VENTING ABOUT MEDICARE
- •When I became disabled and could no longer work I applied for Social Security Disability and was approved in just 6 weeks.I was too young for Medicare so I had to pay for health insurance from my job at a higher rate than when I was employed, but at least I could keep my insurance under the Cobra laws.
- •When the 18-months of guaranteed eligibility under Cobra were up, I applied for and received a one-year extension.I was still paying very high rates but again, I need insurance.
- •Then I got a Medicare Part A and Part B card in the mail and learned that after 24 months on SSD you are eligible for Medicare regardless of age.I was thrilled- no more payments for Cobra coverage.
- •Then I found out how unwelcome Medicare patients are in physician practices because they have the lowest reimbursement rates.It became apparent when my spine surgeon, who was managing my pain medication, had a heart attack and stopped practicing. I couldn't find a pain specialist in the entire Denver Metro area who accepted Medicare. I had to rapidly decrease my dose, resulting in horrific withdrawal symptoms, so I could meet the required standards for my primary care doc to manage my pain meds.
- •Then I learned Medicare wouldn't pay for my oxygen at night because I had sleep apnea. If you have sleep apnea, you have to be on CPAP or they won't pay for oxygen.I had multiple sleep studies and trials with various CPAP devices but all of them triggered excessive coughing. Despite this being documented, no CPAP, no oxygen.So we had to buy a full-size oxygen concentrator and a portable one with our already limited income.
- •Recently I was diagnosed with cognitive dysfunction related to all the narcotics I have taken for pain in the last three years. I need cognitive therapy from a speech therapist and Medicare will pay for it. I also need cognitive behavioral therapy( CBT) and Medicare will only pay for that if provided by a psychiatrist or clinical psychologist.Guess what? Not one of the therapists in the Denver Metro area who are trained in CBT are covered. There are only about 20 of them who provide CBT. Of these, none are psychiatrists or clinical psychologists. They are therapists, counselors, and psychologists but those are not covered.
- •The neuropsychologists who evaluated my cognitive function said I only need short-term CBT (3-6 months) to help me learn skills to cope with cognitive losses. The speech therapist does the cognitive rehab and the psych person helps you learn to cope with it and manage the grief that is normal when you find out you have brain dysfunction.These therapists charge $120-$140 per session. Weekly sessions for 3 months would cost $1320-$1680 and more of course if 3 months is insufficient.
- •It's just very frustrating.
- •Fortunately I have a lot to be grateful for. So I think I will write a gratitude list and then I will feel better. Thank you for listening.