Buckhorn
Senior member
- Joined
- Jan 3, 2016
- Messages
- 730
- Reason
- Lost a loved one
- Diagnosis
- 12/2015
- Country
- US
- State
- PA
- City
- Small town
I hate to bother people with what I am sure is a question that is asked often. However, I have "googled" and used the search function on this forum but I am not having great success with this. I am looking for a web-site (hopefully more concise than Medicare's own site) which will enlighten me, and others, as to what Medicare will pay for and when. I do have some idea...... For instance, I think Medicare only pays for a PWC every (5?) years. Or, maybe they only pay for one w/c period, so it is best to purchase the manual / push w/c outright, reserving Medicare payment for the more expensive w/c. It has been my experience that MC will only pay for a cane or a walker, so of course, purchase the cane outright. If I am wrong about this, well then I will appreciate your input. I have read many posts on this forum, including all the stickies. These have been VERY helpful. I have been especially thankful for Tillie's sticky on anticipatory planning. I whole heartedly agree with her post, but I am not sure when Medicare will pay for DME that I am fairly certain we will need.
I realize that there is no "one size fits all" reimbursement system with Medicare, and it depends upon whether a PAL has a managed care plan (like Humana, etc.) or just straight Medicare. For the record, my PAL has straight Medicare as primary and Blue Shield as his secondary insurance, and has had this in effect since he was 65. We are very fortunate (and thankful) to have such good coverage.
Our second ALS clinic appointment has not been scheduled yet, but is supposed to be later this month. I am sure that case management/social services and the clinic nurse will be able to provide more detailed information. However, the petition posted by rkn50a under the General Discussion tab (asking the CEO of the ALS assoc. to improve home care for PALS), sheds light upon some inadequacies regarding the education of some ALS clinic and chapter support personnel regarding coverage for DME for PALS.
Thank you!
I realize that there is no "one size fits all" reimbursement system with Medicare, and it depends upon whether a PAL has a managed care plan (like Humana, etc.) or just straight Medicare. For the record, my PAL has straight Medicare as primary and Blue Shield as his secondary insurance, and has had this in effect since he was 65. We are very fortunate (and thankful) to have such good coverage.
Our second ALS clinic appointment has not been scheduled yet, but is supposed to be later this month. I am sure that case management/social services and the clinic nurse will be able to provide more detailed information. However, the petition posted by rkn50a under the General Discussion tab (asking the CEO of the ALS assoc. to improve home care for PALS), sheds light upon some inadequacies regarding the education of some ALS clinic and chapter support personnel regarding coverage for DME for PALS.
Thank you!