Can People with MS and Other Long-Term Illnesses Receive Medicare Coverage?
There is a long-standing myth that people with long-term illnesses and those in need of long-term care are not covered by Medicare. This is not true. Unfortunately, beneficiaries are too often denied Medicare coverage for a variety of services on the grounds that they have a chronic or stable condition, that their condition will not improve, and/or that the services are to maintain, not to improve, their condition. Medicare coverage determinations should be based on what is medically necessary and on the specific qualifying criteria for the particular health care setting and services. The Medicare Act excludes certain services from coverage, and other coverable services may not meet the qualifying criteria in a given case. However, people should not be denied benefits for otherwise coverable services simply because they have a long-term illness such as MS. Further, beneficiaries are legally entitled to an individualized assessment of their qualification for coverage. These assessments
