Hi Everyone,
Hope everyone is doin good this cold November morning. I'm a little frustrated and almost to the point of just sayin heck with everything and just hobble around the rest of my life (yeah I know that is really not an option, but that is how i feel right now). My seating appointment went ok on Tuesday. They did all their tests and they confirmed what all the doctors have been telling me. BUT here is the thing. The chair they say that I NEED I cannot get. Why??? Cause they said that insurance and Medicare will not approve at all. Yes my jaw dropped also. I said "so you mean to tell me that this is the chair that would allow me to do everything that I need and want without having to find to many workarounds......but I'm not allowed to have it.....why wont they approve?" Their answer "your age. That is the only reason they will not approve." SAY WHAT???????? Ok what does my age have to do with the price of tea in China?? Just because I am 35.....my age doesnt change the diagnosis, my age has nothing to do with anything in this. They said they know, but it is what it is and they cannot change it. So they picked out one that comes the closest they can. Even with this said, they said that even the one that they picked that had the bare minimum of what I need we will still have to FIGHT for them to cover it. So I asked point blank, "Ok so let me get this all straight in my head. I cannot have the equipment that I NEED because insurance and medicare believe that they know my situation and medical needs better than 4 separate independent doctors and 2 different PT/OT's. Then they MIGHT approve the bare basic of what I need (heavy on the might part), and I will STILL have to come up with ways to work around things because they wont approve of what I really need." They said "in a nutshell yes that is exactly what the situation is." UGH ok do they do this to everyone? Well....to a point yes, but more so in your particular case. Ummmm WHY???? Cause while you cannot walk correctly.....you can still "shuffle" you feet to a point. We know that you cannot do this without canes, or for very long or long enough for you to be able to do anything at all.....but in their eyes you can shuffle. Insuance and Medicare dont care at all about anything outside of your home. They dont care about getting your kids to the bus stop, shopping for things that you need, church, ANYTHING other than in your home. And even in the home, they dont care that you fall all the time, they only see that you can shuffle to a certian extent and you are only 35....that is the only thing they are gonna look at. If you were older, or if you had fell to the point of where you could not use your legs, THEN they would look beyond your age. DO YOU SEE MY FRUSTRATION. So we are gonna fight for a chair that wont totally meet my needs, but at least MAYBE it will work for what I need it to. Will STILL have to find workarounds. TOTALLY almost to the point of just totally giving up. I fought my doctors for so long on all this, and NOW that I have resided myself to the fact that this is needed I have to FIGHT tooth and nail for it. It's not the doctors that I am having to fight, but insurance and medicare. Tell me how in the devil THAT is gonna work out.
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