $434 each day.”; “Days 91-150: You pay $868 each day while using your 60 lifetime reserve days”; “For example, you won’t have to pay a deductible for inpatient rehabilitation care if:”; “You’re transferred to an inpatient rehabilitation facility directly from an acute care hospital.”
6. Centers for Medicare & Medicaid Services (Medicare.gov). Skilled nursing facility care (Your Medicare coverage; 2026 costs). Checked October 24, 2026.
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   “Physical therapy (if needed to meet your health goal)”; “a prior medically necessary inpatient hospital stay of at least 3 days in a row (starting the day you were admitted as an inpatient, but not including the day you leave the hospital)”; “Time you spend at the hospital under observation or in the emergency room before you’re admitted doesn’t count toward the 3-day qualifying inpatient hospital stay, even if you’re there overnight.”; “Medicare Advantage Plans may also waive the 3-day minimum inpatient hospital stay.”; “If you don’t have a 3-day qualifying inpatient hospital stay and you need care after your discharge from a hospital, ask if you can get care in other settings (like home health care) or if any other programs (like Medicaid or Veterans’ benefits) can cover your SNF care.”; “You enter the SNF within a short time (generally 30 days) of leaving the hospital.”; “Your doctor or other health care provider has decided that you need daily skilled care (like intravenous fluids/medications or physical therapy).”; “Days 1–20: You pay $0 each day after you pay the $1,736 deductible.”; “You don’t have to pay the Part A deductible for skilled nursing facility care if you already paid it for care you got in a hospital during the same benefit period.”; “If you’re in a Medicare Advantage Plan, you may be charged copayments during the first 20 days.”; “Days 21–100: You pay $217 each day.”; “Days 101 and beyond: You pay all costs.”; “Part A limits SNF coverage to 100 days in each benefit period.”; “If the hospital you’re in has its own SNF, and a bed is available, you may choose to stay there.”
7. Centers for Medicare & Medicaid Services (Medicare.gov). Home health services (Your Medicare coverage). Checked October 24, 2026.
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   “Physical therapy, occupational therapy, and speech-language pathology services (if you meet certain conditions)”; “You must need part-time or intermittent skilled services and you’re ‘homebound,’”; “Leaving your home isn’t recommended because of your condition or you have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury.”; “You’re normally unable to leave your home and leaving takes a lot of effort.”; “a doctor or health care provider (like a nurse practitioner) must see you in person and confirm you need home health care. They must also order your care, and a Medicare-certified home health agency must provide it.”; “If you need occupational therapy, your doctor or health care provider must first order it along with nursing care, physical therapy, or speech-language pathology. After that you can keep getting occupational therapy on its own, even if you no longer need the other services.”; “If your provider decides you need home health care, they should give you a list of agencies that serve your area.”; “Your provider must tell you if their organization has a financial interest in any agency listed.”; “You pay nothing for covered home health services.”; “After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for Medicare-covered medical equipment.”; “Custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need”.
8. Centers for Medicare & Medicaid Services (Medicare.gov). Physical therapy services (Your Medicare coverage). Checked October 24, 2026.
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   “Physical therapy helps to restore or improve physical movement in your body after an injury, illness, or surgery.”; “Your doctor or other health care provider (including a nurse practitioner, clinical nurse specialist, or physician assistant) must certify that you need it.”; “After the Part B deductible, you pay 20% of the Medicare-approved amount for these services when they’re medically necessary.”
9. Centers for Medicare & Medicaid Services (Medicare.gov). Medicare costs (2026 Part B amounts). “$283 before Original Medicare starts to pay.”; “Usually 20% of the cost for each Medicare-covered service or item after you’ve paid your deductible”. Checked October 24, 2026.
10. Centers for Medicare & Medicaid Services (Medicare.gov). Fast appeals (when services are ending or you are being discharged too soon). Checked October 24, 2026.
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    “Within 2 days of your admission and prior to your discharge, you should get a notice called ‘An Important Message from Medicare about Your Rights.’”; “If you don’t get this notice, ask for it.”; “Your right to get the services you need after you leave the hospital”; “Skilled nursing facility (SNF)”; “Home health agency (HHA)”; “Follow the directions on the Important Message from Medicare no later than the day you’re scheduled to be discharged from the hospital.”; “If you ask for your appeal within this time frame, you can stay in the hospital while you wait to get the BFCC-QIO’s decision. You won’t have to pay for your stay (except for applicable coinsurance or deductibles).”; “Medicare will continue to cover your hospital stay as long as medically necessary (except for applicable coinsurance or deductibles) if your plan previously authorized coverage of the inpatient admission, or the inpatient admission was for emergency or urgently needed care”; “In other settings: You should get a notice called ‘Notice of Medicare Non-Coverage’ at least 2 days before covered services end.”
11. Electronic Code of Federal Regulations. 42 CFR 405.1206, Expedited determination procedures for inpatient hospital care (Original Medicare). Checked October 24, 2026.
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    “The request must be made no later than the day of discharge and may be in writing or by telephone.”; “the burden of proof rests with the hospital to demonstrate that discharge is the correct decision”; “the QIO must make a determination and notify the beneficiary, the hospital, and physician of its determination within one calendar day after it receives all requested pertinent information.”; “the hospital must deliver a detailed notice to the beneficiary as soon as possible but no later than noon of the day after the QIO’s notification.”; “the beneficiary is not financially responsible for inpatient hospital services (other than applicable coinsurance and deductible) furnished before noon of the calendar day after the date the beneficiary (or his or her representative) receives notification (either orally or in writing) of the expedited determination by the QIO.”; “may request QIO review within 30 calendar days after the date of discharge, or at any time for good cause.”
12. Electronic Code of Federal Regulations. 42 CFR 422.101, Requirements relating to basic benefits (Medicare Advantage). Checked October 24, 2026.
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    “Provide coverage of, by furnishing, arranging for, or making payment for, all services that are covered by Part A and Part B of Medicare”; “General coverage and benefit conditions included in Traditional Medicare laws, unless superseded by laws applicable to MA plans.”; “requirements for payment of Skilled Nursing Facility (SNF) Care, Home Health Services under 42 CFR part 409, and Inpatient Rehabilitation Facilities (IRF) at 42 CFR 412.622(a)(3).”
13. Electronic Code of Federal Regulations. 42 CFR 422.570, Expediting certain organization determinations (Medicare Advantage). Checked October 24, 2026.
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    “For a request made or supported by a physician, the MA organization must provide an expedited determination if the physician indicates that applying the standard timeframe for making a determination could seriously jeopardize the life or health of the enrollee or the enrollee’s ability to regain maximum function.”
14. Electronic Code of Federal Regulations. 34 CFR 303.303, Referral procedures (IDEA Part C). Checked October 24, 2026.
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    “procedures for use by primary referral sources for referring a child under the age of three to the part C program.”; “Provide for referring a child as soon as possible, but in no case more than seven days, after the child has been identified;”; “Hospitals, including prenatal and postnatal care facilities;”; “Parents, including parents of infants and toddlers;”.
15. Electronic Code of Federal Regulations. 34 CFR 300.301, Initial evaluations (IDEA Part B). Checked October 24, 2026.
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    “either a parent of a child or a public agency may initiate a request for an initial evaluation to determine if the child is a child with a disability.”; “Must be conducted within 60 days of receiving parental consent for the evaluation; or”; “If the State establishes a timeframe within which the evaluation must be conducted, within that timeframe”.
16. Electronic Code of Federal Regulations. 34 CFR 300.34, Related services (IDEA Part B; binds public schools). “Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services”; “physical and occupational therapy”. Checked October 24, 2026.
17. Centers for Medicare & Medicaid Services (Medicare.gov). Your discharge planning checklist (CMS Product No. 11376, December 2025, PDF). Checked October 24, 2026.
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    “You and your caregiver (a family member or friend who may be helping you) are important members of the planning team.”; “Talk to your doctor and the staff (like a discharge planner, social worker, ombudsman, or nurse)”; “Write down the names and phone numbers of people to call if you have questions or concerns.”; “Use this space to write down the dates and times of any upcoming appointments.”; “an independent reviewer under contract with Medicare, called a Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO)”; “Ask where you’ll get care after you’re discharged. Do you have options (like home health care)? Tell the staff what you prefer.”; “Ask if you’ll need medical equipment (like a walker), if it’s covered by Medicare, and who will arrange for its delivery.”; “Ask the staff to show you and your caregiver, if you have one, how to do any tasks that require special skills (like changing a bandage or giving a shot), then practice those skills yourself.”; “Talk to a social worker or your health plan if you have questions about what your insurance will cover and how much you’ll have to pay.”; “Ask for written discharge instructions (that you can read and understand) and a summary of your current health status. Bring this information and your drug list to your follow-up appointments.”; “Visit Medicare.gov/care-compare to compare the quality of home health agencies, nursing homes, dialysis facilities, inpatient rehabilitation facilities, and hospitals”.
18. U.S. Department of Health and Human Services, Office for Civil Rights. Your Medical Records (HIPAA for individuals). Checked October 24, 2026.
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    “The Privacy Rule gives you, with few exceptions, the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule.”; “A provider cannot deny you a copy of your records because you have not paid for the services you have received.”; “a provider may charge for the reasonable costs for copying and mailing the records. The provider cannot charge you a fee for searching for or retrieving your records.”
19. Electronic Code of Federal Regulations. 42 CFR 485.642, Condition of participation: Discharge planning (critical access hospitals) (Medicare). Checked October 24, 2026.
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    “A Critical Access Hospital (CAH) must have an effective discharge planning process that focuses on the patient’s goals and treatment preferences”; “The CAH must discharge the patient, and also transfer or refer the patient where applicable, along with all necessary medical information”.
20. Centers for Medicare & Medicaid Services (Medicare.gov). Occupational therapy services (Your Medicare coverage). “Therapy to help you perform activities of daily living (like dressing or bathing).” Checked October 24, 2026.
21. Centers for Medicare & Medicaid Services (Medicare.gov). Speech-language pathology services (Your Medicare coverage). “Speech-language pathology services provide evaluation and treatment to regain and strengthen speech and language skills. This includes cognitive and swallowing skills”. Checked October 24, 2026.
22. American Physical Therapy Association (ChoosePT). About physical therapists and physical therapist assistants (consumer page). “Physical therapists are licensed health care providers. They evaluate, diagnose, and manage health conditions and movement problems in people of all ages and abilities.” Checked October 24, 2026.
23. American Occupational Therapy Association. What is occupational therapy? (consumer page). “Occupational therapists and occupational therapy assistants focus on the things you want and need to do in your daily life.”; “Adaptive equipment (such as shower chairs, or equipment to make daily tasks easier)”; “Caregiver and family training”; “Falls prevention and home safety and accessibility”. Checked October 24, 2026.
24. American Speech-Language-Hearing Association. Adult Dysphagia (Practice Portal, overview). “Speech-language pathologists (SLPs) are the preferred providers of dysphagia services and are integral members of an interprofessional team to diagnose and manage oral and pharyngeal dysphagia.” Checked October 24, 2026.
25. Centers for Medicare & Medicaid Services (Medicare.gov). Long-term care hospital services (Your Medicare coverage; 2026 costs). “Long-term care hospitals typically provide care to patients with more than one serious medical condition.”; “Days 1-60: After you pay the $1,736 deductible you pay $0 each day.” Checked October 24, 2026.
26. Electronic Code of Federal Regulations. 42 CFR 412.622, Basis of payment (inpatient rehabilitation facility coverage criteria, paragraph (a)(3) and (a)(4)) (Medicare). Checked October 24, 2026.
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    “requires the active and ongoing therapeutic intervention of multiple therapy disciplines (physical therapy, occupational therapy, speech-language pathology, or prosthetics/orthotics therapy), one of which must be physical or occupational therapy.”; “this intensive rehabilitation therapy program generally consists of at least 3 hours of therapy (physical therapy, occupational therapy, speech-language pathology, or prosthetics/orthotics therapy) per day at least 5 days per week. In certain well-documented cases, this intensive rehabilitation therapy program might instead consist of at least 15 hours of intensive rehabilitation therapy per week.”; “is sufficiently stable at the time of admission to the IRF to be able to actively participate in the intensive rehabilitation therapy program”; “the rehabilitation physician must conduct face-to-face visits with the patient at least 3 days per week throughout the patient’s stay in the IRF”; “It is conducted by a licensed or certified clinician(s) designated by a rehabilitation physician within the 48 hours immediately preceding the IRF admission.”; “All required therapy treatments and/or therapy evaluations ordered must begin no later than 36 hours from midnight on the day of admission to the IRF.”
27. Electronic Code of Federal Regulations. 42 CFR 424.24(c), Outpatient physical therapy, occupational therapy, and speech-language pathology services (Medicare certification of the plan of care). Checked October 24, 2026.
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    “the certification must be signed by a physician or by a nurse practitioner, clinical nurse specialist, or physician assistant who has knowledge of the case”; “Recertification is required at least every 90 days.”; “No references to an order or referral in this subsection shall be construed to require an order or referral for outpatient physical therapy, occupational therapy, or speech-language pathology services.”
28. Electronic Code of Federal Regulations. 42 CFR 424.22, Requirements for home health services (Medicare certification). Checked October 24, 2026.
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    “The individual needs or needed intermittent skilled nursing care, or physical therapy or speech-language pathology services”; “A face-to-face patient encounter, which is related to the primary reason the patient requires home health services, occurred no more than 90 days prior to the home health start of care date or within 30 days of the start of the home health care”.
29. Centers for Medicare & Medicaid Services (Medicare.gov). Compare Original Medicare & Medicare Advantage (Medicare basics). Checked October 24, 2026.
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    “You may need to use doctors and other providers who are in the plan’s network and service area (for non-emergency care).”; “Plans must cover all medically necessary services that Original Medicare covers.”; “You may need to get approval (prior authorization) from your plan before it covers certain services or supplies.”
30. Centers for Medicare & Medicaid Services (HealthCare.gov). Preauthorization (glossary). Checked October 24, 2026.
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    “A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.”; “Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost.”
31. Centers for Medicare & Medicaid Services (Medicare.gov). Inpatient or outpatient hospital status affects your costs (Your Medicare coverage). Checked October 24, 2026.
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    “Your hospital status may also affect whether Medicare will cover care you get in a skilled nursing facility (SNF) following your hospital stay.”; “You’re an inpatient starting when you’re formally admitted to the hospital with a doctor’s order.”; “In these cases, you’re an outpatient even if you spend the night in the hospital.”; “Observation services are hospital outpatient services you get while your doctor decides whether to admit you as an inpatient or discharge you.”; “Each day you have to stay, you or your caregiver should ask the hospital and/or your doctor, a hospital social worker, or a patient advocate if you’re an inpatient or outpatient.”; “The hospital must give you this notice if you’re getting outpatient observation services for more than 24 hours.”
32. Centers for Medicare & Medicaid Services (Medicare.gov). Appeal when a hospital changes your status from “inpatient” to “outpatient getting observation services” (Original Medicare appeals). Checked October 24, 2026.
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    “Starting on February 14, 2025, you’ll have the right to ask for a fast appeal if you were admitted as a hospital inpatient and your status was changed to ‘outpatient getting observation services’ during your hospital visit.”; “you should get a ‘Medicare Change of Status Notice (CMS-10868)’ before you leave the hospital.”; “Medicare won’t pay if you go to a skilled nursing facility after you leave the hospital.”; “If possible, it’s best to file an appeal while you’re still in the hospital. However, you still have appeal rights and can ask for an appeal after you leave the hospital.”; “Make a decision and let you know what they decided about 2 days after you file your appeal.”; “You may qualify for a Medicare-covered skilled nursing facility stay within 30 days of your discharge from this hospital stay (if other coverage requirements are also met).”
33. Centers for Medicare & Medicaid Services. FFS & MA IM/DND (Beneficiary Notices Initiative; page last modified July 17, 2026). Checked October 24, 2026.
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    “Hospitals are required to deliver the Important Message from Medicare (IM), formerly CMS-R-193 and now CMS-10065, to all Medicare beneficiaries (Original Medicare beneficiaries and Medicare Advantage plan enrollees) who are hospital inpatients.”; “A Detailed Notice of Discharge (DND) is given only if a beneficiary requests an appeal.”
34. Electronic Code of Federal Regulations. 42 CFR 405.1205, Notifying beneficiaries of hospital discharge appeal rights (Original Medicare). Checked October 24, 2026.
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    “This definition includes critical access hospitals.”; “For all Medicare beneficiaries, hospitals must deliver valid, written notice of a beneficiary’s rights as a hospital inpatient, including discharge appeal rights.”; “The hospital must provide the notice at or near admission, but no later than 2 calendar days following the beneficiary’s admission to the hospital.”; “The notice should be given as far in advance of discharge as possible, but not more than 2 calendar days before discharge.”
35. Electronic Code of Federal Regulations. 42 CFR 422.622, Requesting immediate QIO review of the decision to discharge from the inpatient hospital (Medicare Advantage). “The request must be made no later than the day of discharge and may be in writing or by telephone.”; “within one calendar day after it receives all requested pertinent information.” Checked October 24, 2026.
36. Electronic Code of Federal Regulations. 29 CFR 2560.503-1, Claims procedure (employee benefit plans under ERISA, including job-based group health plans). Checked October 24, 2026.
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    “not later than 72 hours after receipt of the claim by the plan”; “Could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function”; “Any claim that a physician with knowledge of the claimant’s medical condition determines is a ‘claim involving urgent care’ within the meaning of paragraph (m)(1)(i) of this section shall be treated as a ‘claim involving urgent care’”.
37. Electronic Code of Federal Regulations. 42 CFR 438.410, Expedited resolution of appeals (Medicaid managed care). “Each MCO, PIHP, and PAHP must establish and maintain an expedited review process for appeals”; “ability to attain, maintain, or regain maximum function.” Checked October 24, 2026.
38. Electronic Code of Federal Regulations. 42 CFR 422.138, Prior authorization (Medicare Advantage coordinated care plans). Checked October 24, 2026.
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    “To confirm the presence of diagnoses or other medical criteria that are the basis for coverage determinations for the specific item or service; or”; “For basic benefits, to ensure an item or service is medically necessary based on standards specified in § 422.101(c)(1)”; “If the MA organization approved the furnishing of a covered item or service through a prior authorization or pre-service determination of coverage or payment, or a concurrent determination made during the enrollee’s receipt of inpatient or outpatient services, it may not deny coverage later on the basis of lack of medical necessity”.
39. Electronic Code of Federal Regulations. 42 CFR 422.566, Organization determinations (Medicare Advantage). Checked October 24, 2026.
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    “The MA organization’s refusal, pre- or post-service or in connection with a decision made concurrently with an enrollee’s receipt of services, to provide or pay for services, in whole or in part, including the type or level of services, that the enrollee believes should be furnished or arranged for by the MA organization.”; “Reduction, or premature discontinuation, of a previously authorized ongoing course of treatment.”; “Any provider that furnishes, or intends to furnish, services to the enrollee”; “A physician (regardless of whether the physician is affiliated with the MA organization).”
40. Electronic Code of Federal Regulations. 42 CFR 422.572, Timeframes and notice requirements for expedited organization determinations (Medicare Advantage). “as expeditiously as the enrollee’s health condition requires, but no later than 72 hours after receiving the request.” Checked October 24, 2026.
41. Centers for Medicare & Medicaid Services (HealthCare.gov). Summary of Benefits and Coverage (SBC) (glossary). “An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans.” Checked October 24, 2026.
42. Electronic Code of Federal Regulations. 42 CFR 438.208, Coordination and continuity of care (Medicaid managed care). Checked October 24, 2026.
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    “Ensure that each enrollee has an ongoing source of care appropriate to his or her needs and a person or entity formally designated as primarily responsible for coordinating the services accessed by the enrollee. The enrollee must be provided information on how to contact their designated person or entity;”; “Between settings of care, including appropriate discharge planning for short term and long-term hospital and institutional stays;”.
43. Electronic Code of Federal Regulations. 42 CFR 438.62, Continued services to enrollees (Medicaid managed care transition of care). Checked October 24, 2026.
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    “The State must have in effect a transition of care policy to ensure continued access to services during a transition from FFS to a MCO, PIHP, PAHP, PCCM or PCCM entity or transition from one MCO, PIHP, PAHP, PCCM or PCCM entity to another when an enrollee, in the absence of continued services, would suffer serious detriment to their health or be at risk of hospitalization or institutionalization.”; “The enrollee has access to services consistent with the access they previously had, and is permitted to retain their current provider for a period of time if that provider is not in the MCO, PIHP or PAHP network.”
44. Centers for Medicare & Medicaid Services (Medicaid.gov). Mandatory & Optional Medicaid Benefits (Medicaid state plan benefits). Checked October 24, 2026.
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    Listed under “Mandatory Benefits”: home health; under “Optional Benefits”: physical therapy, occupational therapy and speech, hearing and language disorder services: “States are required to provide all mandatory benefits under federal law.”; “States may provide optional benefits if they choose to add them through the state plan process.”; “Home health services (1905(a)(7), 42 CFR 440.70 and 42 CFR 441.15)”; “Physical therapy (1905(a)(11), 42 CFR 440.110(a))”; “Occupational therapy (1905(a)(11), 42 CFR 440.110(b))”; “Speech, hearing and language disorder services (1905(a)(11), 42 CFR 440.110(c))”.
45. Electronic Code of Federal Regulations. 42 CFR 440.110, Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders (Medicaid). Checked October 24, 2026.
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    “Physical therapy means services prescribed by a physician or other licensed practitioner of the healing arts”; “Occupational therapy means services prescribed by a physician or other licensed practitioner of the healing arts”; “for which a patient is referred by a physician or other licensed practitioner of the healing arts”.
46. Centers for Medicare & Medicaid Services (Medicaid.gov). Early and Periodic Screening, Diagnostic, and Treatment (Medicaid benefits for children). Checked October 24, 2026.
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    “The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid.”; “States are required to provide any additional 1905(a) services that are coverable under the Federal Medicaid program and found to be medically necessary to treat, correct, or reduce illnesses and conditions discovered regardless of whether the service is covered in a state’s Medicaid plan.”
47. Centers for Medicare & Medicaid Services (HealthCare.gov). What Marketplace health insurance plans cover (essential health benefits). “Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)”; “Specific services covered in each broad benefit category can vary based on your state’s requirements.” Checked October 24, 2026.
48. Electronic Code of Federal Regulations. 45 CFR 149.610, Requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) individuals (No Surprises Act). Checked October 24, 2026.
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    “upon request or upon scheduling an item or service”; “When a primary item or service is scheduled at least 10 business days before such item or service is scheduled to be furnished: Not later than 3 business days after the date of scheduling”; “When a good faith estimate is requested by an uninsured (or self-pay) individual: Not later than 3 business days after the date of the request.”
49. U.S. Department of Health and Human Services, Office for Civil Rights. Personal Representatives (HIPAA Privacy Rule guidance, 45 CFR 164.502(g)). Checked October 24, 2026.
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    “A person with legal authority to make health care decisions on behalf of the individual”; “Health care power of attorney”; “In most cases under the Rule, a parent, guardian, or other person acting in loco parentis (collectively, ‘parent’) is the personal representative of the minor child and can exercise the minor’s rights with respect to protected health information, because the parent usually has the authority to make health care decisions about his or her minor child.”; “the Privacy Rule specifies three circumstances in which the parent is not the ‘personal representative’ with respect to certain health information about his or her minor child.”; “When State or other law does not require the consent of a parent or other person before a minor can obtain a particular health care service, and the minor consents to the health care service;”.
50. Electronic Code of Federal Regulations. 34 CFR 303.13, Early intervention services (IDEA Part C, infants and toddlers under 3). Checked October 24, 2026.
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    “Are selected in collaboration with the parents;”; “Are provided at no cost, except, subject to §§ 303.520 and 303.521, where Federal or State law provides for a system of payments by families, including a schedule of sliding fees;”; “To the maximum extent appropriate, are provided in natural environments”; “Occupational therapy includes services to address the functional needs of an infant or toddler with a disability”; “Physical therapy includes services to address the promotion of sensorimotor function”; “Speech-language pathology services include”.
51. Electronic Code of Federal Regulations. 34 CFR 104.33, Free appropriate public education (Section 504 of the Rehabilitation Act; binds public schools that receive federal funds). Checked October 24, 2026.
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    “A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate public education to each qualified handicapped person who is in the recipient’s jurisdiction”; “the provision of regular or special education and related aids and services”.
52. Electronic Code of Federal Regulations. 42 CFR 482.24, Condition of participation: Medical record services (what every hospital medical record must contain). “Discharge summary with outcome of hospitalization, disposition of case, and provisions for follow-up care.” Checked October 24, 2026.
53. Centers for Medicare & Medicaid Services (Medicare.gov). Durable medical equipment (DME) coverage (Your Medicare coverage). Checked October 24, 2026.
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    “Commode chairs”; “Hospital beds”; “Walkers”; “Wheelchairs and scooters”; “Part B covers medically necessary DME if your doctor or other health care provider orders it for use in your home.”; “Medicare will only pay for DME items if you get them from suppliers who are enrolled in Medicare.”; “After you meet the Part B deductible, you pay 20% of the Medicare-approved amount (if your supplier accepts assignment).”
54. Electronic Code of Federal Regulations. 45 CFR 164.524, Access of individuals to protected health information (HIPAA Privacy Rule). “the covered entity must act on a request for access no later than 30 days after receipt of the request”; “may extend the time for such actions by no more than 30 days”. Checked October 24, 2026.
55. U.S. Department of Health and Human Services, Office for Civil Rights. Family Members and Friends (HIPAA for individuals; content last reviewed December 23, 2022). Checked October 24, 2026.
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    “The Privacy Rule does not require a health care provider or health plan to share information with your family or friends, unless they are your personal representatives.”; “If you do not object, your doctor could talk with the friend who goes with you to the hospital or with a family member who pays your medical bill.”

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your individual situation.