TalkingMedicare

TalkingMedicare

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Sorry for the delay

Let me apologize for the delay between posts the last 2 weeks.

Let me apologize for the delay between posts the last 2 weeks.

Unfortunately I had a situation in the family that had me using some of the benefits from Medicare that we have been talking about.

My wife, Jolan, went for a stress test after her regular doctor noticed some irregularities on a EKG he had done. When they did an EKG at the testing center and the doctor reviewed it they refused to do the stress test and sent her to the ER to have it done under hospital conditions.

When we got to the ER she was given another EKG along with some Xrays and blood tests. They held her for a few hours to monitor her condition.

Since her heartrate was low and her blood pressure varying wildly, they decided to admit her for further observation and to see a Cardiologist. This all happened on a Thursday.

She was admitted to the hospital, but not as an in-patient, simply for observation. When she saw the cardiologist and he reviewed the situation, his reccomendation was to not have the stress test done since it would only give him results that would be inconclusive. He suggested doing a cardiac cathorization to check for blockages.

One advantage (?) to living in an over 55 communittee is that a lot of our neighbors had had that procedure done, and other cardiac related problems taken care of, so we were getting a number of recommendations on who to use for the procedure and as a follow up cardiologist - most of them highly recommending one doctor in particular. When we asked to have that doctor do the procedure we were told we would have to wait till Monday. More days in the hospital but still under observation.

We had the luxury of having a Cardiac Surgeon in the family, although a few states away, and we had him and the local doctor review the case and recommendations to give us a second opinion - the result was they were both in agreement.

So we were going to wait it out until Monday for the procedure.

Unfortunately my wife suffers from severe migraines and takes some specialized drugs daily to prevent/treat these migraines. She is also highly allergic to sulfa, an ingrediant in many drugs, which limits the drugs she can take for high blood pressure. When we told the hospital staff these things it presented a problem in that they would not administer the specific drugs she needs, but wanted to give generics which we knew she couldn't take. So until we could convince all the doctors and staff to allow her to use her own drugs, she suffered through bad migraines each night.

Bottom line is that she had the test and there were no troubling blockages and no further treatment was necessary.

But there were some things about Medicare and hospitalizations that we became aware of that we had never had to deal with before.

  1. Since she was not admitted to the hospital for the first few days as an in-patient, just for observation, we were "advised" by the hospital Medicare advocate that part of the hospital stay would not be covered under Part A but might be covered under Part B. I called Medicare directly and was informed that because the observation was ordered by the cardiologist and he was reviewing the records and examining the patient daily the charges would be covered under part B - we hope that bears out in the final billing or we will contest it.
  2. You have to be your own advocate when it comes to certain aspects of your health care - in this case what medications she could or should not take - and sometimes it can be very complicated and frustrating.

So anyway that put me behind schedule and I will get back to writing posts in the next few days.