Home Health Care Patients With Chronic Conditions Are Having Trouble Getting Medicare

Estate Planning, Wills And Trusts

Medicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of reasons, many home health care agencies are simply telling patients they are not covered.

Medicare is mandated to cover home health benefits indefinitely. In addition, Medicare is required to cover skilled nursing and home care even if a patient has a chronic condition. Unfortunately, many home health providers are not aware of the law and tell home health care patients that they must show improvement in order to receive benefits.

According to a Kaiser Health News article, confusion over whether or not improvement is required (it is not) is one part of the problem. Another issue is that home health care workers are afraid they will not get paid if they take on long-term care patients. In an effort to crack down on fraud, Medicare is more likely to audit providers who provide long-term care. This encourages providers to favor patients who need short-term care.

In addition, Medicare’s Home Health Compare ratings website may be having a negative effect on home health care agencies’ willingness to provide for long-term care patients. One measure of care qualify is whether a patient is improving. Because patients with chronic conditions don’t necessarily improve, they could lower an agency’s rating. Also, under a rule that just went into effect, home health care agencies cannot dismiss a patient without a doctor’s note. This may make agencies even more reluctant to take on long-term care patients.

If you are wrongly denied Medicare home health benefits, you can appeal, although you may have to be persistent to get coverage. The Center for Medicare Advocacy has a self-help packet for navigating appeals.

Share:

Share on facebook
Share on twitter
Share on linkedin

More Posts

Vaccine for Snowbirds

Snowbirds to get Florida Covid Vaccine

When it comes to the vaccine for COVID-19, snowbirds are equal to the rest of us.

Senior visitors spending the winter in Florida, (including some just entering the state looking for the vaccine?) along with seniors who live in the state full-time and those with medical conditions, can get the vaccine here.

How to Celebrate Holidays with Seniors 2020

Although we really want a big family celebration where we can all celebrate the holidays together, that might not be the best idea right now. Many families are understandably trying to find other ways to be able to connect with our silver-aged loved ones during the holidays.

End of Year Taxes and Charitable Donation

As part of the Coronavirus Aid, Relief and Economic Security (CARES) Act, Congress created a one-time $300 charitable deduction for people who do not itemize on their tax returns. To qualify, you must give cash (including paying by check or credit card) to a 501(c)(3) charity. G

Jakob Legal helps a senior couple with Health Care Directives sitting together on plaid at sandy beach.

Its Medicare Advantage Season

Now is the annual opportunity to change medicare coverage. From Oct. 15 until Dec. 7, enrollees can shop Medicare’s marketplace for the prescription drug and Advantage plans offered by commercial insurance companies. They can also switch between fee-for-service original Medicare and Advantage.
And they will have plenty of choices: Next year, the typical Medicare enrollee will be able to choose from 57 Medicare prescription or Advantage plans that include drug coverage, according to the Kaiser Family Foundation.

Please Contact Me

Skip to content