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  • Now What?

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Thread: Now What?

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  1. 12-02-2014, 03:38 AM #1
    dyin_myelin
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    dyin_myelin is offline Registered Member
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    Unhappy Now What?

    I have approval letter from my insurance company, prescription from my doctor, and endorsement from a recreational therapist. I am trying to get a home health aide. This is all I need. My insurance company will only bundle that with a PT or a nurse. I said PT but reiterated that I didn't need this service. I contacted the approved agency and a PT named Pat called me. She said that since I worked outside of the home it would be insurance fraud if she came out and she wouldn't do it. I could really use the HHA, what's the next step, or am I out of luck?
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  2. 12-02-2014, 05:30 AM #2
    Marco
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    Marco is online now Volunteer Attorney
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    I believe outpatient therapy is your next step.
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  3. 12-02-2014, 03:11 PM #3
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    SNOOPY
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    SNOOPY is offline Registered Member
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    Hi dyin_myelin,

    The only time insurance covered any type of home care for me was when I broke my ankle and was non-weight bearing for 7 weeks (being able to walk took longer).

    Insurance covered a PT coming into my home shortly before my surgery and there after for twice a week. After a little over 2 months, when I was able to walk and drive insurance no longer covered my in home PT.
    Diagnosed 1984
    “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic
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  4. 12-02-2014, 11:27 PM #4
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    Kimba22
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    Medicare should pay for therapy services to maintain your condition and prevent you from getting worse as long as these services require the skill or supervision of a licensed therapist, regardless of your potential to improve.
    http://www.medicareinteractive.org/p...t&script_id=69

    I also wanted to clarify this only applies to Medicare, not private insurance. http://www.medicareadvocacy.org/medi...ment-standard/

    But, as wonderful as this all sounds, there are still episode caps that limit these services for anyone who has a chronic condition, like MS. http://www.medicareadvocacy.org/caut...-payment-caps/

    No matter what, it seems like we can't win.
    Kimba
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  5. 01-17-2015, 04:09 AM #5
    aitch10
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    Quote Originally Posted by Marco View Post
    I believe outpatient therapy is your next step.
    This. Why does PT have to be at home?
    Aitch - Writer, historian, wondermom. First symptoms in my teens, DX'd in my twenties, disabled in my thirties. Still the luckiest girl in the world.
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