This post was contributed by a community member. The views expressed here are the author's own.

Health & Fitness

Medicare Settlement Could Increase Coverage of In-Home Care

A proposed change to Medicare could expand the coverage for in-home care.

Caregivers who are trying to get Medicare coverage for home health care for their elderly loved ones have long been caught in a Catch-22. Short-term care, in-home care is covered, but only for a limited period of time and only if the care will help improve the patient’s medical condition or ability to function. If the condition is chronic or not getting better, Medicare would not pay for care, regardless of necessity of the services, citing an “improvement standard.”

But all of that may change.

The proposed settlement of a nation-wide, class action lawsuit, Jimmo v. Sebelius, which challenged that “improvement standard,” would significantly expand coverage of therapy and skilled nursing services for Medicare beneficiaries. Under an agreement reached in October, Medicare would pay for skilled therapy or nursing care to maintain the patient’s current condition or prevent or slow further decline. A Fairness Hearing to determine final approval of this agreement is being held on January 24 in U.S. District Court.

Find out what's happening in Shelby-Uticawith free, real-time updates from Patch.

Experts are praising this settlement for both its cost-effectiveness and compassion. Articles in the New York Times, USA Today, and other media outlets, quote leaders discussing the many benefits of this change. For more information on this issue, visit the Center for Medicare Advocacy.

Don Berwick, former administrator of the Centers for Medicare & Medicaid Services, said in a Nov. 1 USA Today article: "I don't know that you can predict the costs, but I think they did the right thing. Medicare exists to provide people with the care they need."

Find out what's happening in Shelby-Uticawith free, real-time updates from Patch.

We couldn’t agree more.

Anne Marie Gattari is president of BrightStar Care of Grosse Pointe/Southeast Macomb, providers of companion, personal and nursing care services that help keep your elderly loved ones in the comfort and familiarity of their own homes. Call 586-279-3610 or visit www.brightstarcare.com/grosse-pointesoutheast-macomb.

We’ve removed the ability to reply as we work to make improvements. Learn more here

The views expressed in this post are the author's own. Want to post on Patch?