A person that deals with Medicare and Medicaid says that these

[michaz]

two have been the most consistent with denying coverage to those that need the health care the most, especially to Seniors and that they cut completely Hospice coverage for Seniors. Anyone have any info on this?

[Oregone]

1. They said it, so it must be true

[Rabrrrrrr]

2. Unless they cut hospice in the last couple days, that's not true.

And the elderly I know who have medicare have said nothing about ever being denied coverage.

Perhaps this alleged person is a rightwing fuckwit, who, like all rightwing fuckwits, never has truth on their side and so just makes up shit to make their points, which in this case I'm sure the alleged asshole shitbag's point is "Look, the gummint can't even get medicare right for a few people, why think they can do it for the whole population?"

Tell your alleged person to stop being such an ignorant fuck.

[DefenseLawyer]

3. I spoke recently to a friend that used to manage nursing homes

He said that Medicare was good at controlling costs, that Medicare generally had a set amount that they would pay and they stuck to it, whereas private insurance patients generally got everything under the sun at whatever price they wanted (until their coverage was canceled). It was more complicated than that but that was the gist of the conversation.

[michaz]

5. Would it make a difference if this guy worked in the southern states? n/t

[Sgent]

4. Your friend

maybe thinking of Medicare Advantage plans, not straight Medicare.

Also, Medicare does have some wacky limitations like those on outpatient physical therapy that make no sense -- most of these are codified into law, so it shouldn't come as a surprise to anyone who deals with it regularly.

[madfloridian]

7. Yes, I think Medicare Advantage is the one they refer to.

.

[SharonAnn]

10. Those are run by private insurance companies under their policies.

People who sign up for those should be concerned, because those insurance companies do everything they can to increase their profits (reduce coverage).

[clear eye]

16. The two "public" options on the table in Congress now are both like Medicare Advantage

or more accurately the old Medicare Pt. C b/c they won't have prescription coverage. They are both to be privatized, and even worse than privatized Medicare b/c they don't have any gov't administered program that they have to match in cost.

Maybe the person was opposing the proposed "public" option (what Orwellian terminology) by describing the deficiencies of privatized Medicare. That would explain why a person in the business said what he/she did.

The mandates will mean that health insurance will just suck more money out of the economy with minimal job creation. And this monstrosity is being sold as giving Americans more free choice in health care. Just ask Massachusetts residents what they think of it. Mandates would be important to put a gov't administered plan on a solid footing and include members from all risk groups. But, since insurers claim to believe in the free market...

NO MANDATED PRIVATE INSURANCE!!

[RobinA]

21. Nope

My grandmother is currently in hospice on a Medicare Advantage Plan. I don't believe that an Advantage Plan can cut hospice, since hospice is part of straight Medicare. Now, the company SPONSERING the Advantage Plan can cut the Advantage Plan, which is happening in my area and to my Grandmother and parents, but worst case scenario she just reverts to straight Medicare with a Part D. They are still researching Advantage Plans.

[classof56]

6. Tell the person (or you can do this) to check 2009 Medicare & You

Which details all Medicare Part A covered benefits. This includes Hospice Care for people with terminal illness expected to live 6 months or less as certified by a doctor. Could probably access this information online. Unless it changes significately in the future, right now clients pay $0 for hospital care, a copayment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management, 5% of the Meicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest) but Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home). I have no information or experience regarding Medicare denying this coverage or completely cutting Hospice coverage for Seniors, but if the person who told you this has examples to cite, I'd really like to know. Have yet to receive my Medicare & You 2010 booklet, but if these kind of changes in service are in the works, would be nice to have a heads up.

[MindandSoul]

8. NOT TRUE!

As a Social Worker, I have been intimately involved in getting many of my clients (mostly adults with developmental disabilities, or adults with mental illness, or adults with AIDS) to become eligible for Social Security, Supplemental Income (SSI), Medicare, and Medicaid. I have never failed to obtain eligibility for any of my clients and several of them became eligible for medicaid (with a deductible if their income was above a certain level.

While working with AIDS patients, I also worked closely with hospice care. This program is generally not Federally funded, but is State funded, or even funded by the City. However, I have NEVER encounter a case when a person for whom all treatment had failed and had a prognosis of a maximum of 6 month survival was refused Hospice care! However, a person doesn't become eligible for hospice until he/she is ready to accept ONLY palliative care (no more treatments, such as chemotherapy, or interventions, but only assistance with controlling pain, making the person more comfortable, helping the family and the patient with end of life decisions, etc. .), and the prognosis for survival is a maximum of 6 months (although I have had patients whose prognosis was less than 6 months, but extended to 10 months. . . and hospice continued to the day they died.

Eligibility for Medicare is very simple: You must be 65! That's it. No one gets rejected!
Eligibility for Medicaid is more complex and is based on your needs (contrary to private insurance, the greater the needs, more likely you WILL be eligible for Medicaid) and your income (if your income is too high, you will not be eligible for medicaid).

The person making that comment is either an outright liar, or he/she is misguided.

[NC_Nurse]

9. No. Not that I know about. My mother receives hospice services through Medicare

and so did my husband's granny - who just passed away last night at the inpatient hospice here.

[Horse with no Name]

11. Myth.

These two GIVE coverage to those who need it most.
The person you have quoted must be a wingnut who hates the government.

[ecstatic]

12. My sister did have something denied

to be honest. They put in a birth control device (I think that part was covered), but when it caused her pain and she went in to have it removed, she was charged a lot of money. I think 600.

[Frances]

13. I have had Medicare for 3 years

Nothing has changed in that time.

However, I have the original Medicare where I go to my doctor and she bills the gov't.

Some people have Bush Medicare where an insurance company handles their care (Medicare Advantage). The gov't pays an insurance company to handle the care. Of course, this way of doing things is unnecessary in my opinion. A person in Medicare Advantage costs the gov't more than a person in the original Medicare. But the insurance companies do profit.

[michaz]

14. Thanks for the help. This gave me some good info to pass on to this guy.

I am not sure of what capacity he works in for sure but I know he is in South Carolina! Hmmmm.

[madrchsod]

15. big pile of steaming bullshit

first-medicare and medicaid are two different health care providers

my parents were never denied any procedure under medicare. they had a supplemental retirement benefit that paid the difference in treatments. i took my mom to her doctors visits and she just showed her card and that was it. i wish the hell i had medicare for all my operations and doctor`s visits

[REACTIVATED IN CT]

17. I work at a hospital and hear complaints about Medicare

not paying enough compared to private insurers and also them taking back payments after the fact. The patient gets the care but the hospital doesn't get paid . So if this person works for a health care provider, they might be talking about payment hassles,not service denial.

[GreenPartyVoter]

18. Dunno about Medicare, but we have done pretty well with the Medicaid. I have had

to get my docs to sign off on certain meds before I got approval for them, and they don't do glasses or teeth, but other than that it's not been bad at all. Certainly cheaper than paying for insurance out of pocket!

[clear eye]

19. Medicaid varies widely depending on which state you're in. n/t

[Freddie Stubbs]

20. With Medicaid, the biggest problem is finding a doctor who is willing to treat you

The reimbursement rates are very low, to the point where doctors may actually lose money by seeing you.

[GreenPartyVoter]

22. That is the case with the orthodontists in my area. No one will take it.