ASKING MEDICARE A QUESTION CAN BE AN ORDEAL

I was helping a widow when I had a question for Medicare. Getting an answer was an adventure. Here is my adventure.

The widow’s husband was transported by an ambulance service from a hospital in Indiana to a hospice in Indiana before he passed away.

The widow got a bill for this service. I checked and learned that the deceased husband’s Medicare supplement insurance company never got a claim from Medicare for the ambulance service. The insurance company was willing to pay on the claim if Medicare approved it.

A few months ago, I wrote a letter to the ambulance company requesting that it file the claim with Medicare. The ambulance company never responded except to send another bill to the widow. I phoned the ambulance company and asked why it had not filed a claim with Medicare. The representative said that it never files a claim when the service is just “wheel chair transport” because Medicare won’t pay for that.

I phoned Medicare’s Coordinator of Benefits to ask if the ambulance company’s claim was true. First, I got a recording of Mike that told me that he would not take calls directly and that everyone who wanted to talk to him had to first talk to Charlene. Then, I got a recording that Charlene would not answer her phone and that I should leave a message. So, after leaving a message for Charlene, I phoned again and was directed to Marlene, but Marlene said that she was absent from the office and that I should leave a message or dial the operator. I dialed the operator and waited a long time. Finally, an operator who did not speak English well answered. Her accent was so thick that trying to talk to her was frustrating. But, I did get directed to Cathy who did help me. She checked on my question and phoned me a bit later with an answer.

Well, it was an answer of sorts. If the ambulance ride is not an emergency, then Medicare will not usually pay for it. But, the federal government’s “Medicare And You” handbook has some “doublespeak” in it about how Medicare might cover it if a doctor’s notes justify a medical need for the wheel chair transport ride.

The Medicare bureaucrat with whom I spoke was nice and helpful. But, I had to respond to this information by saying, ”So, Medicare will pay on the hospital charges and the nursing home or hospice charges, but not on the wheel chair transport that gets the patient from one place to another? Why? Does Medicare want the little wife of the man to throw him in the back of a pickup truck to get him from one point to another? How is the sick man’s little wife going to throw him and the wheel chair in the back of the truck?” I didn’t get an answer.

To me, this rule of Medicare is absolutely ridiculous. But, all this does help me to make an important point. Don’t trust the federal government to run the nation’s health care system in a rationally human way. The federal government and its bureaucracy only pretend to help the people to justify their paychecks. All the rules and regulations get stacked against the people and for the federal government to save money for itself by shifting costs back onto the public which it pretends to serve.

Well, now I know to tell the widow that the ambulance bill is hers and that Medicare won’t help her to pay for it. Case closed.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana. That is one of the largest senior citizen oriented insurance agencies in the Midwest.

© 2009 Woodrow Wilcox

www.WoodrowWilcox.com