[QUAD-L] Medicare?

[greg]

Does anyone have Social Security help covering attendants?
I know Medicaid will, but was told when at a VocRehab meeting that I should make an appointment with SS to get help.
She was wrong on a few other things, so thought I'd ask.
 
Thanks, Greg

Re: [QUAD-L] Medicare

[Lori Michaelson]

The sad part is that once ANY president gets in office he is fully covered
for the rest of his life but I wouldn't want his job either!

It is my opinion that Hillary is the biggest crook of all crooks and her
husband's administration took away, in 1999, all of the home help that I
was getting through Medicare prior to that. After Billy changed the payment
system to home health agencies for those on Medicare... I lost over 99% of
my home healthcare.

Does anyone remember when Bill Clinton was in office and it was around 1993
when Hillary had this big "National Healthcare Plan" that was all her idea
and was going to help everybody but it fell flat on its face?

The Clinton Health Care Plan, known back then *officially *as the Health
Security Act and *unofficially *nicknamed "Hillarycare" (of course after
Hillary who wore the pants in that administration) by its detractors was in
1993 healthcare reform package proposed by the administration of Pres. Bill
Clinton and of course closely associated with the chair of the task for his
devising the wonderful plan --  First Lady of the United States Clinton.
Its goal was to come up with a comprehensive plan to provide *universal
health care for all Americans, *which was to be a cornerstone of the
administration's first-term agenda. "The 1994 midterm election became
common in the opinion of one media observer, a "referendum on big
government -- Hillary Clinton had launched a massive health care reform
plan that strangled itself by its own red tape."

Gee does The Health Security Act (Hillarycare) not sound familiar to The
Affordable Care Act and known as Obamacare? Why do these Democrats feel so
empowered, egotistic and arrogant to name these plans after themselves? We
have been overly governed and where has it gotten us? Only at their mercy.

I remember being really excited about The Health Security Act even though I
was well covered with health insurance at that time by working for a state
agency and I had full coverage for everything by being employed by the
state/government. I now wish I could have continued working but
syringomyelia got the best of me and I retired early. A colleague of mine
is also a quadriplegic and he is still working there so he will get, like
he told me semi-recently, long-term healthcare. But I am sure that will be
over governed as well by only a select few healthcare providers from
pharmaceutical companies to doctors and hospitals to home health care
agencies.

Anyway, of course the Democrats and the Clinton administration at that time
(1993) wanted to blame the Republicans and Libertarians and anyone else
they could blame to reflect the blame (as they always do). But those who
are really guilty need only to look in a mirror.

But when the rubber hits the road... where DID that mighty national health
care plan go? Down the drain... that's where it went! On September 26,
1994, the final compromise Democratic bill was declared dead by a Senate
Majority leader. But people have short memories and most have forgotten
about that big Clinton health care plan and governments count on that so
they get away with murder... literally many times.

Bill Clinton did a great job of not owning up to what he was guilty for
(federal perjury) and anyone else who would be guilty of this perjury would
be imprisoned but, oh god no, ... not a Clinton!

Now, Donald Trump is not even in the office yet and already he is being
crucified and, mark my words, no matter what he does or how he does it ...
those who did not and do not want him into office will continue to crucify
him and blame him for everything.

I am not a Republican or a Democrat ... just the common sense and a good
memory to see what has happened and how history repeats itself over and
over again.

Our country is falling apart and has been for a long time in the exact same
way that the greatest empire in our history did... through economics,
politics, arguing and crucifying others and losing a country by having
barbarians take over.

~Lori


On Thu, Jan 5, 2017 at 7:55 PM, RONALD L PRACHT 
wrote:

> The people against national health insurance are the people that have
> great insurance through their employer. They say screw everyone else. We
> need an across the board national healthcare for everyone, then if you want
> better or extra coverage buy it.
>
> Ron
>
>
> On Thursday, January 5, 2017 8:27 PM, Danny Hearn 
> wrote:
>
>
> I'm with you GregI wish they could have a National Insurance where all
> states had coverage and was not so confusing to all, The big Insurance Co.
> are ran for profit, but I think they could still do well enough even with a
> National coverage. Dan H**
>
>
> On Thursday, January 5, 2017 6:24 PM, greg  wrote:
>
>
> There is no perfect insurance option, but I think the best option would
> simply to have a National Medicare. Then if you want extra, you can buy it.
>
> I never understood those against government insurance that say their
> reasons are they don't want govern

Re: [QUAD-L] Medicare

[RONALD L PRACHT]

The people against national health insurance are the people that have great 
insurance through their employer. They say screw everyone else. We need an 
across the board national healthcare for everyone, then if you want better or 
extra coverage buy it.
Ron  

On Thursday, January 5, 2017 8:27 PM, Danny Hearn  
wrote:
 

 I'm with you GregI wish they could have a National Insurance where all 
states had coverage and was not so confusing to all, The big Insurance Co. are 
ran for profit, but I think they could still do well enough even with a 
National coverage. Dan H** 

On Thursday, January 5, 2017 6:24 PM, greg  wrote:
 

 #yiv1540485406 #yiv1540485406 -- body{font-size:14pt;}#yiv1540485406 
LI{display:list-item;margin:0.00in;}#yiv1540485406 
p{display:block;margin:0.00in;}#yiv1540485406 body{}#yiv1540485406 There is no 
perfect insurance option, but I think the best option would simply to have a 
National Medicare. Then if you want extra, you can buy it. I never understood 
those against government insurance that say their reasons are they don't want 
government making medical decisions. Yet they think having insurance companies 
that make profits by denying you make the decisions is better??? Insurance co. 
gives bounces for denying you, even if its covered, knowing a lot of people do 
not appeal. I hate the Obamacare system. Way to confusing, but I'm 100% for 
National Insurance. Greg

   

   

Re: [QUAD-L] Medicare

[Danny Hearn]

I'm with you GregI wish they could have a National Insurance where all 
states had coverage and was not so confusing to all, The big Insurance Co. are 
ran for profit, but I think they could still do well enough even with a 
National coverage. Dan H** 

On Thursday, January 5, 2017 6:24 PM, greg  wrote:
 

 There is no perfect 
insurance option, but I think the best option would simply to have a National 
Medicare. Then if you want extra, you can buy it. I never understood those 
against government insurance that say their reasons are they don't want 
government making medical decisions. Yet they think having insurance companies 
that make profits by denying you make the decisions is better??? Insurance co. 
gives bounces for denying you, even if its covered, knowing a lot of people do 
not appeal. I hate the Obamacare system. Way to confusing, but I'm 100% for 
National Insurance. Greg

   

[QUAD-L] Medicare

[greg]

There is no perfect insurance option, but I think the best option would simply to have a National Medicare. Then if you want extra, you can buy it.
 
I never understood those against government insurance that say their reasons are they don't want government making medical decisions. Yet they think having insurance companies that make profits by denying you make the decisions is better??? Insurance co. gives bounces for denying you, even if its covered, knowing a lot of people do not appeal.
 
I hate the Obamacare system. Way to confusing, but I'm 100% for National Insurance.
 
Greg

[QUAD-L] Medicare

[greg]

Those that have had a Medicare Replacement insurance for awhile, might want to 
check the new ones.
By chance at the store yesterday, they had a lady answering questions. I've had 
mine for almost 10 years. She showed me the same one I'm on, just a newer 
Network. All doc co-pays were half, year out of pocket went from $6000 to 
$3000. Outpatient things went from 20% to $150. Though chairs and equipment 
stayed at 20%.
Only issue is it's newer so not as many docs in it yet. My primary was not, 
though he is old and I need a new one soon.

Greg

[QUAD-L] Medicare cuts on seating and other

[shirley bell]

Hi all, just signed this petition on cuts to wheelchair custom needs. Starting 
in Jan of 2016. Just when I am going for a new chair, worried I am, sigh. here 
it is. 
https://petitions.whitehouse.gov//petition/stop-medicare-making-inappropriate-cuts-complex-wheelchair-accessories

www.ShirleyBellDesigns.com

Re: [QUAD-L] medicare

[Jim Lubin]

I have private duty nurses paid for by Medicaid not Medicare. You are not
required to be homebound. I don't know how it is assessed in other states,
in Washington it is based on how you score on Personal Care Assessment Key
shown here
https://www.dshs.wa.gov/altsa/home-and-community-services/information-clients

this page show the types of in-home services available
https://www.dshs.wa.gov/altsa/home-and-community-services/home-care-adults

On Fri, May 8, 2015 at 12:30 PM,  wrote:

> Hi, Does anyone use Medicare's home health careyou are supposed to be
> homebound..how do they check?
> Carolyn
>

[QUAD-L] medicare

[carolyndeandrea]

Hi, Does anyone use Medicare's home health careyou are supposed to be 
homebound..how do they check?
Carolyn 

RE: [QUAD-L] medicare / personal care

[nichole rohling]

I do get skilled nursing (cath change) from home health and bowel care would be 
covered still under Medicaid (they allow 15 extra minutes for bowel program 
days…….lol) I don’t know why they are cutting other than they feel hours are 
excessive (however they’ve been the same for years)……..they can cut my hours 
allowed for cleaning, laundry, etc………but not the personal care hours that are 
my bath, dressing, grooming………..geez 

 

From: jume9...@comcast.net [mailto:jume9...@comcast.net] 
Sent: Tuesday, February 25, 2014 4:18 PM
To: nichole rohling; quad-list
Subject: Re: [QUAD-L] medicare / personal care

 

i had heard Medicare pays only if you are "homebound" and that they consider 
bowel care maintenence, so not covered. Why did medicaid cancel? Move to 
Caifornia...they give IHSS, plenty of hours. Hard to find decent aides though.

 

Meredith

 

  _  

From: "nichole rohling" 
To: quad-list@eskimo.com
Sent: Tuesday, February 25, 2014 9:11:56 AM
Subject: [QUAD-L] medicare / personal care

 

Department of Human Services in my home state of OK wants to cancel my Medicaid 
personal care hours I have received for years and wants me to have home health 
provide those hours through medicare. My home health says medicare will only 
cover 45 minutes twice a week.  Anyone know what medicare covers? What a 
flippin’ nightmare!

 

Nicki

 

RE: [QUAD-L] medicare / personal care

[nichole rohling]

Yes……Oklahoma

 

Nicki

 

From: wheelch...@aol.com [mailto:wheelch...@aol.com] 
Sent: Tuesday, February 25, 2014 4:52 PM
To: zoocr...@windstream.net; quad-list@eskimo.com
Subject: Re: [QUAD-L] medicare / personal care

 

 

Nicki, I would contact your local Center for Independent Living (CIL) with a 
copy of your new information.  You want more people involved on your side.  
Are you still living in OK?

 

Best Wishes

In a message dated 2/25/2014 11:12:36 A.M. Central Standard Time, 
zoocr...@windstream.net writes:

Department of Human Services in my home state of OK wants to cancel my Medicaid 
personal care hours I have received for years and wants me to have home health 
provide those hours through medicare. My home health says medicare will only 
cover 45 minutes twice a week.  Anyone know what medicare covers? What a 
flippin’ nightmare!

 

Nicki

Re: [QUAD-L] medicare / personal care

[wheelchair]

Nicki, I would contact your local Center for Independent Living (CIL) with  
a copy of your new information.  You want more people involved on your  
side.  Are you still living in OK?

 
Best Wishes
 
In a message dated 2/25/2014 11:12:36 A.M. Central Standard Time,  
zoocr...@windstream.net writes:

 
Department of Human Services in my home state of OK wants  to cancel my 
Medicaid personal care hours I have received for years and wants  me to have 
home health provide those hours through medicare. My home health  says 
medicare will only cover 45 minutes twice a week.  Anyone know what  medicare 
covers? What a flippin’ nightmare! 
Nicki

Re: [QUAD-L] medicare / personal care

[jume9999]

i had heard Medicare pays only if you are "homebound" and that they consider 
bowel care maintenence, so not covered. Why did medicaid cancel? Move to 
Caifornia...they give IHSS, plenty of hours. Hard to find decent aides though. 

Meredith 

- Original Message -

From: "nichole rohling"  
To: quad-list@eskimo.com 
Sent: Tuesday, February 25, 2014 9:11:56 AM 
Subject: [QUAD-L] medicare / personal care 



Department of Human Services in my home state of OK wants to cancel my Medicaid 
personal care hours I have received for years and wants me to have home health 
provide those hours through medicare. My home health says medicare will only 
cover 45 minutes twice a week. Anyone know what medicare covers? What a 
flippin’ nightmare! 



Nicki 

[QUAD-L] medicare / personal care

[nichole rohling]

Department of Human Services in my home state of OK wants to cancel my
Medicaid personal care hours I have received for years and wants me to have
home health provide those hours through medicare. My home health says
medicare will only cover 45 minutes twice a week.  Anyone know what medicare
covers? What a flippin' nightmare!

 

Nicki

Re: [QUAD-L] Medicare/Wheelchairs

[Eric W Rudd]

hmm...would like me some food elevators...lmao!

Eric W Rudd
c5sc...@gmail.com
  - Original Message - 
  From: Quadius 
  To: quad-list 
  Sent: Saturday, August 27, 2011 4:37 PM
  Subject: Re: [QUAD-L] Medicare/Wheelchairs


  I don't know about all this stuff, but I would think Medicare would have to 
cover something that is a medical necessity, i.e. food elevators because of 
severe edema in lower extremities.


  On Wed, Aug 24, 2011 at 5:00 PM, Derrick  wrote:

Medicare will not pay for my new Invacare Arrow Storm with seat elevator.
I have to get a Invacare Torque or something cheaper.

I have goten Arrow Storms before but not now.
Derrick W

  - Original Message - 
  From: Dan 
  To: quad-list@eskimo.com 
  Sent: Tuesday, August 23, 2011 7:15 PM
  Subject: [QUAD-L] Medicare/Wheelchairs


  After 11 years, I'm trying to get a new chair. My DME tells me it costs 
$22,000. This is my second chair of the same make and model. They both lasted 
11 years. I know the company is changing electronics which is why I'm getting a 
new chair or at least trying to.

  I have three insurances. Medicare, Blue Cross Blue Shield, and Medicaid. 
Medicare is my primary. They consider this chair a group 4 chair. The most they 
will pay for a group 4 chair is $14,000. That leaves me than $8,000 co-pay. 
This is crazy! The only option this chair has is a reclining back. Neither Blue 
Cross or Medicaid will pay any part of the $8,000.

  Have any of you had this problem? It's apparent that Medicare is paying 
less and less as time goes on. Have any of you dropped Medicare and just kept 
your private insurance and Medicaid?

  Dan -- who is very frustrated!


  The greatest transgression of war is making heroes of our children. 

Re: [QUAD-L] Medicare/Wheelchairs

[Quadius]

I don't know about all this stuff, but I would think Medicare would have to
cover something that is a medical necessity, i.e. food elevators because of
severe edema in lower extremities.

On Wed, Aug 24, 2011 at 5:00 PM, Derrick  wrote:

> **
> Medicare will not pay for my new Invacare Arrow Storm with seat elevator.
> I have to get a Invacare Torque or something cheaper.
>
> I have goten Arrow Storms before but not now.
> Derrick W
>
>
>  - Original Message -
> *From:* Dan 
> *To:* quad-list@eskimo.com
> *Sent:* Tuesday, August 23, 2011 7:15 PM
> *Subject:* [QUAD-L] Medicare/Wheelchairs
>
>  After 11 years, I'm trying to get a new chair. My DME tells me it costs
> $22,000. This is my second chair of the same make and model. They both
> lasted 11 years. I know the company is changing electronics which is why I'm
> getting a new chair or at least trying to.
>
> I have three insurances. Medicare, Blue Cross Blue Shield, and Medicaid.
> Medicare is my primary. They consider this chair a group 4 chair. The most
> they will pay for a group 4 chair is $14,000. That leaves me than $8,000
> co-pay. This is crazy! The only option this chair has is a reclining back.
> Neither Blue Cross or Medicaid will pay any part of the $8,000.
>
> Have any of you had this problem? It's apparent that Medicare is paying
> less and less as time goes on. Have any of you dropped Medicare and just
> kept your private insurance and Medicaid?
>
> Dan -- who is very frustrated!
>
> **
>
> **The greatest transgression of war is making heroes of our children.
>
>

Re: [QUAD-L] Medicare/Wheelchairs

[Derrick]

Medicare will not pay for my new Invacare Arrow Storm with seat elevator.
I have to get a Invacare Torque or something cheaper.

I have goten Arrow Storms before but not now.
Derrick W

  - Original Message - 
  From: Dan 
  To: quad-list@eskimo.com 
  Sent: Tuesday, August 23, 2011 7:15 PM
  Subject: [QUAD-L] Medicare/Wheelchairs


  After 11 years, I'm trying to get a new chair. My DME tells me it costs 
$22,000. This is my second chair of the same make and model. They both lasted 
11 years. I know the company is changing electronics which is why I'm getting a 
new chair or at least trying to.

  I have three insurances. Medicare, Blue Cross Blue Shield, and Medicaid. 
Medicare is my primary. They consider this chair a group 4 chair. The most they 
will pay for a group 4 chair is $14,000. That leaves me than $8,000 co-pay. 
This is crazy! The only option this chair has is a reclining back. Neither Blue 
Cross or Medicaid will pay any part of the $8,000.

  Have any of you had this problem? It's apparent that Medicare is paying less 
and less as time goes on. Have any of you dropped Medicare and just kept your 
private insurance and Medicaid?

  Dan -- who is very frustrated!


  The greatest transgression of war is making heroes of our children. 

Re: [QUAD-L] Medicare/Wheelchairs

[DAANOO]

 
I was told that Medicare would not pay for electronics, such as tilt,  
elevate chair for elevating the feet. I was told that should pay for me  
electronic, I just got on Medicare as my parent retired. I'm trying to find  
out.. 
You have to go through your Blue Cross Blue Shield case manager. I wish  you 
good luck. I am trying to get a new chair also.
 
Dana
 
In a message dated 8/23/2011 6:39:08 P.M. Central Daylight Time,  
c5sc...@gmail.com writes:

  
In '04 medicare pd $30,000 for a permobil w/  tilt/recline/elevation.  I 
don't have medicaid nor additional  insurance.  I got a quantum about a yr ago 
but think my trust pd 4  it...i'll check.
 
Eric W Rudd
_c5sci97@gmail.com_ (mailto:c5sc...@gmail.com) 

- Original Message - 
From:  _Dan_ (mailto:d...@unh.edu)  
To: _quad-list@eskimo.com_ (mailto:quad-list@eskimo.com)  
Sent: Tuesday, August 23, 2011 6:15  PM
Subject: [QUAD-L]  Medicare/Wheelchairs


After 11 years, I'm trying to  get a new chair. My DME tells me it costs 
$22,000. This is my second chair  of the same make and model. They both lasted 
11 years. I know the company is  changing electronics which is why I'm 
getting a new chair major you were 29  or at least trying to.

I have three insurances. Medicare, Blue Cross  Blue Shield, and Medicaid. 
Medicare is my primary. They consider this chair  a group 4 chair. The most 
they will pay for a group 4 chair is $14,000. That  leaves me than $8,000 
co-pay. This is crazy! The only option this chair has  is a reclining back. 
Neither Blue Cross or Medicaid will pay any part of the  $8,000.

Have any of you had this problem? It's apparent that Medicare  is paying 
less and less as time goes on. Have any of you dropped Medicare  and just kept 
your private insurance and Medicaid?

Dan -- who is very  frustrated!

The greatest  transgression of war is making heroes of our children.  

Re: [QUAD-L] Medicare/Wheelchairs

[Eric W Rudd]

In '04 medicare pd $30,000 for a permobil w/ tilt/recline/elevation.  I don't 
have medicaid nor additional insurance.  I got a quantum about a yr ago but 
think my trust pd 4 it...i'll check.

Eric W Rudd
c5sc...@gmail.com
  - Original Message - 
  From: Dan 
  To: quad-list@eskimo.com 
  Sent: Tuesday, August 23, 2011 6:15 PM
  Subject: [QUAD-L] Medicare/Wheelchairs


  After 11 years, I'm trying to get a new chair. My DME tells me it costs 
$22,000. This is my second chair of the same make and model. They both lasted 
11 years. I know the company is changing electronics which is why I'm getting a 
new chair or at least trying to.

  I have three insurances. Medicare, Blue Cross Blue Shield, and Medicaid. 
Medicare is my primary. They consider this chair a group 4 chair. The most they 
will pay for a group 4 chair is $14,000. That leaves me than $8,000 co-pay. 
This is crazy! The only option this chair has is a reclining back. Neither Blue 
Cross or Medicaid will pay any part of the $8,000.

  Have any of you had this problem? It's apparent that Medicare is paying less 
and less as time goes on. Have any of you dropped Medicare and just kept your 
private insurance and Medicaid?

  Dan -- who is very frustrated!


  The greatest transgression of war is making heroes of our children. 

Re: [QUAD-L] Medicare/Wheelchairs

[Danny Hearn]

My last chair cost almost $ 18,000 about a year ago, I had to pay $2,600 out of 
my own pocket--thank goodness I got it paid off finally---I had medicare 
advantage plan  and my DME made me come up with 640 dollars down and they let 
me 
pay payments on the remainder.  Dan H.**





From: Dan 
To: quad-list@eskimo.com
Sent: Tue, August 23, 2011 6:15:29 PM
Subject: [QUAD-L] Medicare/Wheelchairs

After 11 years, I'm trying to get a new chair. My DME tells me it costs 
$22,000. 
This is my second chair of the same make and model. They both lasted 11 years. 
I 
know the company is changing electronics which is why I'm getting a new chair 
or 
at least trying to.

I have three insurances. Medicare, Blue Cross Blue Shield, and Medicaid. 
Medicare is my primary. They consider this chair a group 4 chair. The most they 
will pay for a group 4 chair is $14,000. That leaves me than $8,000 co-pay. 
This 
is crazy! The only option this chair has is a reclining back. Neither Blue 
Cross 
or Medicaid will pay any part of the $8,000.

Have any of you had this problem? It's apparent that Medicare is paying less 
and 
less as time goes on. Have any of you dropped Medicare and just kept your 
private insurance and Medicaid?

Dan -- who is very frustrated!


The greatest transgression of war is making heroes of our children. 

[QUAD-L] Medicare/Wheelchairs

[Dan]

After 11 years, I'm trying to get a new chair. My DME tells me it 
costs $22,000. This is my second chair of the same make and model. 
They both lasted 11 years. I know the company is changing electronics 
which is why I'm getting a new chair or at least trying to.


I have three insurances. Medicare, Blue Cross Blue Shield, and 
Medicaid. Medicare is my primary. They consider this chair a group 4 
chair. The most they will pay for a group 4 chair is $14,000. That 
leaves me than $8,000 co-pay. This is crazy! The only option this 
chair has is a reclining back. Neither Blue Cross or Medicaid will 
pay any part of the $8,000.


Have any of you had this problem? It's apparent that Medicare is 
paying less and less as time goes on. Have any of you dropped 
Medicare and just kept your private insurance and Medicaid?


Dan -- who is very frustrated!


The greatest transgression of war is making heroes of our children.  

[QUAD-L] Medicare cover splints or binder?

[greg]

Does Medicare cover abdominal binders and or universal cuffs?
My old insurance did and my chair dealer/repair shop sold both. They also sold med supplies so I could just call up and order some.
I still get my supplies from my new chair dealer/repair shop, but they do not carry these things.
So my doc thinks I need to go to a place that custom makes prosthetics. That would end up costing me 20% and probably be more than just buying them on Amazon.
If Medicare pays for them, I might be able to get my insurance to cover them from another med supply provider. 
 
Greg

[QUAD-L] Medicare / Co Pay

[greg]

I finely had someone from my insurance company explain how all this stuff works (if he has it right).
 
Under age 65... You can have Medicare, a Medicare Replacement, or Medicaid.
Over 65... You can have Medicare + a secondary or supplemental.
 
But if you are under 65 on Medicare/Replacement, there is no insurance you can get to cover the 20% co-pay on wheelchairs. Unless you are on a Medicaid plan. That sucks!
 
Greg

[QUAD-L] Medicare / Secondary

[greg]

Does anyone who is on Medicare or a Medicare Replacement insurance have a secondary insurance?
I can't find one who will take me because of my injury. I think it isn't until 2014 before the law begins when they can't refuse you.
 
Greg

Re: [QUAD-L] Medicare and supplies

[Eric W Rudd]

i get catheter, leg bag, night bag & cath insertion kit pd for or at least 
mostly pd 4

Eric W Rudd
c5sc...@gmail.com



  - Original Message - 
  From: Billy Lang 
  To: quad-list@eskimo.com 
  Sent: Monday, February 15, 2010 7:17 PM
  Subject: [QUAD-L] Medicare and supplies


  Can anyone tell me if Medicare covers supplies, and of what type?

  Leg bags,  cath kits?
   
  Don't let what you cannot do interfere with what you can do!


  Billy

  www.langfoundation.org

Re: [QUAD-L] Medicare and supplies

[wheelchair]

Check with your state's administrator for the details. I believe that a  
given number of legbags and cath kits per month.  This is all based on your  
MD Orders.
Best Wishes
 
 
In a message dated 2/15/2010 7:23:49 P.M. Central Standard Time,  
blan...@verizon.net writes:

 

Can anyone tell me if Medicare covers supplies, and of what type?
 
Leg bags,  cath kits?

Don't let what you  cannot do interfere with what you can do! 

Billy

_www.langfoundation.org_ (http://www.langfoundation.org/) 

[QUAD-L] Medicare and supplies

[Billy Lang]

Can anyone tell me if Medicare covers supplies, and of what type?

Leg bags,  cath kits?
 
Don't let what you cannot do interfere with what you can do!

Billy

www.langfoundation.org

[QUAD-L] medicare

[Danny Hearn]

Hi All,  I got a question---my wife lost her job of 14 years in december-- i 
had only medicare part A. Now I had to get part b and drug coverage, which is 
part d since we lost my wifes private insurance coverage. Well i was told a 
medicare advantage ppo--like i chose with Mercy would be my best bet.  part b 
will only pay 80 percent of things like wheelchairs and other medical things. 
Now I hear that  A and B plus a supplement may have been better? I'm really 
confused... don't think you can have a medicare advantage plan plus a 
supplement does anyone on medicare know more on this subject.  thanks 
for any help...   Dan H.   St.Louis, Missouri area. 

Re: [QUAD-L] medicare sux...

[wheelchair]

CMS, who pays for the chair requires the following protocol:
 
Dr's Order for Eval by OT
OT evaluation
Dr's Order for New Chair with Eval Recommendations
Visit to DME with Dr's Order and Eval Report
DME, submits the REQ to CMS for Approval with all paperwork
Once approved by CMS, the chair is ordered.
When the chair arrives, final adjustments are made
Then you get your chair.  
The process has been known to take 6 months to a year and longer.
Best Wishes
 
 
In a message dated 10/13/2009 10:12:10 P.M. Central Daylight Time,  
c5sc...@gmail.com writes:

wats it take 2 get a chair  approved?

Eric W Rudd
_c5sc...@gmail.com_ (mailto:c5sc...@gmail.com) 
 

[QUAD-L] medicare sux...

[Eric W Rudd]

wats it take 2 get a chair approved?

Eric W Rudd
c5sc...@gmail.com

Re: [QUAD-L] Medicare/Medicaid wheelchair issue

[LadyOnWheels725]

Contact the State Medicaid office,, not  the regional office.  When they give 
you the extension number try durable  equipment for your answers.  They will 
be able to see if Medicaid ever  bought him a chair and the date it was 
purchased.  If they did buy it,,then  it is his.  If they didn't he can get a 
new 
chair fitted by a physical  therapist and a provider.
Good luck and hope this  helps.
Kathy
**Worried about job security? Check out the 5 safest jobs in a 
recession. 
(http://jobs.aol.com/gallery/growing-job-industries?ncid=emlcntuscare0002)

Re: [QUAD-L] Medicare/Medicaid wheelchair issue

[John S.]

He should read his contract with the facility. They are notorious for such 
tricks. If it says the chair is theirs in the contract, he needs a lawyer 
because Med/Med is supose to provide for him, not them. Just because a lawyer 
wrote it and he signed it does not make it a legal action.

Best of Luck,
john





From: Quadius 
To: Quad-liST 
Sent: Tuesday, March 10, 2009 3:49:28 PM
Subject: [QUAD-L] Medicare/Medicaid wheelchair issue

An acquaintance of mine sent me this e-mail.  Since I am not familiar with 
Medicare or Medicaid, I thought I would send it to you guys for some advice.
I appreciate your help.
Quadius

My friend Matt Heimbach who has been in long term care for 3 years here in 
Tampa is moving to Colorado this month. Problem is thatthe issue/obstacle with 
Matt's wheelchair is that the facility in Tampa does not want to release his 
chair that is here.  They say it is the facilities and his mom is going back 
and forth with them arguing that it was paid for by Medicare/Medicaid??  So 
in lies the rub... I thought if Matt did buy the chair through Medicare, then 
he should be allowed to take the chair.  It fits him physically and a regular 
wheelchair is not really an option with his condition.  
 
Let me know your thoughts or suggestions ...



  

[QUAD-L] Medicare/Medicaid wheelchair issue

[Quadius]

An acquaintance of mine sent me this e-mail.  Since I am not familiar with
Medicare or Medicaid, I thought I would send it to you guys for some advice.
I appreciate your help.
Quadius

My friend Matt Heimbach who has been in long term care for 3 years here in
Tampa is moving to Colorado this month. Problem is that the issue/obstacle
with Matt's wheelchair is that the facility in Tampa does not want to
release his chair that is here.  They say it is the facilities and his mom
is going back and forth with them arguing that it was paid for by
Medicare/Medicaid??  So in lies the rub... I thought if Matt did buy the
chair through Medicare, then he should be allowed to take the chair.  It
fits him physically and a regular wheelchair is not really an option with
his condition.
Let me know your thoughts or suggestions ...

[QUAD-L] medicare and insurance related questions

[Danny Espinoza]

I just got on medicare and am wondering what kind of things it will help me 
with. I need a reliable power chair since I dont have one. Id really like a new 
bed. mine only partialy works and leaves little room to cuddle up at night 
with my girlfriend. Also should I have a SCI doc? Right now I have only a GP. 
Thanks in advance!


I am paralyzed from the neck down for now.. 
Occupation before accident - Network engineer / SR. Network security engineer 
Certs A+, N+, LPI, CCNA, CCNP, CCSP
Broke c2,c6,c7 and doner bone at c2 
TBI from blood going to central cortex from spinal cord off a vent "woohoo" 
however only one half of my diaphragm works right now "due to asymmetric SCI"
My unfinished webpage http://spinalcordinjured.net /

Re: [QUAD-L] Medicare & Reimbursement

[Debbie Hamilton]

Tim, I'm sorry to hear that Medicare doesn't reimburse.  I got an air mattress 
last May and put in for reimbursement through Medicare and haven't heard 
anything yet.  I called and they said it was still being processed.  I will let 
you know if I get any money.  I am suppose to be reimbursed 70% for durable 
medical equipment.

Debbie
C4 incomplete/April 2005

--- On Tue, 9/9/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:

From: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
Subject: Re: [QUAD-L] Medicare & Reimbursement
To: [EMAIL PROTECTED], quad-list@eskimo.com
Date: Tuesday, September 9, 2008, 8:02 PM



Medicare,  always wants the 1st right of acceptance or refusal.  If you got 
them to reimburse you after the sale, I gather you'd be the 1st in history.  
Now ya know the rest of the story.
 
Best Wishes
 

In a message dated 9/9/2008 2:31:01 P.M. Central Daylight Time, [EMAIL 
PROTECTED] writes:





Has anyone here purchased a peice of durable medical equipment out-of-pocket 
and gotten reimburseds by Medicare? 
 
Tim






Pt...Have you heard the news? There's a new fashion blog, plus the latest 
fall trends and hair styles at StyleList.com.


  

Re: [QUAD-L] Medicare & Reimbursement

[wheelchair]

Medicare,  always wants the 1st right of acceptance or refusal.   If you got 
them to reimburse you after the sale, I gather you'd be the 1st in  history.  
Now ya know the rest of the story.
 
Best Wishes
 
 
In a message dated 9/9/2008 2:31:01 P.M. Central Daylight Time,  
[EMAIL PROTECTED] writes:

Has anyone here purchased a peice of durable medical  equipment out-of-pocket 
and gotten reimburseds by Medicare? 
 
Tim






**Pt...Have you heard the news? There's a new fashion blog, 
plus the latest fall trends and hair styles at StyleList.com.  
(http://www.stylelist.com/trends?ncid=aolsty000514)

Re: [QUAD-L] Medicare & Reimbursemen

[Lori Michaelson]

Many, many companies or vendors try to tell people that if they purchase a
piece of durable medical equipment (or even part of it) that the persons
will be reimbursed by Medicare. This is FALSE information!

I know that is not your question but companies and vendors are supposed to
bill Medicare FIRST and then your CMS statement will you how much you how
much you are responsible for.

But, to answer your question... no, I don't think Medicare works that way.
It has never been my experience that it has.

Lori Michaelson

Age - 44

C4/5 complete quad, 28 years post

Tucson, AZ
On Tue, Sep 9, 2008 at 12:30 PM, Tim Syfert <[EMAIL PROTECTED]> wrote:

>   Has anyone here purchased a peice of durable medical equipment
> out-of-pocket and gotten reimburseds by Medicare?
>
> Tim
>

Re: [QUAD-L] Medicare & Reimbursement

[Tim Syfert]

Dana,
 
It only took me about a month to get my new chair. Guess it depends on the 
supplier you are working with and how on-the-ball the person you are working 
with is.
 
Tim
http://THEQUADLINK.COM 


--- On Tue, 9/9/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:

From: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
Subject: Re: [QUAD-L] Medicare & Reimbursement
To: [EMAIL PROTECTED], quad-list@eskimo.com
Date: Tuesday, September 9, 2008, 1:30 PM



That is a great question.  I have also wanted to know that question? I always 
wanted to get a half tray but they are really pricey and not covered.
Does anyone know, where's you get a larger glass holder that a insulated mug 
Permobile .  I really need a new one.

it is great to hear that Medicare/Medicaid paid for a Permobile.  Do you think 
it happens because of a good letter by a physical therapist documenting your 
needs well ?
 
How long do most people have to wait to get a new chair, how many years?
Thank you,
Dana





Pt...Have you heard the news? There's a new fashion blog, plus the latest 
fall trends and hair styles at StyleList.com.


  

Re: [QUAD-L] Medicare & Reimbursement

[DAANOO]

That is a great question.  I have also wanted to know that question? I  
always wanted to get a half tray but they are really pricey and not  covered.
Does anyone know, where's you get a larger glass holder that a  insulated mug 
Permobile .  I really need a new one.

it is great to hear that Medicare/Medicaid paid for a Permobile.   Do you 
think it happens because of a good letter by a physical therapist  documenting 
your needs well ?
 
How long do most people have to wait to get a new chair, how many  years?
Thank you,
Dana



**Pt...Have you heard the news? There's a new fashion blog, 
plus the latest fall trends and hair styles at StyleList.com.  
(http://www.stylelist.com/trends?ncid=aolsty000514)

[QUAD-L] Medicare & Reimbursement

[Tim Syfert]

Has anyone here purchased a peice of durable medical equipment out-of-pocket 
and gotten reimburseds by Medicare? 
 
Tim


  

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[John S.]

I don't doubt anything you said. I'm just saying, I haven't had the same 
problems. In fact, I have had problems with Medicare, not doctors or hospitals 
or DME's. I certainly do not doubt you. If I had a doormat like you I wouldn't 
miss so many visitors. 
I think you might try looking at the coding your insurance expects your doctor 
to use to bill them. It is all gibberish that is required to get paid 
"EFFICIENTLY".?
Honestly, no insurance company or medical payer can withstand an audit because 
of these codes. Obviously, you are being ripped off, but see if you can follow 
the money.

john
P.S. I wasn't at anytime saying you shouldn't ask questions, just letting you 
know what I have run into here.




- Original Message 
From: Lori Michaelson <[EMAIL PROTECTED]>
To: John S. <[EMAIL PROTECTED]>; quad-list@eskimo.com
Sent: Wednesday, July 2, 2008 8:05:11 PM
Subject: Re: [QUAD-L] Medicare fraud is blatant but is not being stopped


I think you missed the part whereby WE DID NOT accuse them of fraud.  We only 
wanted, and kindly asked for numerous times, for a readable bill and they 
refused to give us one.
 
Are we supposed to let the problem only worsen by not questioning things?  
Being doormats?  Which only exacerbates the problem that already exists.  
 
If my a*s was covered 100% and *I* was not having to shell out what I have 
to... I would probably just go along.  It's always easier just to go along 
isn't it???  The problem with that is that more and more people walk all over 
you.  And they will walk all over others.  Constantly taking advantage of the 
elderly also and robbing them of their life savings.
 
I had a huge problem with a home infusion Co. as well.  The owner said that he 
would only charge me $500 (as I was a second customer giving him business) but 
that changed when his billing department changed and he eventually turned us in 
to a collection agency.  We were getting a bill from them for $1500 for all the 
paraphernalia that Medicare does not cover.  BUT ... if I need them again they 
better not refuse to give me what the doctor ordered or they will be in court.  
And we have saved everything (paperwork).
 
Bottom line... does everyone here want to remain sheeple?  I don't think the 
quad list will let me attach a photograph of an example of sheeple so if anyone 
does not have it and wants it... e-mail me separately with the subject changed 
to SHEEPLE or I will miss it.  Or perhaps you can google it and see it online 
somewhere.  
 
I almost missed this post from John below to respond to.
 
Lori


On Tue, Jul 1, 2008 at 2:09 PM, John S. <[EMAIL PROTECTED]> wrote:

I don't doubt a word you say, but I have never had a doctor get what Medicare 
owed them. I know a lot of people think Dr.s should be paid the same as 
barbers. My doctors have also employed relatives. Why not? Nepotism is a 
problem in police forces and government, not a doctors office. My doctor 
charges $80 per visit and Medicare pays him $42. My podiatrist will get $66. 
The vet gets $65. The insurance company flips a coin and if the doctor wins, he 
gets the coin. 
Medicare fraud to me is when I am told I'll soon be using a Pride Jazzy. My  
Waiver representative is an atheist so to save gas she calls me each month to 
see if I'm alive and have I started jogging yet?  A usual litany of questions 
regarding each others lives and g'bye. On occasions I have had bad doctors. A 
urologist in fact. I did report him to Medicare, but I'm sure he still 
practices medicine. 
I would not expect the doctor to set up more appointments if I just accused him 
of fraud! This accusation is a doctor/patient relationship killer. Some Doctors 
are so good they do make millions. I do not resent a single dollar.  If you 
accuse the medical system of malpractice and fraud very often, you will start 
having trouble seeing doctors that are  not in an Emergency Room. You won't 
find anyone that wants to work for while you accuse them of federal crimes. 
Your name will get around and you will be going to Dr's that only see Medicare 
cases. 
I've seen doctors submit very large bills to Medicare that I thought were a 
little steep. This guy is 44 years old and still paying student loans from hell 
while trying to raise a family and after the insurance company is allowed to 
price fix against doctors, Medicare undercuts him by 70% and the rest are too 
poor to even send an X-mas card, then he has to buy malpractice insurance that 
costs him so much that many really good doctors only work for drug companies.
Now, just to show how stupid they can be, congress has decided it will cut any 
doctor bills by 10 percent. Why not cut what tort lawyers get by ten percent. 
Cut the amount lawyers get from Medicare by 10 percent and save big money. Cut 
back all payments from the US government to lawyers until the budget i

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Lori Michaelson]

I think you missed the part whereby WE DID NOT accuse them of fraud.  We
only wanted, and kindly asked for numerous times, for a readable bill and
they refused to give us one.

Are we supposed to let the problem only worsen *by not questioning things*?
Being doormats?  Which only exacerbates the problem that already exists.

If my a*s was covered 100% and *I* was not having to shell out what I have
to... I would probably just go along.  It's always easier just to go along
isn't it???  The problem with that is that more and more people walk all
over you.  And they will walk all over others.  Constantly taking advantage
of the elderly also and robbing them of their life savings.

I had a huge problem with a home infusion Co. as well.  The owner said
that he would only charge me $500 (as I was a second customer giving him
business) but that changed when his billing department changed and he
eventually turned us in to a collection agency.  We were getting a bill from
them for $1500 for all the paraphernalia that Medicare does not cover.  BUT
... if I need them again they better not refuse to give me what the doctor
ordered or they will be in court.  And we have saved everything (paperwork).

Bottom line... does everyone here want to remain sheeple?  I don't think the
quad list will let me attach a photograph of an example of sheeple so if
anyone does not have it and wants it... e-mail me separately with the
subject changed to SHEEPLE or I will miss it.  Or perhaps you can google it
and see it online somewhere.

I almost missed this post from John below to respond to.

Lori

On Tue, Jul 1, 2008 at 2:09 PM, John S. <[EMAIL PROTECTED]> wrote:

>  I don't doubt a word you say, but I have never had a doctor get what
> Medicare owed them. I know a lot of people think Dr.s should be paid the
> same as barbers. My doctors have also employed relatives. Why not? Nepotism
> is a problem in police forces and government, not a doctors office. My
> doctor charges $80 per visit and Medicare pays him $42. My podiatrist will
> get $66. The vet gets $65. The insurance company flips a coin and if the
> doctor wins, he gets the coin.
> Medicare fraud to me is when I am told I'll soon be using a Pride Jazzy.
> My  Waiver representative is an atheist so to save gas she calls me each
> month to see if I'm alive and have I started jogging yet?  A usual litany of
> questions regarding each others lives and g'bye. On occasions I have had bad
> doctors. A urologist in fact. I did report him to Medicare, but I'm sure he
> still practices medicine.
> I would not expect the doctor to set up more appointments if I just accused
> him of fraud! This accusation is a doctor/patient relationship killer. Some
> Doctors are so good they do make millions. I do not resent a single dollar.
> If you accuse the medical system of malpractice and fraud very often, you
> will start having trouble seeing doctors that are  not in an Emergency Room.
> You won't find anyone that wants to work for while you accuse them of
> federal crimes. Your name will get around and you will be going to Dr's that
> only see Medicare cases.
> I've seen doctors submit very large bills to Medicare that I thought were a
> little steep. This guy is 44 years old and still paying student loans from
> hell while trying to raise a family and after the insurance company is
> allowed to price fix against doctors, Medicare undercuts him by 70% and the
> rest are too poor to even send an X-mas card, then he has to buy malpractice
> insurance that costs him so much that many really good doctors only work for
> drug companies.
> Now, just to show how stupid they can be, congress has decided it will cut
> any doctor bills by 10 percent. Why not cut what tort lawyers get by ten
> percent. Cut the amount lawyers get from Medicare by 10 percent and save big
> money. Cut back all payments from the US government to lawyers until the
> budget is balanced! We will have a balanced budget in 6 months.
> Treating Doctors as if they cause health care problems is the DUMBEST thing
> congress has done since passing the Patriot Act, and ranks with the meanest
> thing since forcing Japanese Americans into intern camps. Why not force Oil
> corporations to cut prices by 10 percent? Because of their honesty?
> We have found the line between good and evil and made a mad dash to the
> wrong freakin side again!
>
> john
>
>   - Original Message 
> From: Lori Michaelson <[EMAIL PROTECTED]>
> To: quad-list@eskimo.com
> Sent: Monday, June 30, 2008 8:18:07 PM
> Subject: [QUAD-L] Medicare fraud is blatant but is not being stopped
>
> Todd ... here I will get to what I found out is happening more and more AND
> in one doctor's office in particular (further below my first-hand e

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Lori Michaelson]

Be fortunate and count your blessings then that your sweet patootie sounds
like it is covered 100%.  :-)

My outpatient stay for bladder-stone removal surgery cost me a little under
$500 I think it was.  I asked my husband yesterday if he remembered.  That
is, after all was said and done since the bills come from different places
(Hospital, Dr., anesthesiologist, etc.).  That was not too bad.  My doctors
bill was extremely reasonable.  This may sound strange but I think my doctor
would not tolerate exorbitant billing.  Yes, she belongs to a group and they
make the decisions but she is one of the best of the best.  And the best
actor I have ever seen regarding anything needed in my life medically.

I was there about eight or nine hours.  But that is because of the prep time
and staying in recovery to make sure that my blood pressure did not start
going off the wall after the epidural started wearing off.  I was also
treated like the Queen.  Literally.  And I think, or I am pretty damn sure,
that this over-the-top behavior was because of a snafu surrounding the
doctor's office at the hospital regarding me being able to see the
anesthesiologist first.

When I went to get my preoperative blood work done... my husband and I were
greeted by the hospital administrator and the head of the nursing Department
regarding everything surrounding my simple preoperative blood work.  It's a
long story so I won't put you through it or myself through it.  LOL.

Regardless, I am staying away from Medicaid as long as I can.  Been there,
done that for several years after my injury before I started working.

Lori

On Tue, Jul 1, 2008 at 5:15 PM, <[EMAIL PROTECTED]> wrote:

>  **
>
>  In a message dated 7/1/2008 8:03:09 P.M. Eastern Daylight Time,
> [EMAIL PROTECTED] writes:
>
> Perhaps you mean that they pay 'close to nothing'? * I meant NOTHING.  If
> you have Medicare, Medicaid will reimburse 79% of a bill, BUT since Medicare
> has already paid 80% Medicaid refuses to pay ANYTHING since Medicare already
> paid more than Medicaid would have paid.*
> **
> *More importantly*... which one gets billed first or is the primary? Medicare
> pays first.
>
>  I have to guess that it is Medicaid since you are waiting on them???
> Regardless it sounds like you won't have much to pay out-of-pocket...
> correct?  Correct.
> *Bill
> C6 Incomplete since 7/20/68
> Age 57
> Leesburg, FL
> *Don't get your knickers in a knot, it solves nothing; and makes you
> walk funny.
>
>
>
>
>  --
> Gas prices getting you down? Search AOL Autos for fuel-efficient used 
> cars
> .
>



-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Quadius]

What gets me is they (the hospitals) exaggerate their bills so they can get
at least a modicum of payment from Medicare and other insurance companies.
I understand they're trying to cover their costs, but when someone comes in
and is trying to pay for their own care because they can't afford insurance,
they are charged the same exact exorbitant rates as the insured.  The
uninsured, on the other hand, are expected to pay the full amount.

I know there are a large number who don't, but does that try to take their
debt seriously into a pain to use exorbitant fees.  Our system is so screwed
up now it's going to take a major overhaul and I don't believe some little
tax credit is going to take care of it.
Quadius


On 7/1/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:
>
>  *Well, you'll be more flabbergasted to hear that it's the opposite in FL.
> *
> **
> *I spent 8 hours in the ER on a Sunday last month due to a UTI.  I saw 2
> doctors, had one CT scan, was administered 2 pain meds and 1 antibiotic
> (100mL Levaquin) by IV.  Here is the Medicare statement I received.*
> **
> *Amount billed $6,557.09
> Medicare is paying $481.70*
> *Itemized list:
> Urinalysis & scope $99.25
> Levaquin $121.25
> Tx/pro/dx injection same drug addon $363.75
> Tx/pro/dx new drug addon $242.50
> ER visit $452
> 2 CAT scans $4,458.25
> Pharmacy $182.90
> Med/surg supplies $148.24
> Routine venipuncture $9.24
> Comprehensive metabolic panel $157.25
> Blood culture for bacteria $108.25
> Complete CBC with auto diff $44.10
> Hydromorphone injection $40.00
> Morphine sulfate $120.10
> Ambulance $374.75 (Medicare approved $324.64 and paid $259.71)
> Radiology Assoc. $236.00 (Medicare approved $110.06 paid $88.05)*
>
>  In a message dated 6/30/2008 8:18:34 P.M. Eastern Daylight Time,
> [EMAIL PROTECTED] writes:
>
> So doctors, hospitals, clinics, etc. are definitely getting paid more by
> the *Federal Medicare* program but it is the feds to set it up that way to
> begin with!
> *Bill
> C6 Incomplete since 7/20/68
> Age 57
> Leesburg, FL
> *Don't get your knickers in a knot, it solves nothing; and makes you
> walk funny.
>
>
>
>
>  --
> Gas prices getting you down? Search AOL Autos for fuel-efficient used 
> cars
> .
>

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[wheelchair]

Sharon, you have offered very tangible advice.  That is, money in the  bank.
It also means taking charge of your life and the responsibilities  associated
with your life.  Will you make some mistakes?  Sure you will...  we all do.
Every mistake is a lesson in life.
 
Ask a lot of questions and if you don't like the answers... ask more  
questions.
Best Wishes
 
 
In a message dated 7/2/2008 10:05:17 A.M. Central Daylight Time,  
[EMAIL PROTECTED] writes:

 
- Original Message -  
From: _Lori  Michaelson_ (mailto:[EMAIL PROTECTED])  
To: [EMAIL PROTECTED] (mailto:quad-list@eskimo.com)  
Sent: Monday, June 30, 2008 8:18 PM
Subject: [QUAD-L] Medicare fraud is blatant but is not being  stopped


Dear  list,
My name is Sharon, I had to  respond to Lori's mail on fraud! About 5 years 
ago I had a roll in shower put  in my home to assist me in being more 
independent!!! by a state agency here in  Ohio. That's when it all went 
wrong!!! They 
sent contractors that had never  done a wheeled in shower before!!! To make a 
long story short!!! It took four  long years of ripping out 4 times in 4 years 
to just get the bathroom to stop  leaking!!! It still not a independent 
bathroom I can use on my own!!!   But if you all want the whole story I can 
send 
it!!! was a nightmare to say  the least!!!
But I have learned 2 hard  lessions from this!!! Don't sign anything until 
you are completely sure your  satisfied with the job they do!! Don't trust 
everyone not even State agencies  to come in and do anything to your home
 
Sincerely
 
Sharon
Cerebral Palsy  
Electric Wheelchair  user





**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Eric W Rudd]

yep lol thnx

Eric W Rudd
[EMAIL PROTECTED]

  - Original Message - 
  From: Tod E. Santee 
  To: Eric W Rudd ; quad-list@eskimo.com 
  Sent: Wednesday, July 02, 2008 10:13 AM
  Subject: Re: [QUAD-L] Medicare fraud is blatant but is not being stopped


  Yep... something's wrong and we disagree on what percent of blame belongs to 
which party  Except that so far we attribute 0% to ourselves.

  Summed up enough?

  Best!
  --Tod
- Original Message - 
From: Eric W Rudd 
To: Lori Michaelson ; [EMAIL PROTECTED] ; quad-list@eskimo.com 
Sent: Tuesday, July 01, 2008 6:03 PM
Subject: Re: [QUAD-L] Medicare fraud is blatant but is not being stopped


can sum 1 sum this up?

Eric W Rudd
[EMAIL PROTECTED]

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Tod E. Santee]

Yep... something's wrong and we disagree on what percent of blame belongs to 
which party  Except that so far we attribute 0% to ourselves.

Summed up enough?

Best!
--Tod
  - Original Message - 
  From: Eric W Rudd 
  To: Lori Michaelson ; [EMAIL PROTECTED] ; quad-list@eskimo.com 
  Sent: Tuesday, July 01, 2008 6:03 PM
  Subject: Re: [QUAD-L] Medicare fraud is blatant but is not being stopped


  can sum 1 sum this up?

  Eric W Rudd
  [EMAIL PROTECTED]

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[|ANGELIC SHARON|]

- Original Message - 
From: Lori Michaelson 
To: quad-list@eskimo.com 
Sent: Monday, June 30, 2008 8:18 PM
Subject: [QUAD-L] Medicare fraud is blatant but is not being stopped

Dear list,
My name is Sharon, I had to respond to Lori's mail on fraud! About 5 years ago 
I had a roll in shower put in my home to assist me in being more independent!!! 
by a state agency here in Ohio. That's when it all went wrong!!! They sent 
contractors that had never done a wheeled in shower before!!! To make a long 
story short!!! It took four long years of ripping out 4 times in 4 years to 
just get the bathroom to stop leaking!!! It still not a independent bathroom I 
can use on my own!!!  But if you all want the whole story I can send it!!! was 
a nightmare to say the least!!!
But I have learned 2 hard lessions from this!!! Don't sign anything until you 
are completely sure your satisfied with the job they do!! Don't trust everyone 
not even State agencies to come in and do anything to your home

Sincerely

Sharon
Cerebral Palsy 
Electric Wheelchair user

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Eric W Rudd]

can sum 1 sum this up?

Eric W Rudd
[EMAIL PROTECTED]

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[MikeyBird3]

 
In a message dated 7/1/2008 8:03:09 P.M. Eastern Daylight Time,  
[EMAIL PROTECTED] writes:

Perhaps you mean that they pay 'close to  nothing'?  I meant  NOTHING.  If 
you have Medicare, Medicaid will reimburse 79% of a  bill, BUT since Medicare 
has already paid 80% Medicaid refuses to pay ANYTHING  since Medicare already 
paid more than Medicaid would have  paid.
 
More  importantly... which one gets billed first or is the  primary? Medicare 
pays  first.
 
 I have to guess that it is Medicaid  since you are waiting on them???  
Regardless it sounds like you won't  have much to pay out-of-pocket... correct? 
 
Correct.  

Bill
C6 Incomplete since 7/20/68
Age 57
Leesburg,  FL
Don't get your knickers in a knot, it solves nothing; and makes  you
walk  funny.






**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[MikeyBird3]

Well, in Florida it's illegal to bill a Medicare or Medicaid  recipient for 
any amount if Medicare or Medicaid paid any amount.  Chalk  one up for FL.
 
 
In a message dated 7/1/2008 5:01:36 P.M. Eastern Daylight Time,  
[EMAIL PROTECTED] writes:

I  thought I would mention it again that you are not responsible for anything 
 more than what CMS says that you are responsible for.  

Bill aka "Ding"



Don't get your  knickers in a knot, it solves nothing; and makes  you



**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[John S.]

I don't doubt a word you say, but I have never had a doctor get what Medicare 
owed them. I know a lot of people think Dr.s should be paid the same as 
barbers. My doctors have also employed relatives. Why not? Nepotism is a 
problem in police forces and government, not a doctors office. My doctor 
charges $80 per visit and Medicare pays him $42. My podiatrist will get $66. 
The vet gets $65. The insurance company flips a coin and if the doctor wins, he 
gets the coin. 
Medicare fraud to me is when I am told I'll soon be using a Pride Jazzy. My  
Waiver representative is an atheist so to save gas she calls me each month to 
see if I'm alive and have I started jogging yet?  A usual litany of questions 
regarding each others lives and g'bye. On occasions I have had bad doctors. A 
urologist in fact. I did report him to Medicare, but I'm sure he still 
practices medicine. 
I would not expect the doctor to set up more appointments if I just accused him 
of fraud! This accusation is a doctor/patient relationship killer. Some Doctors 
are so good they do make millions. I do not resent a single dollar.  If you 
accuse the medical system of malpractice and fraud very often, you will start 
having trouble seeing doctors that are  not in an Emergency Room. You won't 
find anyone that wants to work for while you accuse them of federal crimes. 
Your name will get around and you will be going to Dr's that only see Medicare 
cases. 
I've seen doctors submit very large bills to Medicare that I thought were a 
little steep. This guy is 44 years old and still paying student loans from hell 
while trying to raise a family and after the insurance company is allowed to 
price fix against doctors, Medicare undercuts him by 70% and the rest are too 
poor to even send an X-mas card, then he has to buy malpractice insurance that 
costs him so much that many really good doctors only work for drug companies.
Now, just to show how stupid they can be, congress has decided it will cut any 
doctor bills by 10 percent. Why not cut what tort lawyers get by ten percent. 
Cut the amount lawyers get from Medicare by 10 percent and save big money. Cut 
back all payments from the US government to lawyers until the budget is 
balanced! We will have a balanced budget in 6 months.
Treating Doctors as if they cause health care problems is the DUMBEST thing 
congress has done since passing the Patriot Act, and ranks with the meanest 
thing since forcing Japanese Americans into intern camps. Why not force Oil 
corporations to cut prices by 10 percent? Because of their honesty? 
We have found the line between good and evil and made a mad dash to the wrong 
freakin side again!

john


- Original Message 
From: Lori Michaelson <[EMAIL PROTECTED]>
To: quad-list@eskimo.com
Sent: Monday, June 30, 2008 8:18:07 PM
Subject: [QUAD-L] Medicare fraud is blatant but is not being stopped


Todd ... here I will get to what I found out is happening more and more AND in 
one doctor's office in particular (further below my first-hand experience which 
I talk about first) regarding Medicare fraud or theft.  Same difference. 
 
I know long e-mails are laborious to read but I hope that many of you DO read 
this for yourself, for your parents, for your grandparents or whomever who will 
probably, in some way and some time, fall into these traps.
 
FIRST THOUGH -- Here is one of my first-hand case scenarios with a doctor's 
offices getting away with double dipping Medicare and getting away with it.
 
I had a primary care physician here four years ago. My husband was also a 
patient of his.  Had him abt 2 yrs.  Neither of us go to the doctor's office 
that much but it does not even have to take that to let me/us see what is going 
on.  Whenever I DID go ... I would receive their bill and what they billed 
Medicare for.  And then I would have to wait for CMS's Medicare's Explanation 
of Benefits to see what my responsibility of the bill was.
 
Well, the last bill I received from this particular doctor (for a visit of 
mine) was so screwy you could not even read what was what.  My husband called 
and asked for a bill that was more itemized and readable.  They disagreed that 
there was anything wrong with their billing statement.  Heanen forbid!  My 
husband called because he is better at dealing with people... especially those 
that are trying to lie to your face.   The other problem we saw was that the 
bill was SO VERY screwy but it was also set up to be able to double dip in 
getting Medicare payments.  In other words... getting paid twice by Medicare.
 
I get a tiny bit of help from a home health agency paid for 100% by MediCARE.  
I'm getting robbed of over 98% of what I am eligible for but that is an 
entirely different story.  Anyway, every 65 days I have to be recertified to 
make sure that I am still a quadriplegic (ha ha - ho -ho)and still in need of 
home health help.  The home

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Lori Michaelson]

I thought I would mention it again that you are not responsible for anything
more than what CMS says that you are responsible for.  It usually takes
quite some time to receive your CMS statement.  But if you have other
insurance than it is going to be different.

Also, Levaquin is one of the more expensive antibiotics.

On Tue, Jul 1, 2008 at 7:24 AM, <[EMAIL PROTECTED]> wrote:

>  *Well, you'll be more flabbergasted to hear that it's the opposite in FL.
> *
> **
> *I spent 8 hours in the ER on a Sunday last month due to a UTI.  I saw 2
> doctors, had one CT scan, was administered 2 pain meds and 1 antibiotic
> (100mL Levaquin) by IV.  Here is the Medicare statement I received.*
> **
> *Amount billed $6,557.09
> Medicare is paying $481.70*
> *Itemized list:
> Urinalysis & scope $99.25
> Levaquin $121.25
> Tx/pro/dx injection same drug addon $363.75
> Tx/pro/dx new drug addon $242.50
> ER visit $452
> 2 CAT scans $4,458.25
> Pharmacy $182.90
> Med/surg supplies $148.24
> Routine venipuncture $9.24
> Comprehensive metabolic panel $157.25
> Blood culture for bacteria $108.25
> Complete CBC with auto diff $44.10
> Hydromorphone injection $40.00
> Morphine sulfate $120.10
> Ambulance $374.75 (Medicare approved $324.64 and paid $259.71)
> Radiology Assoc. $236.00 (Medicare approved $110.06 paid $88.05)*
>
>  In a message dated 6/30/2008 8:18:34 P.M. Eastern Daylight Time,
> [EMAIL PROTECTED] writes:
>
> So doctors, hospitals, clinics, etc. are definitely getting paid more by
> the *Federal Medicare* program but it is the feds to set it up that way to
> begin with!
> *Bill
> C6 Incomplete since 7/20/68
> Age 57
> Leesburg, FL
> *Don't get your knickers in a knot, it solves nothing; and makes you
> walk funny.
>
>
>
>
>  --
> Gas prices getting you down? Search AOL Autos for fuel-efficient used 
> cars
> .
>



-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[MikeyBird3]

It is still up in the air as Medicaid has not said what they'll  pay.  A CT 
scan was justified because of my history of kidney (in the  kidney) stones.
 
 
In a message dated 7/1/2008 4:37:19 P.M. Eastern Daylight Time,  
[EMAIL PROTECTED] writes:

What was the bottom line for you as to how much you were  responsible for the 
bill?  Or do you wait for the CMS explanation of  benefits to see what you 
are responsible for?  

Bill
C6 Incomplete since 7/20/68
Age 57
Leesburg,  FL
Don't get your knickers in a knot, it solves nothing; and makes  you
walk  funny.





**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Lori Michaelson]

Perhaps I came across wrong somewhere in my previous e-mail but your
hospital's itemized list below it that is what I would expect.  I spent
three hours in the emergency room last August because my home health nurse
was not able to get my catheter in.  Incompetence.  The first time in 28 and
half years that a nurse could not get my catheter in!

Sooo... fortunately my urologist was available and she met me at the
hospital ER.  She slid it in lickety-split no problem.  I can't recall, and
don't know where it is right now, but my hospital itemized bill probably
would not be much different if I was there to treat a UTI like you. The ER
visit WAS HELL though during the almost 2 hours that I had to wait for my
doctor to get there.

When I went in as an outpatient the summer before last to have many big
bladder stones removed ... my list was probably similar.  But my urologist
(who did the surgery) charged me very little for her outpatient surgery.
That was a separate bill.  But there was the hospital bill, the
anesthesiologist bill (epidural and then mildly sedated), etc etc etc.

Since I do not have a Medicare supplement (had to drop mine about 3 1/2 or
four years ago because the premiums were too much) ... I am responsible for
20% of all bills.

There was really no justification for a CT scan for you.  But INDEED *FOR
THEM*.  $$$

I went to the emergency room probably three different times between 1981 in
1992 and all they did was a urinalysis and gave me an antibiotic.

NOW ... doctors, hospitals, clinics have all gotten into the greedy ballpark
game and charge anything and everything they can!  They do unnecessary tests
or procedures and secretly tack on extra money for the air that you breathed
while you were in there.  LOL

What was the bottom line for you as to how much you were responsible for the
bill?  Or do you wait for the CMS explanation of benefits to see what you
are responsible for?  They usually only get what Medicare will pay unless
you have another insurance.

Lori
Age - 43
C4/5 complete quad, 28 1/2 years post
Tucson, AZ



On Tue, Jul 1, 2008 at 7:24 AM, <[EMAIL PROTECTED]> wrote:

>  *Well, you'll be more flabbergasted to hear that it's the opposite in FL.
> *
> **
> *I spent 8 hours in the ER on a Sunday last month due to a UTI.  I saw 2
> doctors, had one CT scan, was administered 2 pain meds and 1 antibiotic
> (100mL Levaquin) by IV.  Here is the Medicare statement I received.*
> **
> *Amount billed $6,557.09
> Medicare is paying $481.70*
> *Itemized list:
> Urinalysis & scope $99.25
> Levaquin $121.25
> Tx/pro/dx injection same drug addon $363.75
> Tx/pro/dx new drug addon $242.50
> ER visit $452
> 2 CAT scans $4,458.25
> Pharmacy $182.90
> Med/surg supplies $148.24
> Routine venipuncture $9.24
> Comprehensive metabolic panel $157.25
> Blood culture for bacteria $108.25
> Complete CBC with auto diff $44.10
> Hydromorphone injection $40.00
> Morphine sulfate $120.10
> Ambulance $374.75 (Medicare approved $324.64 and paid $259.71)
> Radiology Assoc. $236.00 (Medicare approved $110.06 paid $88.05)*
>
>  In a message dated 6/30/2008 8:18:34 P.M. Eastern Daylight Time,
> [EMAIL PROTECTED] writes:
>
> So doctors, hospitals, clinics, etc. are definitely getting paid more by
> the *Federal Medicare* program but it is the feds to set it up that way to
> begin with!
> *Bill
> C6 Incomplete since 7/20/68
> Age 57
> Leesburg, FL
> *Don't get your knickers in a knot, it solves nothing; and makes you
> walk funny.
>
>
>
>
>  --
> Gas prices getting you down? Search AOL Autos for fuel-efficient used 
> cars
> .
>



-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[MikeyBird3]

Yes.  I have FL Medicaid, too, but it pays  nothing.
 
 
In a message dated 7/1/2008 12:10:38 P.M. Eastern Daylight Time,  
[EMAIL PROTECTED] writes:

Is there  a state system like Medicaid or other state-operated federal 
program that  helps cover costs?

Bill aka "Ding"



Don't get your  knickers in a knot, it solves nothing; and makes you
walk  funny.



**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[Tod E. Santee]

Is there a state system like Medicaid or other state-operated federal program 
that helps cover costs?

In AZ there is the "Arizona Health Care Cost Containment System" (which is 
anything but) that substitutes for Medicaid.  Many times 70% or so is covered 
by the state with the remainder going to Medicare.

Just curious.

Best!
--Tod

 [EMAIL PROTECTED] wrote: 
> Well, you'll be more flabbergasted to hear that it's the opposite  in FL.
>  
> I spent 8 hours in the ER on a Sunday last month due to a  UTI.  I saw 2 
> doctors, had one CT scan, was administered 2 pain meds and 1  antibiotic 
> (100mL 
> Levaquin) by IV.  Here is the Medicare statement I  received.
>  
> Amount billed $6,557.09
> Medicare is paying  $481.70
> Itemized list:
> Urinalysis & scope $99.25
> Levaquin  $121.25
> Tx/pro/dx injection same drug addon $363.75
> Tx/pro/dx new drug  addon $242.50
> ER visit $452
> 2 CAT scans $4,458.25
> Pharmacy  $182.90
> Med/surg supplies $148.24
> Routine venipuncture  $9.24
> Comprehensive metabolic panel $157.25
> Blood culture for bacteria  $108.25
> Complete CBC with auto diff $44.10
> Hydromorphone injection  $40.00
> Morphine sulfate $120.10
> Ambulance $374.75 (Medicare approved  $324.64 and paid $259.71)
> Radiology Assoc. $236.00 (Medicare approved $110.06  paid $88.05)
>  
>  
> In a message dated 6/30/2008 8:18:34 P.M. Eastern Daylight Time,  
> [EMAIL PROTECTED] writes:
> 
> So doctors, hospitals, clinics, etc. are definitely getting paid more  by the 
> Federal Medicare program but it is the feds to  set it up that way to begin 
> with!  
> 
> Bill
> C6 Incomplete since 7/20/68
> Age 57
> Leesburg,  FL
> Don't get your knickers in a knot, it solves nothing; and makes  you
> walk  funny.

Re: [QUAD-L] Medicare fraud is blatant but is not being stopped

[MikeyBird3]

Well, you'll be more flabbergasted to hear that it's the opposite  in FL.
 
I spent 8 hours in the ER on a Sunday last month due to a  UTI.  I saw 2 
doctors, had one CT scan, was administered 2 pain meds and 1  antibiotic (100mL 
Levaquin) by IV.  Here is the Medicare statement I  received.
 
Amount billed $6,557.09
Medicare is paying  $481.70
Itemized list:
Urinalysis & scope $99.25
Levaquin  $121.25
Tx/pro/dx injection same drug addon $363.75
Tx/pro/dx new drug  addon $242.50
ER visit $452
2 CAT scans $4,458.25
Pharmacy  $182.90
Med/surg supplies $148.24
Routine venipuncture  $9.24
Comprehensive metabolic panel $157.25
Blood culture for bacteria  $108.25
Complete CBC with auto diff $44.10
Hydromorphone injection  $40.00
Morphine sulfate $120.10
Ambulance $374.75 (Medicare approved  $324.64 and paid $259.71)
Radiology Assoc. $236.00 (Medicare approved $110.06  paid $88.05)
 
 
In a message dated 6/30/2008 8:18:34 P.M. Eastern Daylight Time,  
[EMAIL PROTECTED] writes:

So doctors, hospitals, clinics, etc. are definitely getting paid more  by the 
Federal Medicare program but it is the feds to  set it up that way to begin 
with!  

Bill
C6 Incomplete since 7/20/68
Age 57
Leesburg,  FL
Don't get your knickers in a knot, it solves nothing; and makes  you
walk  funny.





**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

[QUAD-L] Medicare fraud is blatant but is not being stopped

[Lori Michaelson]

Todd ... here I will get to what I found out is happening more and more AND
in one doctor's office in particular (further below my first-hand experience
which I talk about first) regarding Medicare fraud or theft.  Same
difference.

I know long e-mails are laborious to read but I hope that many of you DO
read this for yourself, for your parents, for your grandparents or whomever
who will probably, in some way and some time, fall into these traps.

FIRST THOUGH -- Here is one of my first-hand case scenarios with a doctor's
offices getting away with double dipping *Medicare *and getting away with
it.

I had a primary care physician here four years ago. My husband was also a
patient of his.  Had him abt 2 yrs.  Neither of us go to the doctor's office
that much but it does not even have to take that to let me/us see what is
going on.  Whenever I DID go ... I would receive their bill and what they
billed *Medicare* for.  And then I would have to wait for CMS's Medicare's
Explanation of Benefits to see what my responsibility of the bill was.

Well, the last bill I received from this particular doctor (for a visit of
mine) was so screwy you could not even read what was what.  My husband
called and asked for a bill that was more itemized and readable.  They
disagreed that there was anything wrong with their billing statement.
Heanen forbid!  My husband called because he is better at dealing with
people... especially those that are trying to lie to your face.   The other
problem we saw was that the bill was SO VERY screwy but it was also set up
to be able to *double dip* in getting Medicare payments.  In other words...
getting paid twice by Medicare.

I get a tiny bit of help from a home health agency paid for 100% by
MediCARE.  I'm getting robbed of over 98% of what I am eligible for but that
is an entirely different story.  Anyway, every 65 days I have to be
recertified to make sure that I am still a quadriplegic (ha ha - ho -ho) and
still in need of home health help.  The home health agency sends
my physician a sheet of paper for him to sign and date that I am still in
need of services every 2 months for this recertification.  And that is ALL a
physician has to do... sign one and date one.  Every 65 days.

MEDICARE, for approximately the last six years now, *has allowed physicians
to bill Medicare for their signatures!!!*  And it is not just a small
amount.  It is close to $200 or more!  Absolutely crazy!  But that's the
federal government for you!  But it gets worse.

What is so ironic is that *Medicare *has a fraud hotline.  But it is a
joke.  They are also federal government employees and nothing gets done even
if it is reported.  Anyway, when we noticed on the bill that my doctor's
office was billing Medicare twice for my 65 day recertifications over a 9
month period ... I again asked for an itemized, readable bill.  The bill was
a mess *but that was to throw off* Medicare fraud being perpetrated by doing
this.  When my husband asked why their office was billing Medicare twice --
they had a fit to be called on it.  No surprise there.  And then the billing
clerk accused my husband of accusing them of *Medicare *fraud.  Which he
never did.  I might as well say here that... guess who we found out his
billing clerk was (later via the receptionist)???HIS MOMMY!!!

GET THIS - by this last action of ours (questioning the bill) - it was not a
week later where we got a letter from the physician's office saying that we
"had breached the patient/doctor relationship" and that we needed to get new
doctors within two weeks!  *DUMPING BOTH OF US* because of questioning their
billing!  This is the honest to God's truth and, since then, I have found
out that this type of of thing is running rampant.  I will tell you how I
found out next.

OK ... NEXT ... :-)

Approximately 2 months ago when my home health nurse was here to change my
catheter... we began talking about Medicare fraud and I told her what
happened to us four years ago.  She was not surprised in the least.

First of all, MOST *MediCARE* recipients and patients are people over the
age of 65.  And it is the elderly who are the meek and never question
anything for fear of losing what they have.  Or they are usually easily more
conned by these *Medicare* Dr. con artists. They trust their doctors, the
billing, and just pay their bills.

So here is what I nurse told me:

She told me this was not the first story she heard of such events.  IN FACT
she told me *that what happened to me* (inquiring about their bill and then
being told that they had breached the patient-doctor relationship and to
have to find new doctors) had just happened *to one of her other
patients*ON MEDICARE.  An elderly person.

But she told me one MORE thing that was very disturbing to both her, and
then after telling me, very disturbing to me.  Because of one of her
patient's experiences she found out that there is DEFINITELY one doctor's
practice here in town that ONLY accepts *Medicare* patie

[QUAD-L] Medicare Racketeers

[wheelchair]

Dan Meuser, President of Pride Mobility Products.  Dan, has taken  temporary 
leave of absences from Pride until the Pennsylvania elections are  over.  Dan 
is running as a conservative republican.
 
Best Wishes
 
 
In a message dated 6/30/2008 3:35:13 P.M. Central Daylight Time,  
[EMAIL PROTECTED] writes:

Who

On 6/30/08, [EMAIL PROTECTED] (mailto:[EMAIL PROTECTED])  
<[EMAIL PROTECTED] (mailto:[EMAIL PROTECTED]) > wrote:  
 
Quadius, that is very true.  One of the major manufacturers in the  DME 
industry is running for Congress in his District, in Pennsylvania.   Guess who?
 
Best Wishes
 

 
In a message dated 6/30/2008 2:46:25 P.M. Central Daylight Time, 
[EMAIL PROTECTED] (mailto:[EMAIL PROTECTED])   writes:

The problem with Medicare not being allowed to negotiate is they are  unable 
to effectively manage health care prices.  The federal  government can do this 
efficiently, as evidenced by the VA's ability to  get low-cost medication.  
This law is largely in place because our  legislatures are in the coffers of 
private insurance companies.  At  least that's my opinion.
Quadius
 

"Private insurance negotiates for group rates to get the best  charges ... 
smart business for insurance companies PLUS a guarantee to  the medical 
industry 
that more people will use a certain doc or vendor.  (Like the cost of a 
6-pack of Sam Adams versus a case... volume means  lower cost.)  But Medicare, 
by 
law, can't negotiate like this so  vendors, docs, hospitals, etc., charge the 
max to make up for their  "perceived" loss of (or at least 
"less-than-preferred") overall rate for  their  services."







 

 Gas prices getting you down? Search AOL Autos for fuel-efficient _used  
cars_ (http://autos.aol.com/used?ncid=aolaut000507) .









**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare Racketeers

[Lori Michaelson]

And I agree with you 100% Quadius.  There is no difference between Medicare
and the Federal government.  Medicare is operated BY THE FEDS while Medicaid
is state and county.  WITH MediCARE being federal... it is just one big
bureaucracy.  And anyone who works for the government has their own complete
medical coverage so they don't give a damn about the average American
citizen.  So nothing gets done.
Unfortunately, I do not have the luxury of having a secondary insurance.  I
have been dealing with this Medicare crap for 12 years now* firsthand*.  Day
in and day out.  It is just a bunch of bureaucracy bullsh*t at the expense
of the little guy.  That being folks like myself.

Lori
Age - 43
C4/5 complete quad, 28 1/2 years post
Tucson, AZ



On Mon, Jun 30, 2008 at 12:46 PM, Quadius <[EMAIL PROTECTED]> wrote:

> The problem with Medicare not being allowed to negotiate is they are unable
> to effectively manage health care prices.  The federal government can do
> this efficiently, as evidenced by the VA's ability to get low-cost
> medication.  This law is largely in place because our legislatures are in
> the coffers of private insurance companies.  At least that's my opinion.
> Quadius
>
>
> "Private insurance negotiates for group rates to get the best charges ...
> smart business for insurance companies PLUS a guarantee to the medical
> industry that more people will use a certain doc or vendor. (Like the cost
> of a 6-pack of Sam Adams versus a case... volume means lower cost.)  But
> Medicare, by law, can't negotiate like this so vendors, docs, hospitals,
> etc., charge the max to make up for their "perceived" loss of (or at least
> "less-than-preferred") overall rate for their services."
>
>


-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

Re: [QUAD-L] Medicare Racketeers

[Quadius]

Who

On 6/30/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:
>
>  Quadius, that is very true.  One of the major manufacturers in the DME
> industry is running for Congress in his District, in Pennsylvania.  Guess
> who?
>
> Best Wishes
>
>  In a message dated 6/30/2008 2:46:25 P.M. Central Daylight Time,
> [EMAIL PROTECTED] writes:
>
> The problem with Medicare not being allowed to negotiate is they are unable
> to effectively manage health care prices.  The federal government can do
> this efficiently, as evidenced by the VA's ability to get low-cost
> medication.  This law is largely in place because our legislatures are in
> the coffers of private insurance companies.  At least that's my opinion.
> Quadius
>
>
> "Private insurance negotiates for group rates to get the best charges ...
> smart business for insurance companies PLUS a guarantee to the medical
> industry that more people will use a certain doc or vendor. (Like the cost
> of a 6-pack of Sam Adams versus a case... volume means lower cost.)  But
> Medicare, by law, can't negotiate like this so vendors, docs, hospitals,
> etc., charge the max to make up for their "perceived" loss of (or at least
> "less-than-preferred") overall rate for their services."
>
>
>
>
>  --
> Gas prices getting you down? Search AOL Autos for fuel-efficient used 
> cars
> .
>

Re: [QUAD-L] Medicare Racketeers

[wheelchair]

Quadius, that is very true.  One of the major manufacturers in the DME  
industry is running for Congress in his District, in Pennsylvania.  Guess  who?
 
Best Wishes
 
 
In a message dated 6/30/2008 2:46:25 P.M. Central Daylight Time,  
[EMAIL PROTECTED] writes:

The problem with Medicare not being allowed to negotiate is they are  unable 
to effectively manage health care prices.  The federal government  can do this 
efficiently, as evidenced by the VA's ability to get low-cost  medication.  
This law is largely in place because our legislatures are in  the coffers of 
private insurance companies.  At least that's my  opinion.
Quadius
 

"Private insurance negotiates for group rates to get the best charges  ... 
smart business for insurance companies PLUS a guarantee to the medical  
industry 
that more people will use a certain doc or vendor. (Like the cost  of a 
6-pack of Sam Adams versus a case... volume means lower cost.)   But Medicare, 
by 
law, can't negotiate like this so vendors, docs, hospitals,  etc., charge the 
max to make up for their "perceived" loss of (or at least  
"less-than-preferred") overall rate for their  services."






**Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.  
(http://autos.aol.com/used?ncid=aolaut000507)

Re: [QUAD-L] Medicare Racketeers

[Quadius]

The problem with Medicare not being allowed to negotiate is they are unable
to effectively manage health care prices.  The federal government can do
this efficiently, as evidenced by the VA's ability to get low-cost
medication.  This law is largely in place because our legislatures are in
the coffers of private insurance companies.  At least that's my opinion.
Quadius


"Private insurance negotiates for group rates to get the best charges ...
smart business for insurance companies PLUS a guarantee to the medical
industry that more people will use a certain doc or vendor. (Like the cost
of a 6-pack of Sam Adams versus a case... volume means lower cost.)  But
Medicare, by law, can't negotiate like this so vendors, docs, hospitals,
etc., charge the max to make up for their "perceived" loss of (or at least
"less-than-preferred") overall rate for their services."

[QUAD-L] Medicare Racketeers

[wheelchair]

Tod, I hate to say it, but you are most correct.
Best Wishes
 
 
In a message dated 6/29/2008 10:50:39 P.M. Central Daylight Time,  
[EMAIL PROTECTED] writes:

Lori,

I think we differ a little in blame here.  I don't  consider it the fault of 
the Fed.  Medicare sets a MAXimum allowable  charge.  But vendors choose to 
charge Medicare as if what is being  provided is a top-of-line, maximum 
service, 
supply or equipment (and we know  how that is!).

Private insurance negotiates for group rates to get the  best charges ... 
smart business for insurance companies PLUS a guarantee to  the medical 
industry 
that more people will use a certain doc or vendor. (Like  the cost of a 6-pack 
of Sam Adams versus a case... volume means lower  cost.)  But Medicare, by 
law, can't negotiate like this so vendors, docs,  hospitals, etc., charge the 
max to make up for their "perceived" loss of (or  at least 
"less-than-preferred") overall rate for their services.

It's a  medical industry balancing act that drives up prices and bankrupts  
Medicare.  Now, if we wanted to pay more into Medicae so they could hire  more 
inspectors?  Or force senators/representatives at election time  to allow 
(push for) Medicare to compete (the current "bidding" system is a  joke... it 
trusts vndors) maybe we'd get fair pricing and service whether  private pay, 
insurance or Medicare.

Best  regards,
--Tod


 Lori Michaelson  <[EMAIL PROTECTED]> wrote: 
> BINGO Tod!
> 
> As  Medicare is my ONLY insurance ... I see the worst of the worst all the
>  time.  Enough to make me puke.  Drs especially are padding their  pockets
> HEAVILY with MEDICARE patients.  Vendors take monthy  chomps out Medicare 
for
> medical equipment.  The amount Medicare  pays monthly for my alternating
> pressure air mattress (plastic and a  pump) is astronomical.
> 
> Why is all this happening so blatantly  for any moron to be able to see?
> MEDICARE HAS NO TEETH.  It's  Federal - surprise, surprise!  Our g'vmint at
> it's best!
>  
> It gets worse when it comes to raping Medicare eliglible home health  care
> patients (like myself) from what thy ARE eligible for.  I've  talked to the
> Medicare Ombudsman (as high as one can get) and even her  hands are tied at
> getting the home care problem solved.
> A  sick, sick system.  Drs are becoming millionaires easily now just  with
> Medicare patients alone.
> 
> Tod ...I'll tell you  more on what I heard abt a Dr's office (here in Tucson
> where you &  I live) but I doubt it's "rare."  Not today though.  Gotta  go
> 
> 
> Lori
> 
> On Sat, Jun 28, 2008 at  6:02 PM, Tod E. Santee <[EMAIL PROTECTED]> wrote:
> 
> >  Every time I have any procedure done my insurance company sends me an  
EOB,
> > Explanation Of Benefits, that I usually read very closely  even though I 
know
> > everything has been covered.
>  >
> > What has always made me furious is to see that a hospital,  lab, doctor,
> > etc. charges the allowable Medicare amount.   BUT because of contracts the
> > provider accepts the amount or  percentage my insurance company agrees to 
pay
> > for the  service.  This amount is very often approximately 10-15% of the
>  > amount charged.  And this is the amount the doctor, lab or  hospital
> > considers acceptable for the services rendered.
>  >
> > When I have a surgery with a one-month hospital stay and a  hospital bill
> > over $130,000 BUT the hospital was willing to  accept $40,000, that tells 
me
> > there's something wrong with our  system!  If I didn't have insurance I 
would
> > be expected  --no, *required*-- to pay the full amount.  Medicare pays the
>  > full amount.  But the hospital is simply gouging private payers and  the
> > Medicare system simply because it can.
> >
>  > If a doctor is willing to accept 10% of what he/she charges, then  THAT
> > should be the amount he/she actually charges regardless of  insurance,
> > Medicare, or private pay.  Otherwise, the only  other explanation is that
> > medical institutions are using private  payers and Medicare to supplement
> > that which they lose through  contracting with insurance companies.
> >
> > Our health  care system in the US would not be in nearly the trouble it is
> > if  the TRUE cost of services is being charged to those who need it.   
Also,
> > those individuals without health insurance would be charged  the TRUE 
amounts
> > and would not be required to go bankrupt or pile  mortgages on top of
> > mortgages in order to cover themselves in a  catastrophic incident.
> >
> > Just my opinion... so far  very few have been able to argue convincingly 
to
> > point out major  problems in this point of view.
> >
> > Best regards  All,
> > --Tod
> >
> >  [EMAIL PROTECTED]  wrote:
> > >
> > >
> > > Back in the  1960s, Claude Castonguay chaired a Canadian government
> >  committee
> > > studying health reform and recommended that his  home province of 
Quebec —
> > > then  the largest and most  affluent in the country — adopt
> > >  gove

Re: [QUAD-L] Medicare!

[Lori Michaelson]

I don't fully understand your question unless MediCARE is NOT your sole
insurance.  I haven't gotten any letters regarding home NURSING???

Lori

On Sun, Jun 29, 2008 at 3:03 PM, Silas Shelburne <[EMAIL PROTECTED]>
wrote:

>  Anybody get a letter from Medicare saying you had to use your nursing
> care for 16hrs strait, and I would be responsible for 8hrs each day.  Silas
>



-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

Re: [QUAD-L] Medicare!

[Eric W Rudd]

hmm...i'm still paying out of pocket 300+/wk

Eric W Rudd
[EMAIL PROTECTED]

  - Original Message - 
  From: Silas Shelburne 
  To: quad-list@eskimo.com 
  Sent: Sunday, June 29, 2008 5:03 PM
  Subject: [QUAD-L] Medicare!


  Anybody get a letter from Medicare saying you had to use your nursing care 
for 16hrs strait, and I would be responsible for 8hrs each day.  Silas 

[QUAD-L] Medicare!

[Silas Shelburne]

Anybody get a letter from Medicare saying you had to use your nursing care
for 16hrs strait, and I would be responsible for 8hrs each day.  Silas 

Re: [QUAD-L] MEDICARE

[David K. Kelmer]

I was just thinking about her when I was watching the Daytona 500 this past 
weekend.   She was a Rusty Wallace fan!   A NASCAR FAN and a PIT BULL FAN , and 
she was a nurse, too.  She was/is quite a nice a nice person.
   
   
  With Love,
 
CtrlAltDel aka Dave
C4/5 Complete - 31 Years Post
  Texas, USA 


[EMAIL PROTECTED] wrote:

  Yes, Breezy was a good person with pitbulls, lol
  W
   
In a message dated 2/14/2008 9:04:30 P.M. Central Standard Time, [EMAIL 
PROTECTED] writes:
We use to have a quad named Breezy on the list & they told her to get a 
divorce for services. Her husband was an amputee & he did all of her care. I 
miss Breezy.
  Lindaf





-
  The year's hottest artists on the red carpet at the Grammy Awards. AOL Music 
takes you there.

[QUAD-L] Medicare won't pay hospitals for errors...

[Lori Michaelson]

Since Medicare is my ONLY insurance (and has been since 1996) I have seen
them put laws into effect only for them to be broken and then not enforced
by Medicare.  In other words... Medicare has no teeth.  Since incoming
trauma patients, or many other patients, end up being catheterized... They
are supposedly recognizing that this opens the patient to a host of bacteria
that always runs rampant in many hospitals.

Who knows if Medicaid will be following suit.

Nonetheless... My Yahoo Associated Press news just listed this in the last
10 minutes:

http://news.yahoo.com/s/ap/20080218/ap_on_he_me/healthbeat_hospital_errors_2
From the Associated Press medical writer:
Medicare won't pay hospitals for errors 
By LAURAN NEERGAARD, AP Medical Writer 48 minutes ago 
WASHINGTON - It's a new way to push for patient safety: Don't pay hospitals
when they commit certain errors. Medicare will start hitting hospitals where
it hurts in October, and other insurers are hot on the trail. 
That has the nation's hospitals exploring innovative programs to prevent
injury and infection: Hand-washing spies. Surgical sponges that sound an
alarm if left in the body. Even a room sterilizer that promises to wipe out
bacteria left lurking on bedrails.
"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their attention.

And patients' first sign that something is changing may involve lessening of
a big indignity: Today, one in four hospitalized patients is outfitted with
a urinary catheter. The tubes trigger more than half a million urinary tract
infections a year, the most common hospital-caused infection.
Yet many patients don't even need catheters — they're an automatic
precaution after certain surgeries — and many who do have them for days
longer than necessary. Why? The University of Michigan reported the first
national study of catheter practices last month, finding nearly half of
hospitals don't even keep track of who gets one. Fewer than one in 10
hospitals does a daily check to see if the catheter is still needed, a
simple but proven infection-reducing system.
With those infections topping Medicare's do-not-pay list, Gordon says
hospitals already are beginning to get choosier about who needs catheters,
and to yank them faster.
Even when a hospital makes a preventable error, it still can be reimbursed
for the extra treatment that patient will now require. Some errors can add
$10,000 to $100,000 to the cost of a patient's stay.
Beginning Oct. 1, Medicare no longer will pay those extra-care costs for
eight preventable hospital errors, including catheter-caused urinary tract
infections, injuries from falls, and leaving objects in the body after
surgery. Nor can hospitals bill the injured patient for those extra costs.
Next year, Medicare will add three more errors to the no-pay list;
ventilator-caused pneumonia and drug-resistant staph infections are top
candidates.
Medicare, which insures about 44 million elderly and disabled people,
estimates the move will save the government about $190 million over five
years.
It also sparked a movement: Private insurance giants like Aetna are moving
to make hospitals absorb the cost of serious errors. Pennsylvania last month
said it would follow Medicare's example and stop Medicaid payments, too. The
American Hospital Association is urging members to voluntarily quit billing
for treatment of serious errors, and hospitals in a number of states, from
Minnesota to Vermont, have announced they will.
Many hospitals already were trying to improve patient safety for a bigger
reason — to prevent suffering and death — and a question is whether making
them literally pay for mistakes will spur greater improvements. But some
novel attempts are under way:
_A standard mop-and-bucket cleaning leaves bacteria in hospital rooms,
especially on electronic equipment that janitors hesitate to touch. So the
Wellmont Health System in Kingsport, Tenn., is testing a portable machine
that sterilizes a closed room by spewing out vaporized hydrogen peroxide
that reach into every nook and cranny.
STERIS Corp.'s VaproSure is proven to eliminate tough germs; it has long
been used in sterile manufacturing facilities, and even helped clean
buildings tainted in the 2001 anthrax attacks.
But doctors, nurses and others bring new germs into rooms every time they
enter, raising the question of whether sterilizing between check-ins will
really lead to fewer infections.
"There's no question they can sterilize a room," Wellmont chief executive Dr
 Richard Salluzzo says of the $180,000 machines. "Has it prevented
infection? We don't have the answer to that yet."
He hopes to have enough data to tell by year's end.
_Nurses count surgical sponges to make sure they're all out before a patient
is sewn up, but every hospital occasionally misses some. In University of
Michigan operating rooms, doctors are testing sponges tagged with bar
code-like radiofrequency chips

Re: [QUAD-L] MEDICARE

[wheelchair]

Yes, Breezy was a good person with pitbulls, lol
W
 
 
In a message dated 2/14/2008 9:04:30 P.M. Central Standard Time,  
[EMAIL PROTECTED] writes:

We use to have a quad named Breezy on the list  & they told her to get a 
divorce for services. Her husband was an amputee  & he did all of her care. I 
miss 
Breezy.
Lindaf





**The year's hottest artists on the red carpet at the Grammy 
Awards. Go to AOL Music.  
(http://music.aol.com/grammys?NCID=aolcmp0030002565)

Re: [QUAD-L] MEDICARE

[Ms Linda Ferrell]

We use to have a quad named Breezy on the list & they told her to get a divorce 
for services. Her husband was an amputee & he did all of her care. I miss 
Breezy.
Lindaf
  - Original Message - 
  From: Greg 
  To: quad-list@eskimo.com 
  Sent: Monday, February 11, 2008 4:19 PM
  Subject: RE: [QUAD-L] MEDICARE


  I heard of couples divorcing and putting everything in one persons name, then 
the other qualifying for Medicaid.

  Extreme, but works.

  A shame that these things need to happen in this country. We need a national 
health insurance system.

   

  Greg

   



--


  No virus found in this incoming message.
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  Version: 7.5.516 / Virus Database: 269.19.21/1266 - Release Date: 2/8/2008 
10:06 AM

Re: [QUAD-L] MEDICARE

[Quadius]

I have a friend of mine who had to do this in order to get care.  It is a
shame.
Quadius

On 2/11/08, Greg <[EMAIL PROTECTED]> wrote:
>
>  I heard of couples divorcing and putting everything in one persons name,
> then the other qualifying for Medicaid.
>
> Extreme, but works…
>
> A shame that these things need to happen in this country. We need a
> national health insurance system.
>
>
>
> Greg
>
>
>

Re: [QUAD-L] MEDICARE

[Ms Linda Ferrell]

Naomi,
My cna's hours are paid thru Medicaid & Nurse's hours are paid by Medicare. My 
homemaker hrs are thru Medicaid Wavier.
Lindaf

Re: [QUAD-L] MEDICARE

[DAANOO]

I have also heard of this.  It's pretty sad that you have to lie to  survive 
in this country as a person with a disability.  The homebound  ruling is also 
crazy.  Everything in the world cannot be brought to  you.
 
Dana



**The year's hottest artists on the red carpet at the Grammy 
Awards. Go to AOL Music.  
(http://music.aol.com/grammys?NCID=aolcmp0030002565)

[QUAD-L] Medicare Part D

[David K. Kelmer]

Hi Dana,
   
  I bought a Plan from Humana the first year it was offered, and I am really 
pleased with how much its done.  Just this past Tuesday I choked while taking 
my Noon Vitamin C, and aspirated it into my lung.  I called my home-health care 
nurse and she told me what to watch for, and told me she'd be out Wed. morning. 
 When she got here, she took one listen to my lungs and had my Dr. order a 
portable X-Ray.  They were here Noon Wed, and my Dr. read the film by 5PM, and 
started me on 750mg Cephalosporin 4X a day and an injection of Ceftriaxone 
intramuscularly (into a muscle) for 10 days.  I have no idea what this would 
have cost without my Humana, but it was $1.00 per shot and $3.00 for the 
Cephalosporin.  I KNOW that's a small price for saving my life!  Stay Strong.
   
   
  With Love,
 
CtrlAltDel aka Dave
C4/5 Complete - 31 Years Post
  Texas, USA 
   
  

[EMAIL PROTECTED] wrote:
  I was wondering if anybody has ever tried Medicare part D..  Probably 
not.  I know my insurance will not pay as my doctor wrote a prescription for 
them and it didn't do my pharmacy.
   
  Dana




-
  Who's never won? Biggest Grammy Award surprises of all time on AOL Music.

RE: [QUAD-L] MEDICARE

[Greg]

I heard of couples divorcing and putting everything in one persons name,
then the other qualifying for Medicaid.

Extreme, but works.

A shame that these things need to happen in this country. We need a national
health insurance system.

 

Greg

 

Re: [QUAD-L] MEDICARE

[David K. Kelmer]

Hi Naomi,
   
  For me here in TX my Aide is paid through the Community-Based Alternatives 
Program (CBA).  I have Medicare and was able to get on the Community-Based 
Alternatives Program (CBA) through the TX Home and Community-based Waiver 
Program.  Stay strong.
   
   
  With Love,
 
CtrlAltDel aka Dave
C4/5 Complete - 31 Years Post
  Texas, USA 

  

[EMAIL PROTECTED] wrote:
  How do you all acquire aides and who pays for them?  I have been told I 
don't qualify for an aide through Medicare because I am custodial care.  Does 
Medicare pay for an aide for anyone?  Are your aides private pay, or paid 
through Medicaid?  What are your Medicaid guidelines?
   
Naomi
C4 quadriplegic since July 2005
due to Transverse Myelitis






-
  Who's never won? Biggest Grammy Award surprises of all time on AOL Music.

Re: [QUAD-L] MEDICARE

[LadyNotes]

Lori,
 
I have been paying out of pocket for an aide.  It is  really a financial 
struggle, but I haven't been able to get any help from  anywhere.
 
 
Naomi


C4  quadriplegic since July 2005
due to Transverse  Myelitis



**The year's hottest artists on the red carpet at the Grammy 
Awards. Go to AOL Music.  
(http://music.aol.com/grammys?NCID=aolcmp0030002565)

Re: [QUAD-L] MEDICARE

[John S.]

They tell me the exact same thing. I can't find the line to sign up for a car 
or a home let alone $2000? What am I doing wrong?
;)
john 

- Original Message 
From: NICHOLE ROHLING <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]; QUADLIST 
Sent: Sunday, February 10, 2008 10:55:17 AM
Subject: Re: [QUAD-L] MEDICARE


MEDICAID PAYS FOR MY CAREGIVER - I CAN OWN 1 VEHICLE, HOME AND ONLY HAVE  
$2000.00 IN CASH.
   
  NICKI

[EMAIL PROTECTED] wrote:
  How do you all acquire aides and who pays for them?  I have been told I 
don't qualify for an aide through Medicare because I am custodial care.  Does 
Medicare pay for an aide for anyone?  Are your aides private pay, or paid 
through Medicaid?  What are your Medicaid guidelines?
   
Naomi
C4 quadriplegic since July 2005
due to Transverse Myelitis





  Who's never won? Biggest Grammy Award surprises of all time on AOL Music.

 
  
Looking for last minute shopping deals?  
Find them fast with Yahoo! Search.





  

Never miss a thing.  Make Yahoo your home page. 
http://www.yahoo.com/r/hs

Re: [QUAD-L] MEDICARE

[Lori Michaelson]

There is a huge difference between getting home health aides through
Medicare or through Medicaid.  To be eligible for MediCAID you have to be at
the poverty level or somehow hide your money to be at that level and then be
at the mercy of the county and state.
It is harder than hell, since 1999, to get agencies to provide people with
home health aides even if you need them badly and your only insurance is
Medicare (which is federal).  Unfortunately that is my only insurance
(Medicare) and at this point we refused to commit financial suicide to be
eligible for Medicaid.  With my luck... as soon as I did... the laws would
be changed for Medicaid and then I would not have any money to hire a home
health aide if I needed one!

This was all semi-recently discussed so if someone else here can give you a
timeframe of exactly when it was discussed... you can go to the archives to
see that discussion on this list.

*What have you been doing all this time?  Since 2005?*

Lori
C4/5 complete
On Feb 9, 2008 7:11 PM, <[EMAIL PROTECTED]> wrote:

>  How do you all acquire aides and who pays for them?  I have been told I
> don't qualify for an aide through Medicare because I am custodial care.
> Does Medicare pay for an aide for anyone?  Are your aides private pay, or
> paid through Medicaid?  What are your Medicaid guidelines?
>
>  *Naomi*
> C4 quadriplegic since July 2005
> due to Transverse Myelitis
>
>
>
>  --
> Who's never won? Biggest Grammy Award surprises of all time on AOL 
> Music.
>



-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

[QUAD-L] MEDICARE

[Greg]

Will Medicare pay for attendants? Not Medicaid.

I use a Medicare Replacement Insurance and they have paid for Wound Nurses,
and ok'ed a nurse to do IV antibiotics at home. But not a daily aide.

They tell me my needs are not "Medically Necessary".  

I'm sure I could get one every 3 weeks to change my SP cath, but not just to
get dressed, save, shower, eat, etc.

Greg

 

Re: [QUAD-L] MEDICARE

[NICHOLE ROHLING]

MEDICAID PAYS FOR MY CAREGIVER - I CAN OWN 1 VEHICLE, HOME AND ONLY HAVE  
$2000.00 IN CASH.
   
  NICKI

[EMAIL PROTECTED] wrote:
  How do you all acquire aides and who pays for them?  I have been told I 
don't qualify for an aide through Medicare because I am custodial care.  Does 
Medicare pay for an aide for anyone?  Are your aides private pay, or paid 
through Medicaid?  What are your Medicaid guidelines?
   
Naomi
C4 quadriplegic since July 2005
due to Transverse Myelitis






-
  Who's never won? Biggest Grammy Award surprises of all time on AOL Music.


   
-
Looking for last minute shopping deals?  Find them fast with Yahoo! Search.

Re: [QUAD-L] MEDICARE

[LadyNotes]

How do you all acquire aides and who pays for them?  I  have been told I 
don't qualify for an aide through Medicare because I am  custodial care.  Does 
Medicare pay for an aide for anyone?  Are your  aides private pay, or paid 
through Medicaid?  What are your Medicaid  guidelines?
 
 
Naomi


C4  quadriplegic since July 2005
due to Transverse  Myelitis



**Biggest Grammy Award surprises of all time on AOL Music. 
(http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp00300025
48)

Re: [QUAD-L] MEDICARE

[LadyNotes]

How did you get your state to pay for your aide?  I also  have a nurse that 
comes once a month for cath changes.  She told me that  there may be a problem 
since I now go to outpatient therapy.  I am no  longer considered homebound.  
I am unable to drive and has to depend on  others to take me out.  I don't 
really understand how this  works.
 
 
Naomi


C4  quadriplegic since July 2005
due to Transverse  Myelitis



**Biggest Grammy Award surprises of all time on AOL Music. 
(http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp00300025
48)

Re: [QUAD-L] MEDICARE

[Lori Michaelson]

MediCARE home health agencies REQUIRE an RN do cath changes.  No idea how
they're gettin' away with sending an LPN.  BUT THE LAW IS ON THE AGENCY'S
SIDE.  I know cuz I've been doing this since 1996.  There IS  the homebound
requirement which is stoopid and ADAPT and NUMEROUS advocacy groups have
been fighting to eliminate this rule *for 8 years w/o success.*

Nuthin ever changes.

Like we need nurses & aidees to get us up & around to stare at 4 walls
24/7?  Ridiculous but it's the fukin law that never changes.  Oh... you CAN
go out to get a haircut, go to a Dr appnt and go to church.  Wowe!
Praise Jesus y'all!  Halleluja!

Lori
C4/5
28 yrs post

On Feb 9, 2008 1:10 PM, NICHOLE ROHLING <[EMAIL PROTECTED]> wrote:

> HAVE ANY OF YOU APPEALLED A DECISION BECAUSE YOUR HOME HEALTH AGENCY
> DROPPED YOU BECAUSE THEY SAY YOU'RE NO LONGER HOMEBOUND?
>
> I HAVE AN LPN COME 1 TIME EVERY 3 WEEKS FOR CATH CHANGE BUT THE RN THAT
> CAME TO RECERT ME SAID I WASN'T HOMEBOUND BECAUSE I CAN DRIVE NOW.
>
> IF IT WEREN'T FOR THE TAXING EFFORT IT TAKES FOR ME TO GET UP WHICH MY
> AID  IS PAID BY THE STATE I'D BE IN BED.
>
> ANY ADVICE?
>
> NICKI C5
>
> --
> Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it
> now.
>
>


-- 
Lori
C4/5 complete quad, 27 years post
Tucson, AZ

Re: [QUAD-L] MEDICARE

[NICHOLE ROHLING]

YES, I CAN GET TO A DR'S OFFICE BUT THEY DON'T HAVE THE EQUIPMENT TO TRANSFER 
ME NOR A TABLE BIG ENGOUGH TO UNDRESS ME. MY LPN IS GREAT, I CALL AS SOON AS 
I'M OUT OF THE SHOWER AND SHE'S HERE IN 10 MINUTES. THE RN IS THE ONE WHO HAS 
THE PROBLEM. SHE THINKS SHE CAN CALL AT 10 AM TO COME AT NOON. THEY HAVE IN MY 
RECORDS TO CALL 24 HRS AHEAD BUT SHE WON'T DO IT.
   
  NICKI


Stacy Harim <[EMAIL PROTECTED]> wrote:  I was told if I needed a nurse 
to come a do a cath change and not home bound then I  could get to the doctors 
to have them do it there.  Also many agencies have aids come with Medicare and 
don't require you to be homebound or the aid just doesn't say anything about 
you not being homebound.  
   
  I had a nurse come to do bandage changes and she said as long as I was here 
when she was here then she doesn't know anything.
   
  Stacy


  - Original Message 
From: NICHOLE ROHLING <[EMAIL PROTECTED]>
To: quad-list@eskimo.com
Sent: Saturday, February 9, 2008 3:10:54 PM
Subject: [QUAD-L] MEDICARE

  HAVE ANY OF YOU APPEALLED A DECISION BECAUSE YOUR HOME HEALTH AGENCY DROPPED 
YOU BECAUSE THEY SAY YOU'RE NO LONGER HOMEBOUND?
   
  I HAVE AN LPN COME 1 TIME EVERY 3 WEEKS FOR CATH CHANGE BUT THE RN THAT CAME 
TO RECERT ME SAID I WASN'T HOMEBOUND BECAUSE I CAN DRIVE NOW.
   
  IF IT WEREN'T FOR THE TAXING EFFORT IT TAKES FOR ME TO GET UP WHICH MY AID  
IS PAID BY THE STATE I'D BE IN BED.
   
  ANY ADVICE?
   
  NICKI C5

-
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Re: [QUAD-L] MEDICARE

[Stacy Harim]

I was told if I needed a nurse to come a do a cath change and not home bound 
then I  could get to the doctors to have them do it there.  Also many agencies 
have aids come with Medicare and don't require you to be homebound or the aid 
just doesn't say anything about you not being homebound.  

I had a nurse come to do bandage changes and she said as long as I was here 
when she was here then she doesn't know anything.

Stacy


- Original Message 
From: NICHOLE ROHLING <[EMAIL PROTECTED]>
To: quad-list@eskimo.com
Sent: Saturday, February 9, 2008 3:10:54 PM
Subject: [QUAD-L] MEDICARE


HAVE ANY OF YOU APPEALLED A DECISION BECAUSE YOUR HOME HEALTH AGENCY DROPPED 
YOU BECAUSE THEY SAY YOU'RE NO LONGER HOMEBOUND?
 
I HAVE AN LPN COME 1 TIME EVERY 3 WEEKS FOR CATH CHANGE BUT THE RN THAT CAME TO 
RECERT ME SAID I WASN'T HOMEBOUND BECAUSE I CAN DRIVE NOW.
 
IF IT WEREN'T FOR THE TAXING EFFORT IT TAKES FOR ME TO GET UP WHICH MY AID  IS 
PAID BY THE STATE I'D BE IN BED.
 
ANY ADVICE?
 
NICKI C5


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Re: [QUAD-L] MEDICARE

[wheelchair]

John, almost any law professor can provide the same for free.  Its all  based 
on case law.
Best Wishes
W
 
 
In a message dated 2/9/2008 3:33:01 P.M. Central Standard Time,  
[EMAIL PROTECTED] writes:

Let me  know what you get. I can't find lawyers that will discuss ADA cases 
for less  than $1100. 

Best  Wishes,
john





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Re: [QUAD-L] MEDICARE

[John S.]

Let me know what you get. I can't find lawyers that will discuss ADA cases for 
less than $1100. 

Best Wishes,
john

- Original Message 
From: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; quad-list@eskimo.com
Sent: Saturday, February 9, 2008 3:43:39 PM
Subject: Re: [QUAD-L] MEDICARE




 

I like direct action with no left doubts.  Contact a lawyer that 
specializes in Disability Law to draft you a letter on the definition of 
HomeBound.  I'm sure that there is enough case law on file with the courts 
acceptance of the term and what it should mean.  When you receive that 
letter, make a copy and have it covered in plastic for your permanent file and 
exposure to all who read.

 

Best Wishes

 


In a message dated 2/9/2008 2:39:31 P.M. Central Standard Time, DAANOO 
writes:


  I was dropped by a home health agency, because they said I was not 
  homebound, and when I called them they said I didn't have enough reasons for 
a 
  nurse to come but they told my case manager that it was.  I was not 
  homebound, even though she told them insurance would pay even if I was not 
  homebound.  I had had this agency, since I moved to Prairie Village, 18 
  years ago.

   

  What do the guidelines say about the determination for homebound.  I 
  don't drive that I go to doctors and two stores to buy things.  I found 
  another agency that would take me.  I have Blue Cross right now, and I 
  don't know what will happen, when my stepmom retires and I have 
  Medicare/Medicaid.  The agency I have does not take Medicaid.

   

  Just wondering if anyone else has had this experience and what did you 
  do.

   

  It seems so unfair that we should have to stay at home 24/7 days of the 
  week to get a nurse to help us with cultures, looking at skin breakdown and 
  blood work on a routine basis.

   

  Dana.




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Re: [QUAD-L] MEDICARE

[John S.]

Why, in the name of God, do you have to be homebound? Is the agency on drugs 
again? 
I'm sorry, you just aren't miserable enough for us. If you have a flat tire you 
are once again eligible for their help?
I'm glad I use the Access Bus System. I can go anyplace in the service area and 
still be homebound?

Good luck,
john

- Original Message 
From: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]; quad-list@eskimo.com
Sent: Saturday, February 9, 2008 3:14:47 PM
Subject: Re: [QUAD-L] MEDICARE




 

An RN trumps an LPN any day of the week.  A letter from an RN may set 
them straight I hope.

Best Wishes

W

 


In a message dated 2/9/2008 2:11:38 P.M. Central Standard Time, 
[EMAIL PROTECTED] writes:


  HAVE ANY OF YOU APPEALLED A DECISION BECAUSE YOUR 
  HOME HEALTH AGENCY DROPPED YOU BECAUSE THEY SAY YOU'RE NO LONGER 
  HOMEBOUND?

   

  I HAVE AN LPN COME 1 TIME EVERY 3 WEEKS FOR CATH 
  CHANGE BUT THE RN THAT CAME TO RECERT ME SAID I WASN'T HOMEBOUND BECAUSE I 
CAN 
  DRIVE NOW.

   

  IF IT WEREN'T FOR THE TAXING EFFORT IT TAKES FOR 
  ME TO GET UP WHICH MY AID  IS PAID BY THE STATE I'D BE IN 
  BED.

   

  ANY ADVICE?

   

  NICKI 
C5




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Re: [QUAD-L] MEDICARE

[wheelchair]

I like direct action with no left doubts.  Contact a lawyer that  specializes 
in Disability Law to draft you a letter on the definition of  HomeBound.  I'm 
sure that there is enough case law on file with the courts  acceptance of the 
term and what it should mean.  When you receive that  letter, make a copy and 
have it covered in plastic for your permanent file and  exposure to all who 
read.
 
Best Wishes
 
 
In a message dated 2/9/2008 2:39:31 P.M. Central Standard Time, DAANOO  
writes:

I was dropped by a home health agency, because they said I was not  
homebound, and when I called them they said I didn't have enough reasons for a  
nurse 
to come but they told my case manager that it was.  I was not  homebound, even 
though she told them insurance would pay even if I was not  homebound.  I had 
had this agency, since I moved to Prairie Village, 18  years ago.
 
What do the guidelines say about the determination for homebound.  I  don't 
drive that I go to doctors and two stores to buy things.  I found  another 
agency that would take me.  I have Blue Cross right now, and I  don't know what 
will happen, when my stepmom retires and I have  Medicare/Medicaid.  The agency 
I have does not take Medicaid.
 
Just wondering if anyone else has had this experience and what did you  do.
 
It seems so unfair that we should have to stay at home 24/7 days of the  week 
to get a nurse to help us with cultures, looking at skin breakdown and  blood 
work on a routine basis.
 
Dana.





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(http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp00300025
48)

Re: [QUAD-L] MEDICARE

[DAANOO]

I was dropped by a home health agency, because they said I was not  
homebound, and when I called them they said I didn't have enough reasons for a  
nurse 
to come but they told my case manager that it was.  I was not  homebound, even 
though she told them insurance would pay even if I was not  homebound.  I had 
had this agency, since I moved to Prairie Village, 18  years ago.
 
What do the guidelines say about the determination for homebound.  I  don't 
drive that I go to doctors and two stores to buy things.  I found  another 
agency that would take me.  I have Blue Cross right now, and I  don't know what 
will happen, when my stepmom retires and I have  Medicare/Medicaid.  The agency 
I have does not take Medicaid.
 
Just wondering if anyone else has had this experience and what did you  do.
 
It seems so unfair that we should have to stay at home 24/7 days of the  week 
to get a nurse to help us with cultures, looking at skin breakdown and  blood 
work on a routine basis.
 
Dana.
 
 



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(http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp00300025
48)

Re: [QUAD-L] MEDICARE

[wheelchair]

An RN trumps an LPN any day of the week.  A letter from an RN may set  them 
straight I hope.
Best Wishes
W
 
 
In a message dated 2/9/2008 2:11:38 P.M. Central Standard Time,  
[EMAIL PROTECTED] writes:

HAVE ANY OF YOU APPEALLED A DECISION BECAUSE YOUR  HOME HEALTH AGENCY DROPPED 
YOU BECAUSE THEY SAY YOU'RE NO LONGER  HOMEBOUND?
 
I HAVE AN LPN COME 1 TIME EVERY 3 WEEKS FOR CATH  CHANGE BUT THE RN THAT CAME 
TO RECERT ME SAID I WASN'T HOMEBOUND BECAUSE I CAN  DRIVE NOW.
 
IF IT WEREN'T FOR THE TAXING EFFORT IT TAKES FOR  ME TO GET UP WHICH MY AID  
IS PAID BY THE STATE I'D BE IN  BED.
 
ANY ADVICE?
 
NICKI  C5





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(http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp00300025
48)

[QUAD-L] MEDICARE

[NICHOLE ROHLING]

HAVE ANY OF YOU APPEALLED A DECISION BECAUSE YOUR HOME HEALTH AGENCY DROPPED 
YOU BECAUSE THEY SAY YOU'RE NO LONGER HOMEBOUND?
   
  I HAVE AN LPN COME 1 TIME EVERY 3 WEEKS FOR CATH CHANGE BUT THE RN THAT CAME 
TO RECERT ME SAID I WASN'T HOMEBOUND BECAUSE I CAN DRIVE NOW.
   
  IF IT WEREN'T FOR THE TAXING EFFORT IT TAKES FOR ME TO GET UP WHICH MY AID  
IS PAID BY THE STATE I'D BE IN BED.
   
  ANY ADVICE?
   
  NICKI C5

   
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[QUAD-L] Medicare Rights: Issue 3, February 5, 2008

[DAANOO]

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--- Begin Message ---
 

 

Welcome to MEDICARE WATCH, a biweekly electronic newsletter of the Medicare 
Rights Center

Vol. 11, No. 3: February 5, 2008


Contents: 

1.  FAST FACT 
2.  BUSH PROPOSES $178.2 BILLION IN MEDICARE CUTS 
3.  SENATE PANEL INVESTIGATES MEDICARE PRIVATE PLANS 
4.  STUDY: COPAYMENTS LIMIT ACCESS TO ROUTINE MAMMOGRAMS 
5.  CASE FLASH: LOW-INCOME PROGRAMS AND PRIVATE PLANS 



1. FAST FACT

Americans spent nearly $500 billion on the 10 most expensive illnesses in 2005, 
according to recent study by Agency for Healthcare Research and Quality. The 
costliest set of illnesses-heart conditions-cost the nation $76 billion ("Big 
Money: Cost of 10 Most Expensive Health Conditions Near $500 Billion 

 ," ARHQ, January 23, 2008). 

2. BUSH PROPOSES $178.2 BILLION IN MEDICARE CUTS

President Bush unveiled a budget proposal yesterday that slashes Medicare 
spending by $178.2 billion over the next five years largely by imposing a 
three-year freeze on payments to hospitals, nursing homes and other health care 
providers and phasing out special funding to hospitals that care for the 
uninsured. 

However, payment rates for insurance companies that offer Medicare private 
health plans, which cost taxpayers 13 percent more than coverage under Original 
Medicare, would remain untouched under the president's budget. Health and Human 
Services Secretary Mike Leavitt defended the administration's decision to 
protect the plans at a press conference, claiming that private plans are "a 
part of the future that will bring Medicare into a place where it can be 
sustainable." 

Leavitt asserted that Medicare spending had reached "emergency levels" and 
warned that the benefit would not be available to future generations unless 
immediate cuts were made. Kerry Weems, acting administrator of the Centers for 
Medicare & Medicaid Services (CMS), noted that the Part A trust fund, which is 
funded by dedicated payroll taxes and pays for Medicare hospital care, is 
projected by CMS actuaries to become insolvent in 2019. CMS actuaries estimate 
that eliminating overpayments to Medicare private health plans will extend the 
solvency of the trust fund by two years, to 2021. 

The administration's budget plan received a cool reception on Capitol Hill. 
According to John Spratt, Democrat of South Carolina, this is because "most of 
these cuts affect critical needs," and as a result, "are unlikely to generate 
sufficient support to become law." 

3. SENATE PANEL INVESTIGATES MEDICARE PRIVATE PLANS

Private-Fee-for-Service (PFFS) plans, Medicare private health plans that 
operate without provider networks, were the focus of criticism from providers, 
counselors and health policy experts at a Senate Finance Committee hearing last 
week. 

In recent years enrollment has surged in PFFS plans, which allow enrollees to 
visit any doctor who agrees to the plans' terms and conditions but have no 
minimum network of providers. The plans cost taxpayers on average 17 percent 
more than the cost of care under Original Medicare, Mark Miller, executive 
director of the Medicare Payment Advisory Commission (MedPAC), told the 
committee. 

Miller also expressed concerns over lenient federal standards regulating the 
quality of care provided by PFFS plans. Currently, PFFS plans are the only type 
of Medicare private plan not statutorily required to provide federal agencies 
with data on the quality of coverage provided to enrollees. 

Providers at the hearing disclosed that they are increasingly severing their 
financial relationships to the plans. Dr. Albert Fisk, medical director of the 
Everett Clinic in Washington State, testified his clinic had given its 21,000 
patients with Medicare 14 months' notice that it would no longer accept 
coverage provided by PFFS plans. Dr. Fisk attributed the change to PFFS plans' 
refusal to negotiate "acceptable [reimbursement] rates" with the clinic that 
compensate doctors for providing coordinated care. 

Elyse Politi, a health care counselor for Virginia's State Health Insurance 
Assistance Program, testified that the benefit plans and lack of provider 
networks can lead to problems for people with Medicare who enroll in the plans. 

"People who gave up their Medigap policies suddenly had to pay these large, 
unexpected costs out of their own pocket," Politi testified. "Other people find 
out that a health care provider will not accept their PFFS plan just as they 
are scheduled to receive a needed health care service." 

Politi recommended that Congress provide for standardized benefit packages for 
Medicare private health plans, requ

[QUAD-L] Medicare Legislation

[Elizabeth Treston]

 




ATAP has received a request from the ITEM Coalition FOR IMMEDIATE ACTION.
Congressmen Jim Langevin (D-RI) and Jim Ramstad (R-MN) are preparing to
introduce the "Medicare Independent Living Act" . This bill will eliminate
the Medicare restriction for "in the home" use that pertains to individuals
with long term mobility needs. 

 

As many of you are aware, this is an "outdated" restriction on the coverage
of mobility devices. In essence, if a person who has mobility problems can
move around their home without a mobility device, but requires the device to
go to work, school, or anywhere outside the home, this person is not
eligible for a mobility device through Medicare. 

 

In preparation for the introduction of this bill in a few weeks, the
Congressmen have circulated a letter to their colleagues requesting
cosponsorship of the measure. The ITEM Coalition is requesting that you
contact your Representative toll-free using the Capitol switchboard
(1.877.224.0041) and ask he/she to become an original cosponsor of the
Medicare Independent Living Act, a bipartisan piece of legislation designed
to remove Medicare's unfair restriction on "in the home" usage for mobility
devices. 

 

There have been many attempts at removing this restriction in the last
several years. To date none have been successful. You will recall the most
recent attempt last summer when CMS issued new regulations regarding the
procurement and reimbursement of mobility devices. Despite numerous comments
from individuals and organizations around the country recommending this
elimination, CMS chose to take no action in this matter and left the
restriction intact. 

 

If you have any further questions regarding this matter, please contact the
ITEM Coalition directly at 202.349.4260. Thanks.

 

This message, and any attachments, may contain confidential information and
is intended only for the individual(s) named. If you are not an intended
recipient you are not authorized to disseminate, distribute, or copy this
email. Please notify the sender immediately if you have received this email
by mistake and delete this email from your system. 

[QUAD-L] Medicare and Permobile

[Lori Michaelson]

 
My only insurance as Medicare and it paid for all of my Permobile [wait, back then I was able to afford a Medicare supplemental insurance policy and I think they had to cover the 20% that Medicare did not].  But Medicare was the primary payer.
 
Lori  
---Original Message---
 

From: [EMAIL PROTECTED]
Date: 8/21/2006 1:57:51 AM
To: [EMAIL PROTECTED]; quad-list@eskimo.com
Subject: Re: [QUAD-L] Chair back preferences
 
Hi Lori,I had an Everest and Jennings power wheelchair from 74-03, and I always had back neck and shoulder pain and I felt hunched over plus needing to be pulled up in my care, all the time, which I don't experience in my Permobile.  I seemed to fall over and much more, not staying straight.  I still have a world that is a problem because of my broken left leg.  That was not repaired because of osteoporosis and the hip disintegrated causing me to lean to the left.It was so interesting to hear that you had the same problems with your chair.
 
Has anyone ever gotten a Permoble from Medicare.  I just wondered what will happen when I go from the insurance to Medicare, when my stepmother retires, I have always wondered.
 
Thank God my insurance changed.
 
Dana.  . . . .
 

[QUAD-L] Medicare and at home IV antibiotics

[Lori Michaelson]

 My only insurance's Medicare and I had to have [well, it was the last  ditch effort to try to get rid of my dangerous Proteus bacteria] at-home IV antibiotics.
 
At that time, the Medicare Part D. Prescription Drug Plan had not yet gone into effect.  And Medicare did not cover any drug expenses whatsoever.  So that little 10 week stint cost us $850 out-of-pocket.  We paid $100 monthly and just finished paying it a couple of months ago.
 
Lori
---Original Message---
 

From: [EMAIL PROTECTED]
Date: 6/16/2006 11:34:31 PM
To: quad-list@eskimo.com; [EMAIL PROTECTED]
Subject: Re: [QUAD-L] uti
 
Hi Ray,
 
I'm sorry you can't get the IV at home and train your aid to do.  That's what they did when I had Pseudomonas of the lungs.  I guess it depends on the state and the insurance.  I was told I would have to go to nursing home , if I didn't have insurance, because it was three times a day , two different IV's.  The VNA showed by a panel, the medication was some company that deals with infusion therapy. My nurse told me once you have Pseudomonas, it gets colonized, and it will always show up although your symptoms are gone and you feel good.
I had to have two sets.  It was longer than a month.  Then another month of the same drug through my breathing treatment. Leviquin would not work.
 
Has anyone ever gotten IV's at home on Medicare.  I don't know what the new Medicare D will do, because my insurance is primary, Medicare D. is secondary, because my stepmom is still working.  It would be interesting to know.
I hope you feel better soon Ray. I know how it is a drag to be sick and dragging to the hospital every day.
 
I'm just getting over another bronchitis, and it took three antibiotics to get over and over six weeks.
 
Dana
 
correct me if I misunderstood Ray, but it sounds like you're going to the hospital as an outpatient to get the IV?  Sounds like a reasonable treatment to me.  So sorry you are so sick, you must be miserable. 

Peace,

River

On Jun 16, 2006, at 3:24 PM, David K. Kelmer wrote:

Hi Ray,
 
And doctors wonder why they get sued so much, and are disliked by most off their patients!
 
With Love,
CtrlAltDel aka DaveC4/5 Complete - 30 Years PostTexas, USA
[EMAIL PROTECTED] wrote:


Hi everybody, I know everyone gets tired of talking uti's I've done pretty good seeing I've only had a couple in the last couple yrs, anyway this one been hanging on for the last few months just recently got a new urolgist (my old one moved) I explained that oral antibiotics don't work with me but he put me on cipro and macrobid for 14 days twice a day, he had me change my cath half way through so he could check that was about five days after i started! finished today get home and his office had left a message tha! t the re sults show oral antibiotics won't work with this bug but that there is four iv ones that will and wants me to go to hospital to get 10 days of treatments about a hr a day his office said, i'm waiting for the hospital to call so i can schedule my question is dose this sound like standard procedure? Thx Ray c-5 c-6 AZ 5yrs post

Check out AOL.com today. Breaking news, video search, pictures, email and IM. All on demand. Always Free.=
 

Re: [QUAD-L] MEDICARE

[alanh77]

In <[EMAIL PROTECTED]>, on 02/22/06 
   at 08:20 PM, Dan <[EMAIL PROTECTED]> said:


>>How many of you are on Medicare and Medicaid?

>Both. Got on Medicare - SSDI - when my dad died. I was already on
>Medicaid.

Both.


Alan

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