If you’re worried you won’t be able to keep home health under Medicare, don’t be. The coverage rules haven’t changed and patients are still entitled to their regular services. Now, there has been a significant change in how agencies who provide these services are being paid. If you feel this may have affected you in any way, there are ways to ensure you maintain home health care.
Research Your Options
If you find that you’re no longer eligible for services, speak with your therapist (or nurse) regarding the reason. If they believe their services are no longer required, that’s one thing. But if the specialist claims the services are no longer covered, that may be an issue. One physical therapist claims Medicare has not changed its benefits for home health. Everything should still be covered under your Medicare policy.
Discuss With Your Doctor
Be sure to contact the doctor who suggested the home health care for you. Doctors can advocate for their patients and fight to get them the necessary help. Further, he/she can’t be of assistance if they don’t know what’s going on.
Voice Your Concerns
Let the home health agency you have been working with know your concerns. If they don’t take care of it right away, you should have a “Patient Bill of Rights” listing all the different names and phone numbers associated with the agency. The agency’s clinical supervisor should be the first person you speak to regarding this concern. Also, contact the organization in your state that oversees home health agencies. Inform them that you still require home health services. Further, contacting 1-800-Medicare will send you to a representative who can help you file a claim to the general Medicare ombudsman.
File a “Fast Appeal”
You will receive a notice providing the date your services will end. This notice will also provide instructions on how to file a fast appeal. During this appeal, the home health agency is required to continue providing medical services until further notice.
Consider Another Agency
While this mainly applies to bigger cities, if you are dissatisfied with the answers you’re getting from your current agency, research others. Many agencies are just as, if not more, qualified than your current home health provider.
If you feel your home health care agency is not meeting your needs, contact the Center for Medicare Advocacy.
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