Blood Transfusion options in New Jersey with medicare advantage plan

[John Galt III]

My mom is 100 years old and has bladder cancer. She already needed one transfusion, due to bleeding from her bladder gradually lowering her hemoglobin to 5.0. The Assisted Living (where Mom stays) nurse said she could only get a transfusion in a hospital. I took her to the hospital and she got one pint of blood, which increased her hemoglobin to 7.7, and they said that was good enough, and sent her home. I browsed the internet and it says transfusions can be done anywhere, by a nurse. In your home, in a doctor's office, etc. Again, the state is NJ. Mom has a medicare advantage health insurance plan. I know i can just call her insurance and ask, but that is always so unpredictable, unfortunately. One clerk says one thing, another clerk say something else. So I'm asking here for any input, suggestions, on the issue. I asked at the hospital if I could donate my own blood to Mom and they said no, and no other place would allow it either. They said I could donate blood but it would just go into the general pool. Another concern is the insurance coverage, which seems to be a big mess of complexities. The medicare advantage plan denied the hospital's claim for admitting Mom. They insisted on admitting her, to do a transfusion. Ironically, I think the denial may be a good thing because the denial letter also stated that the hospital was not allowed to bill her for the transfusion, even though denied. One day of being admitted would be $360, so the $100 ER copay is cheaper. I'm not assuming anything at this point, though. It would be good to just take Mom to a doctor's office now and then for a transfusion, and have it covered, at least partially, no anxiety about cost. Am I on the right path, looking for a non hospital place to get transfusions? Anybodu have any experience with this? Any input appreciated. Thanks.

 

[Sunset]

No idea, wish you the best, It's a lot of work to help. Thank goodness you are there for her.

 

[joesxm3]

I took my mom to a hemotologist and went to an infusion center where they gave a transfusion in an afternoon. This was not NJ and mom was able to come in with wheel chair and walker.

The infusion center seems to do chemotherapy etc. There was one in the main hospital but the remote site had better parking.

Maybe they worry about your mom being too frail.

 

[target2019]

Can you take her to the infusion center where she has had treatment? That's what I do.

 

[TN Jim]

Access to the unit of blood, maybe part of the issue. I doubt any doctor office has the means to store and process (paperwork) to infuse blood. I worked in anesthesia for over 35 years, infusing blood to a patient is check and double check. along with paper trail from donation to transfusion.

 

[Irishgirlyc58]

My mom is 93 and a few months ago she had a blood test and when the doctor got the results her hemoglobin was “dangerously” low and said she needed to go to the ER stat. So we went to the ER and we were there for 9 hours. Just what a 93 year old needs to do. They did give her a transfusion without admitting her after a lot of back and forth between different doctors.
What a nightmare.
I researched the next day and I came up with that it can’t be done at home, the patient needs to be hooked up to monitors. Your blood pressure can spike really high when getting a transfusion according to the nurses in the ER.

Asked her doctors office what the alternative was to get a transfusion if needed again- her response was go to the ER. That’s the best that they can do. ��

It happened again but I think my mom called an ambulance- my sister met her at the ER. She said that was easier because she could lay on a bed instead of sit in a hard chair.

We are in California but in a small town. However we are only 45 minutes away from a bigger city and 2 hours from S.F. It would be quicker to drive her there and get treated.

What a mess it is in lower served areas. My mom’s answer is to not get tested and just call 911 if she needs to.

 

[John Galt III]

Thanks for the replies. She had her latest blood test today and her hemoglobin was 6.1. She feels fine. The doctor's office recommended she get a transfusion. Mom does not want a transfusion because she feels fine, and has energy. Last time it was 5.0, and she was alert, and a little tired. Maybe the doctor will let us go another month and do another test before another transfusion. Her urologist said she 'tolerates anemia well'.

 

[youbet]

^^^^

Have they tracked down the cause of the anemia?

 

[John Galt III]

^^^^

Have they tracked down the cause of the anemia?

Yes. She has a tumor in her bladder, which is bleeding. Off and on. They won't remove the entire tumor because she is so old. They did a procedure six months ago, and cauterized the bleeding part of the tumor. That stopped the bleeding but just for for 2 months. The recovery from the procedure was grueling though, in the nursing home for 3 weeks, plus PT afterwards, catheters, etc. She doesn't even remember it, but I don't want her to go through that again, and neither do I.

 

[John Galt III]

Can you take her to the infusion center where she has had treatment? That's what I do.

They don't want to do chemo on her due to her age, so no infusions. No one has mentioned hospice care yet. But that could be coming soon. I think the insurance coverage increases when one is in hospice care.

 

[joesxm3]

They will not allow transfusions when on hospice.

 

[target2019]

They don't want to do chemo on her due to her age, so no infusions. No one has mentioned hospice care yet. But that could be coming soon. I think the insurance coverage increases when one is in hospice care.

She would get a transfusion at the center, not infusion.

 

[pacergal]

Blood transfusions need to be monitored well, reactions are unlikely, but some can be deadly. It is best to be in an environment where you can be monitored and your vital signs, etc checked.
I would always desire to be given a transfusion in a monitored, medical facility. But that is just me and my opinion.