Can Medicare stop paying if you don’t improve?

If you hit the point where the care is no longer reasonable and necessary, and it’s just providing custodial care to you at that point, then Medicare will no longer pay, and you’ll receive a notice that Medicare is no longer going to pay. You may still, at that point, require long-term care, and at that point, you have to address how are you going to make your payments. Some of the barriers to Medicare coverage, I mentioned the observation status issue with being admitted to a hospital. Another barrier is the improvement standard. So there was a big case called Jimmo, where what they found is that people who were on Medicare coverage were being denied coverage because they were no longer improving.

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