SOS: Speaking of Seniors – Feds Win, Seniors Lose
On August 28, 2015, I wrote a letter to a client to explain why she may have to pay for a chest x-ray that Medicare refused to cover.
On that day, I received a phone call from a billing person who told me that Medicare usually does NOT pay for a pre-operation chest x-ray. That is an x-ray which our client’s doctor and hospital wanted done in order to make sure that the patient had a heart that was healthy enough to withstand the stress of an operation.
Medicare did not cover the service. With the client in my office, I compared the bill with the Medicare Summary Notice and what our client remembered about the matter. A few “red flags” appeared. The medical billing person understood the “red flags” that I noted in a letter to the medical service provider. But, neither the doctor nor the hospital could change a policy of the federal government to push some medical service costs onto senior citizens in order to save money for the federal government.
In past articles, I warned that the federal government would start changing rules of Medicare to do exactly that – save the federal government money. A Government Accounting Office study that was published in July 2012 stated that the “Obamacare” law would cut $716 billion of Medicare benefits to America’s senior citizens. The federal government would use that money to pay for health care for other people under the new “Obamacare” law.
In 2009, under the Obama administration, legal definitions were changed about when a senior citizen was in a hospital as an “in-patient” or an “out-patient”. The difference is that as an “out-patient”, the senior gets no help with the cost of medicines while in a hospital. That caused the problem of “Self-Administered Drugs”.
Recently, a client was in my office because of “Self-Administered Drugs” charges totaling over a thousand dollars. I explained to him the changes in the Medicare rules and gave him a copy of a four page article that I had written about the matter a few years ago.
“So, the federal government saves money with the new rules but I and other seniors get driven to the poorhouse by big bills for medicine while in a hospital! That stinks!” he said.
I agree with him. But, what can I do? I don’t have a magic wand. I can’t change a federal government policy. All I can do is help protect our clients from financial harm that is caused by mistakes in the Medicare system. Believe me. There are plenty of mistakes in the Medicare system. I stay busy. But, I can’t change an unfair policy or regulation of the federal government that hurts our senior citizen clients. It’s a case of “FEDS WIN, SENIORS LOSE!”
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