Hospice and Trilogy

that's why I rarely say anything on these threads Mike - I thought there was a system I wasn't understanding, but no real system :shock::shock::shock::shock:

I feel like I'm starting to hijack here, so please go back to answering Drewsmom's original questions

Atsugi said:

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A year after Krissy died. I found a DME company on my national credit report. My credit rating was lowered, thus leading to denial of credit and high interest rates. I called the company and discovered that I was supposed to be paying monthly rental fees for a BiPap. I found the mask in a box in the garage and mailed it in with several hundred dollars--enough to pay for the thing!
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Many times I just gave up and paid cash to stop the frustration. ..................

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Yup, when I see a medical bill I just pay it. It is hard to believe, but on one occasion one of the DME vendors sent me a check because I had overpaid.

So, Tillie, when I talked about BiPAP and hospice, I meant care and feeding, not paying for it.

If the pt is still "renting" it from Medicare, one of the really stupid reasons many of us buy our machines secondhand, then whatever plan is doing that will continue while "hospice-only" bills could be paid by a different entity, because only fee-for-service Medicare reimburses hospices. So the hospice won't be out anything, just that it's not something they're as used to as, say, a feeding tube or oxygen.

But Medicare won't approve a new expensive "treatment machine" while on hospice, because you're supposed to be dying, though there are some pilots for "regular diagnoses" (ALS isn't one of them) that allow for continued "treatment" on hospice.

Don't even try to understand our unsystematic system.

Also know, that we didn't need ANY doctor to certify my Jesse for Hospice, the hospice doctor can do that. Second, you can go in and out of hospice to get Medicare provided equipment if needed, but it's good to get it BEFORE you enroll.

Hope it works for you.

Sherry

Okay so we found a company that was recommended by the ALS local chapter. They view the trilogy as a comfort measure, where the other companies view it as too aggressive. She did stipulate that this has been a recent change - like about 2 years.

lgelb - Pals has quite a bit of pain that I feel could be managed better with hospice. Some of it his his fault for not wanting an increase in pain medication for fear that he will be "out of it" all of the time. He already sleeps about 17 hours per day. Another thing that is appealing to me about hospice is that they come to you in a crisis. With 2 young children still at home, it's not easy to make a middle of the night emergency room trip, which is all home health will tell you to do. And they also provide grief counselling for the children, which mine desperately need more of.

I just saw this post and am starting to freak out a bit. Hospice just came in today for my dad. Their first recommendation was starting a small dose o morphine to help with his breathing. I know he is resistant to taking it although he is clearly struggling. Not sure how that will turn out.

In the meantime, got a message from my brother that they brought the Trilogy thing up and are checking on it's use. My father is going to it more and more and I know he couldn't be without it. They think their service will be considered palliative care and it should be ok. I really wish every step wasn't so complicated and confusing.

I've said it before but I'll say it again.
There is not a single thing on the planet more confusing than the American health system.

Drewsmum, I hope you are able to get things sorted.

Star, I agree about things not being so confusing. You have enough going on with out the added stress of navigating health care.

All the best to all.
God bless, Janelle x