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limiting healthcare for seniors?

Posted by on May. 8, 2013 at 4:26 PM
  • 16 Replies

My father had a full knee replacement a couple weeks ago.  He is over the age of 70 so he is on medicare as his insurance wouldn't allow him to continue on once he qualified for medicare.  

He has been in physical therapy and was told he only has four more visits.  He asked if he could continue on and just pay for it himself.  He was told he cannot do so because he is on Medicare and it would be considered fraud.  

He was also told that he cannot go to another physical therapist and start up without presenting his medicare card as it would also be considered fraud.  

Does this sound correct?   


by on May. 8, 2013 at 4:26 PM
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Replies (1-10):
Peanutx3
by on May. 8, 2013 at 4:27 PM

Hmmmm I don't know but I would certainly hope it is not correct.

katy_kay08
by on May. 8, 2013 at 4:29 PM

the therapist told him that medicare holds so much power that providers are really limited.  

Quoting Peanutx3:

Hmmmm I don't know but I would certainly hope it is not correct.


Healthystart30
by Silver Member on May. 8, 2013 at 4:32 PM
If this is true that's just ridiculous! Why would we ever want to deny people wanting to pay for their care?
momtoscott
by Platinum Member on May. 8, 2013 at 4:42 PM

I wouldn't be surprised if it turns out to be the way things work, unfortunately.  The system is super fucked up.  

Has his provider tried an appeal letter?      

Peanutx3
by on May. 8, 2013 at 4:42 PM

What I don't get though is if your dad wants to pay cash how can medicare stop him or stop the provider from offering services for cash.

Quoting katy_kay08:

the therapist told him that medicare holds so much power that providers are really limited.  

Quoting Peanutx3:

Hmmmm I don't know but I would certainly hope it is not correct.




katy_kay08
by on May. 8, 2013 at 4:45 PM

Thankfully he s doing really well. I think he just wanted the help as he doesn't want to plateau in his recovery, but he has been off his cane for  at least a week and it has been less than a month since the surgery.  

Quoting momtoscott:

I wouldn't be surprised if it turns out to be the way things work, unfortunately.  The system is super fucked up.  

Has his provider tried an appeal letter?      


UpSheRises
by Platinum Member on May. 8, 2013 at 4:49 PM
No. He doesnt have to use his insurance if he doesnt want to. They must have not understood what he was asking.
illogicalkat
by Bronze Member on May. 8, 2013 at 4:52 PM

I think this is a case of the physical therapist not wanting to do more work, and/or expecting that your dad doesn't have the money to pay out-of-pocket.

jessilin0113
by Platinum Member on May. 8, 2013 at 4:54 PM
It's not true. There are several things that medicare will not pay for that patients can pay out of their own pocket. The therapy place was wrong.
katy_kay08
by on May. 8, 2013 at 4:54 PM

I think there may be something in their contract as a Medicare provider.  This may not be the case with a non Medicare provider.    

Quoting illogicalkat:

I think this is a case of the physical therapist not wanting to do more work, and/or expecting that your dad doesn't have the money to pay out-of-pocket.


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