Can I sue Medicare, or the government, for poor nursing home care due to Medicare limits?

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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Written by Jeffrey Johnson
Insurance Lawyer Jeffrey Johnson

UPDATED: Jul 16, 2021

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You likely do not have a legal right to sue Medicare or the government due to limited nursing home care.

When a person experiencing extensive medical treatment and/or staying in a nursing home hits the limits of Medicare’s coverage, any additional care required that exceeds the Medicare limit is not covered by the insurance.

In some situations, this might force the insured to make a choice, and simply go without the required care. Ultimately, the patient suffers as a result of Medicare’s limits and to someone in this unfortunate situation, it might seem logical to sue Medicare. 

However, in a legal sense, the burden of responsibility for receiving proper care does not fall on Medicare. It falls on the caregivers, such as the doctors and hospitals, and it falls on the patient and/or his or her caregivers.

If a medical facility makes the decision to limit care due to limitations of medical insurance coverage, they can likely be held legally responsible, at least in some situations. If a patient or his or her caregivers made the decision to limit care because of Medicare coverage issues, even if they were forced by financial barriers to do so, they are considered legally responsible for that choice. The assumption is that it might be possible to seek care or funding elsewhere if the medical care is truly necessary, and the responsibility for doing this falls on the patient.


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