{"id":2766,"date":"2023-05-15T09:42:15","date_gmt":"2023-05-15T09:42:15","guid":{"rendered":"https:\/\/alcleanscarpet.site\/Weatherby\/2023\/05\/15\/medicare-coverage-and-medicare-planning-for-chronic-conditions\/"},"modified":"2023-06-06T06:57:12","modified_gmt":"2023-06-06T06:57:12","slug":"medicare-coverage-and-medicare-planning-for-chronic-conditions","status":"publish","type":"post","link":"https:\/\/alcleanscarpet.site\/Weatherby\/medicare-coverage-and-medicare-planning-for-chronic-conditions\/","title":{"rendered":"Medicare Coverage and Medicare Planning for Chronic Conditions"},"content":{"rendered":"<p><a href=\"http:\/\/weatherby-associates.com\/wp-content\/uploads\/2017\/02\/probate.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-1859\" src=\"https:\/\/alcleanscarpet.site\/Weatherby\/wp-content\/uploads\/2017\/02\/probate.jpg\" alt=\"Medicare Planning - Bloomfield CT\" width=\"150\" height=\"150\" \/><\/a><\/p>\n<p>If you are a Medicare beneficiary receiving skilled care for a chronic condition, you no longer have to show improvement in order to have the care covered, but your provider (such as a doctor, home care agency, or nursing home) may not know this. Even though a recent lawsuit settlement mandated a nationwide educational campaign for providers, many are still refusing to provide needed treatment, claiming that Medicare will not cover it.<\/p>\n<p>For about 30 years, home health agencies and nursing homes that contract with Medicare have routinely terminated the Medicare coverage of a beneficiary who has stopped improving, even though nothing in the Medicare statute or its regulations says improvement is required for continued skilled care.\u00a0Under a settlement agreement in <em>Jimmo v. Sebelius<\/em><em>,\u00a0 <\/em>the federal government agreed to update Medicare rules to require that Medicare cover skilled care as long as the beneficiary needs skilled care, even if it would simply maintain the beneficiary&#8217;s current condition or slow further deterioration.<\/p>\n<p>The policy shift affects beneficiaries with conditions like multiple sclerosis, Alzheimer\u2019s disease, Parkinson\u2019s disease, ALS (Lou Gehrig\u2019s disease), diabetes, hypertension, arthritis, heart disease, and stroke.\u00a0In addition, under the settlement Medicare beneficiaries who\u00a0received a final denial of Medicare coverage after January 18, 2011 (the date the lawsuit was filed) are entitled to a review of their claim denial.<\/p>\n<p>The government launched an educational campaign in January to explain the settlement and the new rules to Medicare providers like home care agencies and nursing homes, but according to a <a href=\"http:\/\/www.reuters.com\/article\/2014\/04\/29\/us-column-miller-medicare-idUSBREA3S0GI20140429%20\" target=\"_blank\" rel=\"noopener\"><em>Reuters<\/em><\/a> article, many providers remain unaware of what is covered or how to bill Medicare for the services. The campaign was not aimed at beneficiaries, so not all Medicare beneficiaries are aware of the rules and that they can fight a denial of coverage.<\/p>\n<p><em>Reuters<\/em> focuses on one beneficiary, Robert Kleiber, 78, who receives weekly visits from a physical therapist to alleviate symptoms of his Parkinson\u2019s disease. Kleiber\u2019s wife recently learned that the treatments should be covered under Medicare\u2019s new rules but so far she has been unable to convince the home health care provider of this.<\/p>\n<p>If you experience problems with a Medicare provider, the Center for Medicare Advocacy has several <a href=\"http:\/\/www.medicareadvocacy.org\/take-action\/self-help-packets-for-medicare-appeals\/\" target=\"_blank\" rel=\"noopener\">self-help packets<\/a>\u00a0explaining how to appeal improvement standard denials.<\/p>\n<p>For more information about Medicare and your options please call the law office of Weatherby-Associates at\u00a0<a href=\"tel:860-769-6938\">860-769-6938<\/a>\u00a0or go to our website at<\/p>\n<h2><a href=\"http:\/\/weatherby-associates.com\">http:\/\/weatherby-associates.com<\/a><\/h2>\n<h1><span style=\"color: #ffffff;\">Medicare Planning &#8211; Bloomfield CT, Avon CT, Simsbury CT\u00a0<\/span><\/h1>\n<p>https:\/\/weatherby-associates.com\/medicare-planning-now-available-chronic-conditions<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you are a Medicare beneficiary receiving skilled care for a chronic condition, you no longer have to show improvement in order to have the care covered, but your provider [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2766","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Medicare Planning | Bloomfield CT, Avon CT, Simsbury CT<\/title>\n<meta name=\"description\" content=\"weatherby-associates can provide you with knowledge on medicare planning and what your options are. 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