Community Chat

[pitdakota]

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@Annabellethecat66 wrote:

Medicare is crazy.  Did you know that when you have knee replacement Medicare does not cover you going to a rehab place?  They will have someone come into your home a few days but that's it.  Most old(er) people don't have anyone to help them when they get home.

I could not believe it.  I checked into it over and over and that's the way it works....no rehab place.  I was going to pay for mine myself but with me (because I have an immune problem my Dr doesn't want me to go anyway, too many germs.

As far as taking jobs away....Are you kidding me?  The poster is assuming this medicine is made in the United States....Ha!

I think it's terrible that they don't pay for people to go there after surgery.  So, once again Medicare people get (well insert the word you want) on.

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@Annabellethecat66, that is not really correct and would certainly be big news to the thousands of rehab centers across the country that are in a rehab. post knee or hip replacement with Medicare covering the costs.

To qualify for Medicare to cover inpatient rehab post knee replacement the individual must have some other complicating situation that also needs to be managed during recovery.

Medicare will not cover the cost of an inpatient rehab facility if the person is healthy and able to go home to receive the same physical therapy services they would receive in an inpatient facility.  The goal of rehab is physical therapy.  If it can be done at home because there are no other complicating factors, then they will pay for in home physical therapy services.

If there are certain other factors in the patient's health history such as other illnesses that might need to be managed postoperatively, etc.  Medicare does cover the cost for inpatient rehab.  If you are healthy and have had no complications, they pay for physical therapy in the home setting. 

Medicare has never covered expenses incurred because someone needs help at home such as getting to the bathroom, fixing meals, etc.  That has never been the role of Medicare. 

[Annabellethecat66]

All I know is I spoke to 2 of my Drs and they both told me it wasn't covered.  I'm just telling you what they said.  

[pitdakota]

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@Annabellethecat66 wrote:

All I know is I spoke to 2 of my Drs and they both told me it wasn't covered.  I'm just telling you what they said.  

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It may not be covered for you if you don't have any other conditions or complications.  Doesn't mean it isn't covered for everyone.  You can simply google does Medicare cover inpatient rehabilitation after knee replacement surgery and get quite a bit of information about it. 

[sidsmom]

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@Annabellethecat66 wrote:
 

As far as taking jobs away....Are you kidding me?  The poster is assuming this medicine is made in the United States....Ha!

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What about the job of dispensing medication?

If there wasn't a prescription to fill, the pharamist & pharmacy helpers would eventually be out of a job.  

So yes, getting prescriptions filled from mail order from another country would be responsible for taking American jobs away.

#BuyAmerican 

[lenapecci]

If American RX drugs that are not covered by an individual's insurance were affordable in the US I think everyone would buy American. 

How is is it that the pharmaceutical companies are not responsible for possibly keeping the costs affordable to patients. 

I always try try to put myself in someone else's shoes before passing judgement on the choices they make when it concerns their health or their families. We do not know what is going on in their lives. 

[mstyrion 1]

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@deedledeedeedle wrote:

Shame on the poster that insinuated ABC has used a "hidden message".

Have you ever heard of formularies with different tiers determined by a group of yukkity yuks? If not, perhaps you should read up on the subject. We have lost many freedoms but this nanny state example is a low blow because now we are talking life & death. And for Pete's sake please hold the snarkiness to one of our own, people.

dee

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Speaking of snarky...

Maybe you can explain why a pharmacy would refuse to fill a prescription because I haven't seen an explanation here yet.

Maybe you can also explain what freedoms we've lost. That's a statement that's bandied about  freely but no one has ever been able to elucidate exactly what freedoms they've lost.

[Mj12]

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@pitdakota wrote:

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@Annabellethecat66 wrote:

All I know is I spoke to 2 of my Drs and they both told me it wasn't covered.  I'm just telling you what they said.  

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It may not be covered for you if you don't have any other conditions or complications.  Doesn't mean it isn't covered for everyone.  You can simply google does Medicare cover inpatient rehabilitation after knee replacement surgery and get quite a bit of information about it. 

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Hi @pitdakota ! My MIL had knee replacement (then later she had shoulder replacement). She also has COPD. She went to a rehab facility (lives alone) after each operation (with Medicare). 

[abbeythe 8th]

I've been on Medicare for almost a year.  This thread contains statements that are not true.

@Annabellethecat66

I do not understand your dilemma about wanting to pay for your prescriptions in full (because you can afford to) and your insurance not allowing the pharmacist to fill the prescription.

I know people that get some of their prescriptions from Canada because their insurance does not cover the prescription or their co-pay is more than the cost of the prescription in Canada.

[pitdakota]

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@Mj12 wrote:

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@pitdakota wrote:

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@Annabellethecat66 wrote:

All I know is I spoke to 2 of my Drs and they both told me it wasn't covered.  I'm just telling you what they said.  

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It may not be covered for you if you don't have any other conditions or complications.  Doesn't mean it isn't covered for everyone.  You can simply google does Medicare cover inpatient rehabilitation after knee replacement surgery and get quite a bit of information about it. 

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Hi @pitdakota ! My MIL had knee replacement (then later she had shoulder replacement). She also has COPD. She went to a rehab facility (lives alone) after each operation (with Medicare). 

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Hi @Mj12!  Yes, to make a statement that Medicare does not pay for inpatient rehab for a knee or hip replacement is certainly not true by any means.  As I tried to explain, if the patient is healthy and doesn't have any complications, they will cover the cost of in home physical therapy.  They will not cover because someone needs help with cooking, bathing, etc. while recuperating from the knee or hip replacement since Medicare has never covered anything considered "custodial care".

Like I said, it would be big news to the thousands of long term care facilities in this country!  We are facing difficulty these days because so many nursing homes have cut Medicaid  long term care beds to make more space for patients that need to recuperate from knee and hip replacement surgeries with rehab.  They are making big money from Medicare and therefore cutting the number of Medicaid beds in their facility.

And when you see those rehab areas in the nursing homes, they are usually very nice.  The PT areas are usually very nice, big, with all kinds of expensive equipment.  Many places now have 2 shifts of physical therapists on duty through the week.  Cost quite a bit of money....but they also get more money from the Medicare  orthropedic rehab patients than they do Medicaid patients.  Thus the cut back on Medicaid beds for patients that need long term placement in a facility with 24 hour care.