Medicare death panel

Been some time from my last post. Still hanging in there.

Couple weeks ago, my transplant team wanted me back on dubutamine 24/7. Said fine, I need the boost. They had to put a new Hickman line in. OK, sure it's going to hurt a couple days, no problem. That will wash out once I get back on the dubutamine 24/7. So, they put it in. Next was that they wanted me to stay overnight in the hospital. OK, no problem. Then all at once, they come up with something out the blue that Medicare requires that I go thru two right heart caths. One before the dubutamine and one on the dubutamine. One night over stay turns into three. Now comes the kicker. For Medicare to pay for the dubutamine for me for 24/7, I have to have a 20% heart improvement. Well, with a EF of10 and a right heart cath pressure of 1.2 off dubutamine, I came up short of less then.02 of a percent. Even though everything else started to work better, Medicare is refusing to pay for the Dobutamine. Even with a 19.8 % improvement. But yet, they are paying for a weekly infusion of dubutamine for me at the local hospital which cost even more then if I were on it 24/7 at home.

Of course my transplant team tried there best. I even tried to contact Medicare. What a joke. Never could get thru even after waiting on hold for up to a hour.

At this point, I'm about to throw in the towel. Feeling like a yo yo from day to day is taking it toll on me and my family. I have excepted the fact things will not get any better.

God bless all, Paul

5 Comments

Hi Paul

by Grateful Heart - 2015-04-29 04:04:57


It's good to hear from you. You have come so far, don't give up please.

If you can't make contact with Medicare, contact your local Senator or Congressman....that is what they are there for....We, the people!! Explain your situation to them just as you have here. They can cut through the bureaucratic red tape in emergency or hardship situations. This certainly qualifies.

You are improving! It's scary that some people can not use common sense since you are only .02% short of the requirement and approve this for you.

Good luck and God bless you and your family.

Grateful Heart

Call again

by doublehorn48 - 2015-04-29 07:04:49

All insurance companies deny claims. You would think medicare would be better, but your post proves that wrong.

Last week my insurance company rejected several procedures that I had, said they hadn't been approved. My great wife called them on the phone and stayed on hold for eons, but she finally got through. They finally agreed to pay for the procedures.

My advice is to call them back and don't give up until you talk to someone. The advice from the other comment is good. If you don't do something those people certainly aren't going to do the right thing.

Be a pest, and good luck

Hi Paul

by jeanlancour - 2015-04-30 11:04:44

Great to see your post, sad to hear Medicare is giving you fits. Not a reason to give up, time to give them fits. As Greateful Heart advised call your Senator and Crongressman and have friends and family call them too.If you have a supplement Ins get them involved. You are very important to a whole lot of people, and you have a whole lot of people who want you around---use them! Your transplant team has not given up on you Paul. so keep putting one foot ahead of the other and keep on keeping on.I just spent a year fighting for a prosceedure I needed to stop the pain that kept me from walking, I'm walking again maybe not to far at a time, but walking. Every single day you and your family are in my prayers remember God knows your there and he hasn't given up on you. Must be something important in you. God Bless Jean

Hi Paul

by jane32 - 2015-05-02 08:05:05

So good to hear from you again, I was getting worried about you. Sorry that you are having trouble with Medicare, have you got someone that can fight for you, you don't need to be using energy to fight for your rights when you are so unwell. Love to you and your family.

Jane

Hi Paul

by Pookie - 2015-05-04 11:05:00

Hi Paul,

I was just thinking of you last week when I visited this site. Seriously I was!!! I don't come online much any more and when I didn't see any posts from you I was concerned.

Paul, you have come SO far and have oodles of people who care about you, so please don't throw in the towel. I know you have been to hell and back, but you do have it in you to fight this fight!!!!!

Perhaps, like the post above mine, it is time to find someone willing to be your advocate because I can just imagine how exhausting it is to deal with Medicare.

I don't know all the answers, I just know that you are on this earth for a reason and although as frustrated and exhausted as you probably are, your loved ones need you. I just wish I could help in some way.

Pookie

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