Not Healing Fast Enough? Coverage Denied.

[pnwmom]

19. They tried to pull that on my mother a few years ago, saying no rehab after 20 days

because she wasn't improving. But that wasn't actually the law. The current law says that there are full benefits for 20 days and benefits with a co-pay for up to 100 days as long as the rehab is necessary to MAINTAIN or improve the patient's condition.

So I had a fax war with the nursing home in my mother's state, sending them copies of the actual law, till they broke down and acknowledged I was right.

It was to THEIR benefit to change their policy and FOLLOW THE DAMN LAW because Medicare pays a higher amount than Medicaid, so they should want patients to stay on Medicare as long as possible.

When my mother walked out of that nursing home, 80 days after entering, staff stood there and clapped for her.

(Unfortunately, the co-pay is quite a bit higher now than it was then. Everyone on Medicare should have a Medigap policy, which would take care of the copay.)