The beginning of open enrollment and intense speculation about the election's impact on Medicare are not the only Medicare-related headlines these days. A new development may greatly help Medicare beneficiaries with chronic conditions who need skilled nursing and rehabilitation.
In the past, Medicare would continue to cover skilled nursing care and short-term rehabilitation, like physical and speech therapy, only if the patient demonstrated that he had the potential to improve as a result of treatment. Obviously, those with chronic conditions like Alzheimer's Disease, heart disease, Parkinsons, Lou Gehrigs disease, arthritis - in other words, those who could not meet the so-called improvement standard -- were most impacted by this rule. (In fact, the so-called "improvement standard" was technically never a part of Medicare law; it had simply become the de facto standard used by Medicare decision makers.)
Now, a federal court has ruled that the improvement standard cannot be used to deny Medicare coverage for skilled nursing care and rehabilitation. The settlement in the class action lawsuit Jimmo v. Sibelius requires Medicare to cover skilled nursing and therapy even if it just maintains a person's medical condition or prevents further deterioration. The proposed settlement was reached in federal district court on Oct. 16, 2012.
However, it's critical to note these important caveats:
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I hope their is huge change in medicare plans for past two years. They increased insurance premium at the same time benefits also increased.