Читать книгу Medicare For Dummies - Barry Patricia, Patricia Barry - Страница 44

If you’ve had a hip replacement but fall again and need another, Medicare isn’t going to turn around and deny you coverage for the second one. If you’re fighting your third bout of pneumonia, Medicare isn’t going to shut you out of the hospital because of the first two episodes. If you’re in your 90s and have heart failure or cancer, Medicare isn’t going to refuse you treatment because you’re too old. For all the loose and cruelly inaccurate talk about “death panels” and “rationing” that still circulates in mass emails meant to exploit older people’s fears of being denied coverage, Medicare simply doesn’t — and can’t, by law — ration care like that. “Medical necessity” is what usually counts.

At the same time, Medicare has always placed limits on certain areas of coverage — and although Washington policymakers may regard these caps as reasonable attempts to rein in runaway costs and guard against fraud, the limits can adversely affect some patients. So on the basis that forewarned is forearmed, the following sections provide an overview of the four main areas where coverage comes with limits: stays in the hospital, stays in a skilled nursing facility, mental health benefits, and therapy services.