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Joined: Jul 2020
Posts: 10,379 Likes: 72
Booner
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Booner
Joined: Jul 2020
Posts: 10,379 Likes: 72 |
The facts are my dad has stage 2 parkinsons. He is in the hospital going on his second week because the discharged him from the ER 2 weeks prior saying he was dehydrated and his symtoms were consistent with a parkinsons patient. NOT SO! He had pneumonia.
Well fast forward to last week, they did a bone marrow biopsy, and he has some sort of blood cancer, we don't know specifics yet. To make matters worse, all he is doing is sleeping, which means he isn't being active, thus accelerating his parkinsons.
Doctors want to send him to inpatient rehab, and of course Humma denied it. Twice.
What are the next options? Hire an attorney? He is 84, as is my mom. She can't care for him by herself. They have long term care insurance, but my mom doesn't know where my dad has the policy paperwork "filed".
It is so aggravating, my dad has paid into medicare all his adult life, and now when he needs care, they deny it.
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Joined: Feb 2002
Posts: 46,042 Likes: 231
Freak of Nature
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Freak of Nature
Joined: Feb 2002
Posts: 46,042 Likes: 231 |
If the long term care policy premium is still being paid, it will show up on bank statements. If it somehow got paid off there will still be banking records.
As to your father’s Medicare situation, it sounds like he has an Advantage Plan.
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Joined: Mar 2015
Posts: 6,251 Likes: 30
12 point
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12 point
Joined: Mar 2015
Posts: 6,251 Likes: 30 |
The facts are my dad has stage 2 parkinsons. He is in the hospital going on his second week because the discharged him from the ER 2 weeks prior saying he was dehydrated and his symtoms were consistent with a parkinsons patient. NOT SO! He had pneumonia.
Well fast forward to last week, they did a bone marrow biopsy, and he has some sort of blood cancer, we don't know specifics yet. To make matters worse, all he is doing is sleeping, which means he isn't being active, thus accelerating his parkinsons.
Doctors want to send him to inpatient rehab, and of course Humma denied it. Twice.
What are the next options? Hire an attorney? He is 84, as is my mom. She can't care for him by herself. They have long term care insurance, but my mom doesn't know where my dad has the policy paperwork "filed".
It is so aggravating, my dad has paid into medicare all his adult life, and now when he needs care, they deny it. Did Humana say why they declined? I would reach out to CMS if you think they declined incorrectly. There is an appeals process. If you find the long term care policy, you typically will have to get a doctor to certify he is unable to do 2 of 6 activities of daily living like bathing, toileting, dressing etc for a certain period of time. There is typically an elimination period (waiting period) before benefits are paid. This is typically 90 days but could be shorter or longer depending on the insurance carrier who wrote the policy.
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Joined: Jul 2020
Posts: 10,379 Likes: 72
Booner
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Booner
Joined: Jul 2020
Posts: 10,379 Likes: 72 |
They said he does not need the level of care. He is bed ridden. He cannot control his bowels at the moment. He can't feed himself, walk, bathe, turn over, etc. His meals are pureed. He can't even comb his hair.
The cadiologist said a week ago he was malnourished. All he does is sleep. He needs someone to get him up and moving, but they don't want us doing that at the hospital.
It's been appealed twice. They were sure quick to send the finance person around and let my mom know she owe's the hospital $9k.
His platlet count is 23. I have a chart of his labs since he went in the hospital.
I want to transfer him to Emory, but he isn't stable enough.
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