Issue #1 · July 7, 2026
Big changes in how Medicare handles care approvals, and what families should know.
Welcome to the very first issue of The Best Hospice and Home Health Brief. We're glad you're here, and we promise to keep this useful.
The biggest story affecting families right now is a troubling pattern with Medicare Advantage plans. Two recent reports have confirmed what many families have been experiencing firsthand: Medicare Advantage insurers are denying prior authorization requests for post acute care at rates significantly higher than their overall denial rates. We're talking about denials for stays in skilled nursing facilities, inpatient rehabilitation hospitals, and long term care hospitals. These are the exact services that families depend on when a loved one is transitioning out of the hospital and still needs serious care. The kicker is that when families do appeal these denials, the decisions are frequently overturned. That tells you something important about the quality of those initial denials.
On a more encouraging note, CMS has been expanding its support for digital health tools in Medicare. More older adults are using technology to manage their health than ever before, and CMS is responding with new initiatives designed to make telehealth and remote monitoring more accessible. For families coordinating care across distances, or for older adults who want to stay in their homes longer, this is genuinely good news. We'll be tracking these efforts closely in future issues.
If your loved one is enrolled in a Medicare Advantage plan and is about to be discharged from the hospital, pay very close attention to any prior authorization requirements for the next level of care. Skilled nursing stays, rehab facility admissions, and home health services often require pre approval from the insurance company, and as we just mentioned, denial rates for these services are running high.
Here is what matters most: do not accept a denial as the final word. You have the right to appeal, and the data shows that appeals are frequently successful. Ask the hospital's case manager or social worker to help you file an appeal immediately. Time matters in these situations, because your loved one may need to stay in the hospital while the appeal is processed, and hospitals sometimes push for quick discharges. Know your rights, ask questions, and don't be afraid to push back. If you need help understanding what your plan covers, our team at Best Hospice and Home Health can point you in the right direction.
Let's talk about something that surprises many families: the Medicare hospice benefit is one of the most comprehensive benefits in all of Medicare, and most people don't fully understand what it covers. When a patient elects the Medicare hospice benefit, Medicare covers virtually all costs related to the terminal illness. That includes nursing care, medications for symptom management, medical equipment like hospital beds and oxygen, aide services, social work support, chaplain visits, and bereavement counseling for the family after a loved one passes. The out of pocket cost to families is remarkably low. Under Original Medicare, there is no deductible for hospice care. Patients may pay a copayment of no more than $5 for each prescription drug and up to 5% of the Medicare approved amount for inpatient respite care, which gives caregivers a short break.
The key detail families often miss is that electing hospice does not mean giving up all medical treatment. It means choosing comfort focused care for the terminal diagnosis. Your loved one can still receive full Medicare coverage for conditions unrelated to the terminal illness. Understanding this distinction can make the decision to explore hospice feel much less like giving up and much more like choosing a different kind of support.
We started Best Hospice and Home Health because finding the right care for someone you love should not feel like a second full time job. Our service is completely free for families. We connect you with verified hospice and home care providers in your area, and we're here to help you ask the right questions along the way. If this newsletter was helpful, we'd love it if you forwarded it to a friend, a neighbor, or a coworker who might be facing these decisions. Nobody should have to figure this out alone.