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Old 02-25-2009, 10:25 PM   #21
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You sound so very angry. It's important to advocate for your mother's care, but it might serve both of you better if you can get past your anger. My mother is sinking into dementia and sometimes I find myself feeling anger at her doctor even though he is the most wonderful caring person and an excellent doctor. I think my anger is really my sadness at what is happening to my mother. We are powerless to stop the decline of our parents and it is natural to want to find someone to blame for what is just the cycle of life.
Sorry about your mom, it is painful, no one is to blame and your anger is only natural. Not getting angry is even worse, it goes inside of you.

My mom fortunately had a good outcome because I became more aggressive to get her shock treatment, which I knew was the only and last way to get her out of her funk. The staff at this particular facility sat on their hands and let the meter run.

Perhaps I'm angry because I'm criticized over some bills I just don't want to pay. It's the attack, and the righteous attitudes that get me. And no, I paid my way all of my life, am not one of those who blame the government nor stand on line for bailout, and yes, there are people here who did financial planning to screw the government. It goes on all the time. There are no angels here, believe me.

I guess I'm seeing a system with eyes wide open. I'm confronting a system, not angry at the doctors, just watching who is naughty and who is nice. Some of my mom's doctors are nice, her therapists are great, but some handling her case were full of misinformation leading me to almost make bad decisions, so I learned to take care of myself. Some of the facilities they recommended to me for aftercare were horrible. I did research and found her a nice place at the same cost as a dive. I later found out there are kickbacks involved in placing the sick and elderly in group homes run by questionable people.

When you are issued a bill, for something medical, that you believe is questionable and there is no recourse for discussion, then what do you do? It's not that I'm not gratefull, it's that I feel like a sucker paying some of these bills, like I've been had.

Being ill puts you at a disadvantage, and precludes you from dealing with all the different financial facets which takes many months to sort out. Only after the fact can you sit back and let the fog of war clear to see what went on. You see the good, and the bad. Each day is a fight for clear information.

I can pay the bill in full tomorrow, but I have the sense that I've been taken. Some doctors love their patients at all costs, but there are some who come to hospital to "clock in, poke around" fill out the paper and go home to rest up for the next day on the gravy train. You just have to sort out who is who.

It's like anything else, if more people would question the systems they get hauled into, then perhaps change would come, but I won't hold my breath.

jug
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Old 02-25-2009, 10:49 PM   #22
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It's the attack, and the righteous attitudes that get me.

jug
Well jug, if your first post had opened with something like:

" Hey, my Mom isn't getting the treatment from the hospital and Doctors that I think she should, anyone have advice on how to deal with this?" ,

you very likely would have got a much different response. I've found many people here to be very helpful and very knowledgeable.

But that is NOT how your posts came across. It looked like you wanted to evade paying the bills, asking how aggressive they pursue collections and such, even though she is now "healthy and stable". Then you claim others do it, only later do you start up with the "well, they don't deserve the money anyhow" lines. Looks like rationalization.

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There are no angels here, believe me.
So why are you here asking advice if no one here is any good?

Get over your anger, get some help if you need it, take care of your Mom, and pay those bills.

< and pay no attention to that angel behind the curtain.


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Old 02-26-2009, 12:47 AM   #23
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Perhaps I'm angry because I'm criticized over some bills I just don't want to pay. It's the attack, and the righteous attitudes that get me. And no, I paid my way all of my life, am not one of those who blame the government nor stand on line for bailout, and yes, there are people here who did financial planning to screw the government. It goes on all the time. There are no angels here, believe me.
That's pretty damned judgemental, without anything to back it up other than your anger and cheapness. If you had paid your way all your life we wouldn't even be having this conversation. And if by saying "there are people here who did financial planning to screw the government" you are talking about tax planning, that's ridiculous. What did you do, pay more taxes than you owed in an effort to not "screw the government"? The tax code is the law, and following the law is our responsibility.

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I'm seeing a system with eyes wide open. I'm confronting a system, not angry at the doctors, just watching who is naughty and who is nice. Some of my mom's doctors are nice, her therapists are great, but some handling her case were full of misinformation leading me to almost make bad decisions, so I learned to take care of myself. Some of the facilities they recommended to me for aftercare were horrible. I did research and found her a nice place at the same cost as a dive. I later found out there are kickbacks involved in placing the sick and elderly in group homes run by questionable people.
There are good and bad people in any field/business. I don't see that as an acceptable reason to break the contract you have, to pay for services rendered. As far as doing research to find better alternatives than the ones recommended to you, that is your privilege and responsbility. Once you have agreed to the service, you must pay up, or you are a deadbeat and in the same class as those you are complaining about.

I find your attitude incredibly childish and irresponsible, and your attacks on the people who responded politely and reasonably to your questions are reprehensible. Off to the ignore pile with you.
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Old 02-27-2009, 07:12 AM   #24
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I recommend you get them to sign up and pay for a medigap insurance plan. This will prevent such large bills in the future.
Yeah, that was a problem. Before they put themselves in my care, I tried to speak with my father about insurance. He is very stubborn, wants no advice. I knew a medigap policy was in order years ago, especially with my moms fragile mental health issues. But he will not hear.

So they moved out here by me, and threw the whole shabang to their care my way.

To be honest, this past year in and out of hospitals, mental wards, shock treatment, nursing homes, assisted living (mom got kicked out of one already) has made me like a deer looking at the headlights. My FIL, 95 years old, broke his pelvis to boot, so I take care of his affairs. My dad so far does not go to doctors and is mean and nasty, stinks of urine all the time, and is just plain nuts like a homeless person. I have to wear a mask and gloves when I visit his apartment.

Oh, the nursing home lost my FIL's teeth, they play like they know nothing. They send me from person to person, office to office. They only acted when I shorted them the cost of new teeth on the monthly rent I send to the nursing home. It's like a game I'm playing here.

So I'm numb, dealing with the system is a crock, inaccurate information, so it's everyman for himself out there.

I don't even justify being a so called deadbeat when it comes to some bills, it's just my way with dealing with an inept and corrupt system. Every elder lawyer and financial planner knows how to get the government to pay for elder care and conserve some wealth, why am I different. If they were so "righteous" then the right thing to do would be to tell their clients that the government should not be responsible for your parents long term care until they are "really" spent down.

Two people I try to stay away from, lawyers and financial planners. They should all be sent to Mexico in exchange for people who do productive work.

jug
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Old 02-27-2009, 08:03 AM   #25
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Great attitude. That'll get you real far. Yep, everybody else is guilty so so it's OK. I can justify anything with that line (but nothing really).

Shouldn't you be in DC getting in line for bailout dollars?

Listen, if you have a problem with the care your Mom got, take it up through the proper channels. Just withholding pay because you suspect you got screwed it not right.

-ERD50
Ha, proper channels, been there, done that. The channels when in the fog of the elder care tango are all clogged up, unhearing, uncaring, and very illogical. From my experience, there is an epidemic of deafness in the corporate world, so they make you do the bureaucratic shuffle. I'm sick of learning new dances, so I let them do some shuffling.

They only react when the check doesn't come in, then the channels surprisingly clear up and the dancing stops. Of course they go on to next sucker and dance with him/her.

jug

Stonewalling is the favorite game of proper channels, most consumers have experienced this many times. Consumers also have the option of stonewalling.
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Old 02-27-2009, 09:13 AM   #26
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To be honest, they were a "step and fetchit" team. They only moved their asses when I came to visit. The hospital was basically a place to park her.
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As for the staff, they get paid anyhow, some were good, some not, but I had the feeling they weren't really trying so hard, just sort of going through the motions and letting the bill tally up, so yes, perhaps I'm a bit pissed.
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So I trust no one. This is basically a system I'm dealing with, so sometimes you have to learn to play along with the game, or the curve balls. So I do not apologize for my behavior.
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If the medical care is good, then I pay, if not, or if you play games with me, then I play back. There is much crap going on in this field, much fraud. Once you deal with elderly parents, and I have three of them, you have to be tough in order not to get screwed.
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I don't even justify being a so called deadbeat when it comes to some bills, it's just my way with dealing with an inept and corrupt system. Every elder lawyer and financial planner knows how to get the government to pay for elder care and conserve some wealth, why am I different. If they were so "righteous" then the right thing to do would be to tell their clients that the government should not be responsible for your parents long term care until they are "really" spent down.
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Two people I try to stay away from, lawyers and financial planners. They should all be sent to Mexico in exchange for people who do productive work.
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Ha, proper channels, been there, done that. The channels when in the fog of the elder care tango are all clogged up, unhearing, uncaring, and very illogical. From my experience, there is an epidemic of deafness in the corporate world, so they make you do the bureaucratic shuffle. I'm sick of learning new dances, so I let them do some shuffling.
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I can pay the bill in full tomorrow, but I have the sense that I've been taken. Some doctors love their patients at all costs, but there are some who come to hospital to "clock in, poke around" fill out the paper and go home to rest up for the next day on the gravy train. You just have to sort out who is who.
So, to sum up, you don’t like Doctors, hospitals, Lawyers, financial planners, nursing homes or their staff, social workers, the corporations or government bureaucrats. You do, however, appear to like Mexicans. You want people to provide you with services because they want to, not just because they “clock in” every day. Otherwise they are on a gravy train. You don’t pay for services you’ve received when you don’t like the attitudes of the service providers. You can pay but don’t, but you’re not a deadbeat.

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Perhaps I'm angry because I'm criticized over some bills I just don't want to pay. It's the attack, and the righteous attitudes that get me.
Clearly your indignation is well founded. Righteous attitudes are like that.

Ever thought about moving? Montana, Wyoming, or SW Ohio. Lots of similar-thinking folk. One novel thought - try Mexico. You seem to like Mexicans. You’ll find lots of what you’re looking for there. Not much of a gravy train. No medicare issues to deal with. No nursing homes to get your undies in a bunch over. Lawyers, financial planners – way less. Government trying to tell you how to live your life – not gonna happen. Hospital bills are much lower. One drawback – they take bill paying a bit more seriously there. Don’t pay your hospital bill and you soon be a new patient.

Anyway, good luck next time you or your parents need medical care.

note - edited to include social workers
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Old 02-27-2009, 09:43 AM   #27
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Two people I try to stay away from, lawyers and financial planners. They should all be sent to Mexico in exchange for people who do productive work.

jug
I love you too!

With regard to issues concerning your mother's care, did you talk to the patient ombudsman at the hospital?
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Old 02-27-2009, 09:55 AM   #28
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Seems to me that if you agreed to take care of your parent's finances, then you either negotiate with the hospital, or you pay the bill. You don't ignore it, any more than you would ignore your own bills.
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Old 02-27-2009, 10:05 AM   #29
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I love you too!

With regard to issues concerning your mother's care, did you talk to the patient ombudsman at the hospital?
All they had at this mental facility was a social worker. She was ok, but when it came to getting aggressive with her treatment, I had to take over and push the ticket with the staff to act. She didn't know that much and I had to do most of the grunt work to get the treatment (shock), and to get her set up in a decent after care facility.

The one the social worker had tried to arrange was attrocious and she was getting a kickback from this shady facilty. The social worker was a bit pissed when I found a better facility on my own. But I don't blame her, that is just the way the system is. She makes an extra buck by steering the aftercare to certain small facilities. We are dealing with a system unique to each geographical location, you have to adapt to it and be realistic.


As for Mexicans, yes I do like them. They do work for me, and damn good work. They don't fart around when you hire them to do odd jobs, they are competent, are productive. Every house built in Nevada lately was put up by them. They are not afraid of hard work and they give good value for the money. Many white folk in Nevada complain about the mexicans, but I tell them, if they were to disappear tomorrow, who would wipe your butt when you get old?

What's wrong with liking mexicans? They give more to this country than freakin lawyers and financial horsethieves any day. As a matter of fact, I've always enjoyed the company of foreigners, I've always gotten along with foreign born, legal and illegal, they were the only people who never called me a Jew bastard.

jug


In the major hospitals my mother was in, they did have patient advocates, and they were pretty good.
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Old 02-27-2009, 10:17 AM   #30
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Apologies

My apologies to folks from Montana and Wyoming. It was mean spirited to call them out like that. SW Ohio - well, that's a different matter. But apologies to them as well.
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Old 02-27-2009, 10:22 AM   #31
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What's wrong with liking mexicans? They give more to this country than freakin lawyers and financial horsethieves any day.
Hey, you're the one that brought them up. True, they have given a lot. Especially Texas and Southern California. There have been times when I wished we could give them back, though.

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As a matter of fact, I've always enjoyed the company of foreigners, I've always gotten along with foreign born, legal and illegal, they were the only people who never called me a Jew bastard.
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Old 02-27-2009, 10:52 AM   #32
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Seems to me that if you agreed to take care of your parent's finances, then you either negotiate with the hospital, or you pay the bill. You don't ignore it, any more than you would ignore your own bills.
Take a look at my original post, I started to pay them, but they screwed that up and I just got disgusted and said the hell with it.

You pay in installments, they don't post, you call up, they know nothing, you ask "what did you do with my money", they don't know, but the check is cashed.

There comes a point where you just throw your hands up and walk away. They can disgust and exhaust you after a while. You pay them, they don't post the payments, they send you threatening letters, and you just say "screw it".

Systems such as that can drive you nuts, it can beat you down. It becomes a game.

See my original post from the beginning. So, if I can beat this, why not?
If people can do financial planning to scoop out their parents money in order to avoid paying for long term care, then why the hell am I being criticized so much.

I am by far no angel, but I admit it.

jug
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Old 02-27-2009, 12:08 PM   #33
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There are a lot of limitations on what one can do to financial plan to impoverish parents. Medicaid regulations are quite stringent and there is a five year look back period at transfers from the parents, from transfers to a trust to any other transfers. A number of estate planning attorneys who I know personally do not do planning with the goal of impoverishing parents so they are eligible for Medicaid some years down the road.
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Old 02-27-2009, 12:15 PM   #34
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Take a look at my original post, I started to pay them, but they screwed that up and I just got disgusted and said the hell with it...

jug
Got it. In that case, I say screw it.
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Old 02-27-2009, 12:23 PM   #35
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I had another thought which you might want to keep in mind. If I was hired to collect the bill I would learn that you were the one in charge of paying the bills, whether through a POA, guardianship, or otherwise. I would petition the court to have you discharged and a guardian appointed claiming that you are not fulfilling your duties to pay the bills.

If you believe that the provider did not provide adequate care I suggest that you address that directly and schedule a meeting with whoever is the patient's rights person at the provider. They should have someone in that role. If not, go to whoever is director of the facility. It may turn out that there were reasons for waiting after she refused meds, I have no idea.
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Old 02-27-2009, 12:42 PM   #36
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I had another thought which you might want to keep in mind. If I was hired to collect the bill I would learn that you were the one in charge of paying the bills, whether through a POA, guardianship, or otherwise. I would petition the court to have you discharged and a guardian appointed claiming that you are not fulfilling your duties to pay the bills.

If you believe that the provider did not provide adequate care I suggest that you address that directly and schedule a meeting with whoever is the patient's rights person at the provider. They should have someone in that role. If not, go to whoever is director of the facility. It may turn out that there were reasons for waiting after she refused meds, I have no idea.
A bill collector would never go that far, it is not their job to petition the court to relieve me as a POA. Actually, I've never seen it happen. Guardianships I guess can be revoked, but POA no.

In this particular case, once I get my bearings, I can negotiate a settlement with the creditor if I/they choose. Everything depends on the dollar amount of the debt and how far one wants to go.

As for the care, once she refused to take meds, you get on the case. They only moved when I came around and learned of the situation and started asking hard questions. Amazing how a crowd can suddenly form when you demand answers as to what they are doing. Not taking meds is dangerous, since my mom takes a bp med and without is the risk of stroke. This is what pissed me off also.

At another facility she was in, I wanted to speak with someone about her case when I came for visiting hours. The clerks said that the staff was out to lunch during visiting hours. I said that was ridiculous as there is no other opportunity for visitors to consult with staff, she said that is how it is. I got pissed off, didn't make any friends there, but got action. A staffer appeared annoyed but attended to my questioning. I know it sounds obsurd, and almost like I'm making this up, but I live in Las Vegas and anyone here who comes from somewhere else will tell you the medical care is "weird".

Never had this in NY. I was greatful for my medical care back there. But this place is touch and go and you have to play hardball with people, doctors, staff who you may find a bit out of reality with you. Most people just sit there and take it, but I've learned in life, when you believe you are getting screwed, you usually are.

So perhaps my hardass attitude is developed over the past few years of experiencing nonsense and finally not taking it any longer.

If more people were to bitch, complain, hold back payment, then perhaps adjustments would be made in the system. Just like our economic problems, if more people would get out and demonstrate their anger at the symbols of government, then perhaps we would get some decent results instead of the step and fetchit approach we are getting now.

I guess my posting is not making people happy, but what I'm trying to convey is that one has to learn to be a good consumer, and a good consumer sometimes may very well mean being a difficult consumer when the NORM gets out of kilter. Again, this ties in with our economic crisis, as the people simply sit back and let a bunch of amatuers posing as experts sort out what they created.

jug
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Old 02-27-2009, 01:08 PM   #37
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Don't assume that you know how far a bill collector might go.

Your complaint about the care is somewhat deflated by the fact that you haven't paid the bill and are waiting for them to take some action which will lead to a settlement. This makes it look like any complaint you have is just a way to get out of the bill. My impression of a number of people who bring up complaints about bills relating to services is often not positive. Some people seem to bring up every little thing as a way out of paying. Some people lie. Other people seem to view doctors and lawyers as guarantors of a good result. You may have this kind of general impression to overcome. I think that the right thing to do is to meet with them as I suggested above and talk about your concerns. I take it that you believe she was hospitalized longer than she should have been because of improper care. You need to find out what the provider has to say about that and if they have a satisfactory response you need to pay the bill in full. If not, work out an appropriate compromise.

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Old 02-27-2009, 02:03 PM   #38
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Jug, I sympathize with you.

I have luckily never had much to pay in the way of medical expenses. But it is frustrating trying to understand the billing and then figure out when they are overcharging or double billing you for something, since they are the medical experts and not you. Things like the 2 minute quick chart glance and then telling the patient "you will probably be discharged tomorrow". $150?!? times a couple days?? Hey, if the insurance pays it all, who cares, right?

My last doctor experience, which I haven't seen the bill or EOB for yet, was a physical which was on the checkout form and another code for an office visit of moderate complexity during the same visit. The separate charge for an office visit of moderate complexity was probably due to a 1-2 minute conversation I had with the doc regarding a commonly prescribed maintenance medication, which he also wrote a scrip for after the physical. Not sure yet how this will play out, but a primary and secondary insurance company is involved, with the secondary covering physicals in full, but not office visits. My crystal ball, though worthless for stock market predictions, reveals quite clearly a future full of four party conference calls between me, the medical provider and the two ins cos with all four parties refusing to have their financial interests cut short. In this war of attrition, someone will eventually break.

I think I know why docs are forced to bill the crap out of it and hope something sticks - insurance companies love to deny payment for anything the can and then some. Gotta love this pricing model.

So jug, I definitely feel your pain, particularly because the treatment and expense you are dealing with is of a much larger magnitude than my puny concerns.
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Old 02-27-2009, 09:49 PM   #39
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In sum, what happens happens. Just have to see how it plays out. I've always been a good payer, until I started with the medicare suffle and moved to Vegas.

Some lessons learned:

Don't pay so fast, let the dust settle and see what happens, especially when the bills overwhelm you.

If medicare age, stay away from HMO's, get a medigap policy and insure for the big stuff, pay out of pocket for the small stuff. Medicare is much less particular in paying for big ticket items such as hospitalization and physical/occupational therapies. HMO's simply discharge you as quick as they can and then dawdle when it comes to rehab.

If hit with big bills, negotiate them down, or a payment plan. Don't pay in full, you may actually end up overpaying in a panic.

Dealing with the elderly in rehab or nursing homes, come often, show your face, look around, let them know you are interested.

Do your own research about where they are sending family member for rehab or assisted living facilities, there are kickbacks from going on between the hospital staff and placement people for these facilities, check them out.

At this point in my neck of the woods, the assisted living places will compete for you dollar, this happened to me as the prices got lower, and these were nice homes.

"Dont let your emotions or what people tell you guide your actions, think it out, and then proceed.

jug
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Old 03-01-2009, 02:24 PM   #40
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Quoting jug:
"If medicare age, stay away from HMO's, get a medigap policy and insure for the big stuff, pay out of pocket for the small stuff. Medicare is much less particular in paying for big ticket items such as hospitalization and physical/occupational therapies. HMO's simply discharge you as quick as they can and then dawdle when it comes to rehab."

Just a quick reply to this. My mom has Humana which she selected when she got on Medicare. They have been good to her. I do not care for the delay in scheduled office visits sometime but my doctor has the same problem most of the time. She had a dissecting aortic aneurysm (inoperable) in 07, was in intensive care for 6 days and monitoring and rehab for 10 days....cost to her, $50. She went into the emergency room last month for chest pain. They quickly did a cat scan, EKG and ran blood work and ascertained there was no heart attack or worsening of her aneurysm. Because of her history they admitted her to the hospital for monitoring and observation and kept her 2 days....cost to her $50. She sees a cardiologist twice a year, has a cat scan every six months and sees her primary doc every 3 months. Her prescription cost are sky high and she has had no trouble with that either.
I have always had a prejudice against Humana because of horror stories passed on to me from acquaintances. Since my mom's case I have been considering choosing Humana as my provider when I reach Medicare age. This is not to say that they do not have problems, all our medical system seems somewhat flawed, but overall they seem to be doing a pretty good job.
Just my 2 cents worth,
2fer
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