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Essential Rehab Visit: But Not Covered!

As a normally moderately active, very positive, below the knee amputee living alone, I recently ran into a unique situation where I felt that an essential rehab visit was in order, but was simply not covered by Medicare nor my supplemental insurance plans. Let me explain: In January 2018 I was diagnosed with severe carpal tunnel syndrome in both of my hands largely in part due to the use of the hand rests on my wheelchair needed while around the house. I went for the CT release surgery on my non dominant hand and exited the hospital with a bandaged hand the size of my head. That means now I am without my right leg AND my left hand. Mathematically I am now half of a person and unable to perform regular daily activities. The only provision from my insurance coverage is that a personal care assistant would visit the house a few hours per day for a few days a week, but what about the midnight bathroom trips and simply trying to apply and remove my prosthesis? I asked about entering a rehab facility temporarily until I am able to function on my own at home and was told by the hospital case worker it was going to cost $200-$350 per day out of my own pocket because it was not covered by my insurance company. “Are there no exceptions” I asked? Of course the answer was “no”! Surely this can’t be the first time this situation has arisen, can it? Regardless, the months of February and March were a complete disaster. I tried to manage alone, and still needed to pay $250 per trip for special transportation each time I went for a follow up doctor visit because I needed to use the wheelchair in order to attend. Needless to say, I will not be having the medically necessary surgery on the other hand because I know now that I cannot manage. I just wish to bring this to the attention of the persons that devise and revise the Medicare guidelines and that sometimes those “one time” hidden challenges do exist for us disabled persons barely surviving on a fixed income. I am not seeking sympathy just a reconsideration of the antiquated Medicare rules written for people with all of their limbs and have access to help from friends and family members. Thank you for listening, understanding, and relating to a fellow Amputee Coalition member.

Passing along some advice that I learned is to be well prepared in advance because the reason I missed out of the medical transportation provided by the county in which I live was because it needed to be arranged prior to the doctor appointment dates.