Major Change to Medicare Rehab

If you or a loved one qualify for Medicare and have been in the hospital and then discharged to a nursing facility for rehab, you are familiar with Medicare’s rehab policy.  Medicare will pay for up to 100 days of rehab services in a nursing facility; however, the patient must make improvements during that time to remain eligible for coverage.

In one of the biggest changes to Medicare in recent years, the federal government has agreed to remove the requirement that the patient show progress or improvement during rehab to remain eligible.  The change is a result of a recent settlement, which must still be formally approved by the court, in Jimmo v. Sebelius.

Once the settlement is approved, Medicare must revise its policies to make it clear that a Medicare beneficiary’s coverage for rehab services “does not turn on the presence or absence of an individual’s potential for improvement” but rather depends on whether or not the beneficiary needs skilled care, even if it would simply maintain the beneficiary’s current condition or slow further deterioration.

Of course, Medicare will continue to only pay for up to 100 days of services.  If you or a loved one have questions or concerns regarding how to pay for nursing home, assisted living or independent living costs in the future, contact our office and schedule an appointment to meet with one of our attorneys.  We can educate you regarding the programs available to pay for care, review your estate and finances, assist you with planning for and applying for government programs, such as Medicaid, and counsel you regarding the legal and practical issues you may face during this time of transition.  Call us today.


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