As commonly known, the older we get, the more health problems we encounter. Additionally, the greater the need for some kind of professional health care. Hospitals are too expensive and insurance companies push to get you out of there as quickly as possible. Nursing homes and even assisted living quarters are very expensive, causing many to stay home and seek alternative care in the shape of home health care.

For us older folks, many end up relying on Medicare to help cover the cost of home health care. But what happens when someone associated with your home health care determine you won’t get any better? Will Medicare continue to pay?

Look what happened to one couple, as reported:

The decision came out of the blue. “Your husband isn’t going to get any better, so we can’t continue services,” an occupational therapist told Deloise “Del” Holloway in early November. “Medicare isn’t going to pay for it.”

The therapist handed Del a notice explaining why the home health agency she represented was terminating care within 48 hours. “All teaching complete,” it concluded. “No further hands on skilled care. Wife states she knows how to perform exercises.”

That came as a shock. In May 2017, at age 57, Anthony Holloway was diagnosed with ALS (amyotrophic lateral sclerosis): The Frederick, Maryland, man can’t walk, get out of bed or breathe on his own (he’s on a ventilator). He can’t use the toilet, bathe or dress himself. Therapists had been helping Anthony maintain his strength, to the extent possible, for two years.

What do you do in situations like this? Craig and Effie Holly faced the same situation when they were told that the home health service had decided to cut off their services. He was told by the home health service that his wife was disabled but stable and that Medicare was changing how it paid home health service companies.

Euphrosyne “Effie” Costas-Holly, 67, has advanced multiple sclerosis. She can’t walk or stand and relies on an overhead lift system to move from room to room in their house.

Effie wasn’t receiving a lot of care: just two visits every week from aides who gave her a bath, and one visit every two weeks from a nurse who evaluated her and changed her suprapubic catheter, a device that drains urine from a tube inserted in the abdomen.

But even that little bit helped. Holly, 71, has a bad back and is responsible for his wife’s needs 24/7. Her urologist didn’t have a lift system in his office and had told the couple it was safer to have Effie’s catheter changed regularly at home.

Craig Holly didn’t take the news lying down, as he knew his wife needed the care, so he decided to fight for what was needed, as reported:

Things snapped into focus when Holly attended a late November presentation about Medicare’s home health services by Kathleen Holt, associate director of the Center for Medicare Advocacy.

If you’re told Medicare’s home health benefits have changed, don’t believe it: Coverage rules haven’t been altered and people are still entitled to the same types of services, Holt told the group. (For a complete description of Medicare’s home health benefit, click here.)

All that has changed is how Medicare pays agencies under a new system known as the Patient-Driven Groupings Model (PDGM). This system applies to home health services for older adults with original Medicare. Managed-care-style Medicare Advantage plans, which serve about one-third of Medicare beneficiaries, have their own rules.

Under PDGM, agencies are paid higher rates for patients who need complex nursing care and less for people with long-term chronic conditions who need physical, occupational or speech therapy.

Holly got lucky. When he reached out to Holt, she suggested points to bring up with the agency. Tell them your wife’s urologist wasn’t consulted about a possible discharge from home health, doesn’t agree with this move and is willing to recertify Effie for ongoing home health services, Holt advised.

Within hours, the agency reversed its decision and said Effie’s services would remain in place.

If you find yourself in the same situation as the Holly’s or Holloway’s, don’t just accept what you’re told. Check with your doctor and Medicare office. Fight for your rights. Some home health agencies may try to drop you simply because they won’t get paid as much for your care as they will for someone else and money is the bottom line to them. This is normal for the socialist nationalized medical program that has been sweeping America, including Obamacare. Many health professionals are guided more by these socialist rules and regulations than they are for actual medical and health needs of individuals.