Ready for a little first hand experience? My wife’s 79 year old mom fell and suffered a compound leg fracture. She had surgery and has been in a re-hab center for two weeks. She is wheel chair bound. When she is released, she will need a wheel chair for quite a while before she is ready for a walker. Her P.T. and her doctor know this. Her doctor wrote her a prescription for a wheel chair. Medicare insists that she does not need a chair and has declined to cover it.
The problem with Medicare is it sucks. To make it useable, most people have to purchase supplemental insurance. Liz want’s to eliminate private insurance. So the option of supplemental insurance will be gone.
Are you really sure that you want to give up your current plan for Medicare?
Medicare declines a lot of things. Unfortunately when i hit 65 last tear the company i retired from cut off my insurance so i pretty much had to get on Medicare.
I have Blue Cross Blue Shield supplemental which helps a lot.
I am guessing that the doctor maybe needs to write more justification for the need for durable medical equipment. I deal with this all the time in my job. The doctor can’t just write a script anymore there needs to be further justification. Medicare thinks if she is released from therapy she’s ok to go home safely. You can petition medicare to keep her at rehab to. We did this three times with my dad.
The doctor knows what to do. He’s done this before. The justification was that the 79 year old patient has suffered a compound fracture and cannot walk. Not good enough for Medicare.
No, it generally isn’t. You’d be surprised what they request. And you’d be surprised what Doctors don’t know. The Rehab should have a social worker that can help with this as well.
There is an appeal process with Medicare. Also, Medicare isn’t the only payor that makes people jump through hoops. I’ve seen that in private insurance too.
That being said, my mother is on a Medicare Advantage policy, and thus gets the best of both worlds
The worst experience I had as far as “jumping through hoops” with private insurance was cleared up by a simple phone call, &, after trying Blue Cross Blue Shield for a year (couldn’t stand ‘em), I went back to the other insurance & haven’t had problem one with ‘em.
The year we had problems with the better insurer it was as if something was in the water in West Texas, where they’re based. They wanted, in the dental plan, justification for a partial in my husband’s mouth, as if he had nothing better to do with his time than have inserted an extra tooth.
With me they sent a whiny notice when I needed my achilles tendon repaired. “Are you sure Workmen’s Comp, or a separate third party, isn’t responsible for these charges?”
I followed with a simple call to indicate that no, I had fallen on the stairs leading to my home. Issue of whose responsible resolved.
My issues with them, though, are minor compared to asking a doctor to justify a wheelchair for a 79 year old woman whose sustained an open leg fracture. Seriously. How stupid can anyone be and not need watered twice a day?
Why is it Medicare’s the entitlement libs look at for all when it sucks even for the populations it serves, the elderly and disabled, and, as indicated, you really need a supplemental insurance to pay what Medicare may not?
A new wheelchair costs $150 bucks. How much did Medicare cover for the rest of the hospital visit?
I don’t mean to sound callous about this because I know that it’s difficult watching your parents struggle, but Medicare is in charge of a large health provider network that is run by the government. Private insurances can be more picky with their coverage, too. I would also have supplemental insurance anyways.
Liz ain’t eliminating private insurance. Republicans would have an easier time privatizing medicare than democrats would outlawing private insurance.
Medicare for all is a way to get everyone insurance. Private insurance is another. In both of them, the insurance company is making medical decisions (e.g. who needs a wheel chair).
The problem isn’t medicare vs. private, the problem is why are accountants making medical decisions?
It’s not as difficult as navigating private insurers in the US.
Medicare is rugged and it works despite the best efforts of Congress to crapify it via privatization.
In Italy, we have a better health care system than the US, having experienced both systems. My great-aunt, who is 82, had a hip replacement after a nasty fall down a concrete flight of stairs. She got a hip replacement and she had a caretaker (home health aid) live with her for 4 weeks and and a home health aide visits her 4 days per week for two hours at a time.
The way other countries do it is by setting prices to bend the cost curve. Medicare for All would enable the federal government to bend the cost curve via monopsony. That’s the only way to lower prices, but I don’t expect the whores in Congress to pursue such a strategy since that would mean actually providing material benefits to Americans. Perish the thought.
