Seniors who have chronic illnesses and disabilities can now get Medicare coverage for skilled nursing and therapy services…..even if those services will simply maintain the person’s present health status and are not likely to improve their condition. This is very important news for people who have diabetes, heart disease, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, Lou Gehrig’s disease, arthritis or the effects of a stroke, among other conditions.
For decades, Medicare had a “rule of thumb” that coverage of these services was available only if they were likely to lead to an improvement in the patient’s condition. Treatments that were not likely to lead to improvement were considered “custodial care” which Medicare does not cover.
Earlier this year, the government agreed to settle a class action lawsuit over this issue. That settlement has now been approved by a federal court- and what’s more, the settlement has been made retroactive to January 18, 2011, so if you were denied coverage for services after that date, you might be able to go back and re-apply for coverage.
Seniors who are enrolled in Part A, which covers hospitalizations, will be eligible for up to 100 days in a skilled nursing facility (as long as it follows a three-day hospitalization), as well as up to 100 home visits following a hospitalization. Seniors who are enrolled in Part B, which covers doctor visits and other outpatient services, are eligible for potentially unlimited home visits.
Ms. MacDonald’s practice is limited to Estate Planning, Probate, Elder Law and Trust Administration. Ms. MacDonald maintains her practice in the Santa Clarita Valley at 25115 Avenue Stanford, Suite B-124 in Valencia, California. She can be reached at 661-294-6464.