Wednesday, October 22, 2008

Logic? What Logic?

Dad's discharge has been delayed until Friday; his wound is oozing a little, evidently since he moved around too much yesterday, so he's currently pinned to his bed by a giant ice pack with orders not to move unless he's eating. If ice and pressure don't work, the doctor will give him an epinephrine injection. I never knew that stopped bleeding; I thought it just made people hyper. I hope he'll be able to move after he gets the shot, or else he'll really be antsy!

He's not enjoying this process. I wouldn't either.

Meanwhile, we're having tons of fun with health coverage. Dad has routinely gotten his care from the VA, but also has Medicare A. He dropped Medicare B (which is essentially outpatient stuff) years ago because the VA was providing those services.

However, since he just arrived in town, he can't receive any services from our local VA until he's gotten established with a primary-care doc, which means that he needs a new-patient appointment, which is currently scheduled for November 20. That's the earliest opening. I'm calling over there every day or two to see if there are any cancellations so he can get in sooner, but I fully understand how swamped they are.

This means that, for at least a month, we'll have to pay out-of-pocket for expenses Medicare B would ordinarily cover. Dad will need home oxygen and home health care after he's discharged. The social worker on his floor was pretty sure that A would cover oxygen, but not home health, which made sense to me. Breathing's more basic than having somebody come over to check your vitals, since if you can't breathe, there won't be any more vitals to check. (Dad quickly desats to 80% on room air, which is truly alarming.)

The social worker called this morning, after doing some research, and told me it's the exact opposite. The home health visits will be covered by Medicare A, but oxygen won't be.

Huh? Are they considering oxygen a prescription drug? I mean, it is, but does that mean that, say, insulin isn't covered by Medicare A either? I thought Medicare A might be just in-hospital stuff, but in that case, home health wouldn't be covered either. The social worker seemed as puzzled by all this as I was.

It's all very confusing. But the good news is that he'll be receiving both services, and that the oxygen (the price for which the social worker gave me) won't break the bank.

Have I mentioned lately that I love social workers? This woman's cheerfully willing to make all kinds of phone calls to make arrangements, whereas entirely too many of the other people we've been dealing with have a "don't ask me to step outside my own carefully circumscribed little box" attitude.

Yay, social workers!


  1. Wow, your comment page has changed. Hope I picked the right role.

    Susan, you sound very productive. Good job! I hope that things get established so that you don't have this much stress but I'm very glad that things are getting handled well and worked out to your satisfaction for your dad. Prayers continuing...they seem to be working. :)


  2. liz lasater11:33 AM

    Just a thought: I believe that Medicare part D (being all pharmacy and I thing durable medical equipment) should cover oxygen and insulin as well as test strips, lancets, meters, ect. I hope he gets better soon!

  3. Thanks, Liz! Wait -- there's a Medicare D? I thought it was just A and B!

  4. Liz Lasater6:44 PM

    Medicare part D just came out a few years ago after decades of complaints that Medicare only covered in-house meds for hospital patients and not outpatient care.


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