Mairead Painter, a vice president of the National Association of State Long-Term Care Ombudsman Programs who directs Connecticut’s office, said, “People are going to the nursing home, and then very quickly getting a denial, and then told to appeal, which adds to their stress when they’re already trying to recuperate.” “In Medicare Advantage, the plan decides.” “In traditional Medicare, the medical professionals at the facility decide when someone is safe to go home,” said Eric Krupa, an attorney at the Center for Medicare Advocacy, a nonprofit law group that advises beneficiaries. The plans must cover - at a minimum - the same benefits as traditional Medicare, including up to 100 days of skilled nursing home care every year.īut the private plans have leeway when deciding how much nursing home care a patient needs. Half of the nearly 65 million people with Medicare are enrolled in the private health plans called Medicare Advantage, an alternative to the traditional government program. Health care providers, nursing home representatives, and advocates for residents say Medicare Advantage plans are increasingly ending members’ coverage for nursing home and rehabilitation services before patients are healthy enough to go home.
The facility gave Christopherson a choice: pay several thousand dollars to stay, appeal the company’s decision, or go home. “This seems unethical,” said daughter Amy Loomis, who feared what would happen if the Medicare Advantage plan, run by UnitedHealthcare, ended coverage for her mother’s nursing home care.
It can be republished for free.īut instead of being relieved, Christopherson and her daughter were worried because her medical team said she wasn’t well enough to leave.
0 kommentar(er)
