Question

Hi,
I have a question my grandfather has been in the hospital for 3 months so far. They wanted to do a bypass out of the blue recently when that was brought to the table in the beginning.
We decided he would have a better chance of survival with the pacemaker. Now we are being told that Medicare has a waiting period of 3 months from some type of test. So we have one more month to go until he gets this pacemaker. I don't know if anyone out there ever experienced this before. i just don't understand how a Insurance can tell a patient who is very sick and has only been home for close to 2 weeks. They have been in the hospital so much and when they are released they are right back in for heart and lung issues. He needs this and they don't seem to care but only care about there rules and the cost. He seriously has Medicare and his Insurance from when he worked still. But Medicare is still holding off knowing that they would of approved a bypass surgery but not a less procedure like the pacemaker.

Please send me some advance. I don't know how to handle these Dr.'s they are making me so frustrated.

Aisha
Worried Grand Daughter

2 Comments

fixing what's wrong

by Tracey_E - 2015-09-16 01:09:15

Bypass and pacer fix two totally different things. The bypass is obviously the more serious surgery. Is he strong enough for it? It will clear the arteries and allow the blood to flow again. The pacer will increase a slow heart rate by signaling the heart to beat when it goes too slowly. The heart muscle has to respond to this signal by contracting. If the heart muscle is diseased, or if his arteries are clogged, the pacer can send signals all day long but the heart won't necessarily react to it. So, needing a pacer doesn't necessarily mean they should jump into giving it to him. If he is going to have a bypass, I can see why they'd want to wait on the pacer until after. The pacer leads go into the heart so it makes sense to not put them in until after the bypass. Or possibly do both at the same time.

If medicare doesn't approve it, private insurance will automatically deny it, that's the way they work. Insurance companies can be infuriating! I was responsible for my grandmother's health care choices the last few years of her life and I felt like banging my head on a wall more than once. When talking to the drs, try to have at least two family members present, and write down your questions. This is just a guess, but it sounds like what you are dealing with now might be more about what he is strong enough to handle rather than what the insurance companies will pay. Bypass is a major surgery with a long recovery. If the odds are making it through the surgery and recovering with a good quality of life are not good, it might make sense to wait and see if he can get stronger first.

IF doctors are a problem ...

by oldearthworm - 2015-09-16 12:09:33

And they are .., IMO. But, this is ONE TUFF assignment ..End of life is approaching .. easy to say .. this is something I could never do .. I think the doctors could show a lot more care and compassion ..I know, I am weak here as well ..
I believe that our medical care can be better after the profit, and insurance companies are removed . . But, there has to be rules and cost control , in my opinion .. , and I had a PM implanted at the age of 75 .. my heart is strong , the kidneys .. ?? so-so ........Doctors must learn that we are humans , NOT money bags ... The Medicare money bags feeling from being in the Holy Spirit hospital for 5 l o n g days...

You know you're wired when...

Your device acts like a police scanner.

Member Quotes

As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.