Don't withhold home health entitlements from qualified beneficiaries

Beth Noyce

Don't withhold home health entitlements from qualified beneficiaries
The Center for Medicare Advocacy (CMA) continues working to increase access to home health and hospice services for qualified beneficiaries who, unfortunately, are denied access to their Medicare entitlements based on erroneous coverage information. Some home health providers, either due to agency policy to control costs, or due to misunderstanding of Medicare coverage policies, withhold entitlements that are medically reasonable and necessary for qualified beneficiaries, to recover from an illness or injury, or to prevent or slow decline.
Don't be one of those agencies.
Problems Accessing Necessary Home Health Care
Regrettably, we have been hearing about people who clearly meet Medicare criteria who cannot access the home health care ordered by their physicians. In particular, people living with long-term and debilitating conditions find themselves without necessary home care. For example, they have been told Medicare will only cover 1 to 5 hours per week of home health aide care, or only one bath per week, or that they aren’t homebound (because they roam outside due to dementia), or that they must first decline before therapy can commence (or recommence). These individuals and their families are struggling as a result of these inappropriate limitations with too little care or no care at all. 

The Center for Medicare Advocacy hopes to do something to correct this harmful situation, and we need your help.  Tell us your story!  [Email your experience to]. If  you or someone you know has been refused, or discharged from, Medicare-covered home health care even though the patient has a physician order for the care, cannot (or should not) leave home without assistance (homebound), and needs skilled care (nursing or therapy)—let us know!


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