Living Well with a Bad Diagnosis - Lung Disease

Thursday, December 15, 2016

And It Continues

The saga continues. When we got to mom's eye doctor, I had a message on my phone from my hospital regarding the $2,775.75 bill. Carolina asked me to phone a special number at Medicare and, from the lobby all alone, I was finally connected to a marvelous woman in the Coordination of Benefits and Recovery department. (It is here that I once again wish to mention how the most wonderful humans work at Medicare. She told me later in the conversation that she feels this was her life's work and she tries to treat each person like others treated her grandmother.)

My Worker's Comp lawsuit was settled in 2009 but I never really understood the Medicare Set-Aside. I have been waiting for Medicare to bill me. For the first time, this wonderful woman explain how mine was different from most (the money is under my control) and that I should have been having the university bill me directly for any of the covered charges.

What is covered? Quite a bit. I was surprised when I looked into the paperwork this morning. It must all be related to my lungs but here is the general list: Primary physician (never see my local doctor for my lungs), imaging studies, blood tests, pulmonary function tests.

The Medicare woman then told me to phone the university and ask them to separate out the bill and re-bill Medicare for the items not related. They should bill me directly for the other items.

Then, we got chatting. I explained that I never understood this and almost hoped I could just write a check to Medicare and be done with it! She paused and said, "Hang on a minute." She told me about a program that I can negotiate to give a lot of the money to Medicare but I would be able to keep a nice hunk of the money as it was part of my settlement. WHAT?!? After the money is gone, Medicare would pay for everything. She gave me the name and number of the persons who deals with this and I will give him a call to get the full information.

In other news: I saw Dr. K. yesterday. She was in a rare good mood and we talked jewelry! A personal conversation! Wow! I am stable, she will see me in six months but she told me several things: she believes I won't need 24/7 supplemental oxygen until 2018 unless I have exacerbations then all bets are off and we talked about the drug study in January. She looked it up, gave me the email address and told me not to give them any information other than I was interested in being in the study. I may not meet one of the prerequisites, such as prednisone, but we couldn't imagine any HP person in the study not on prednisone. She said I have a window of about six years before I hit the age limit for lung transplants and the new drugs couldn't hurt. It is a year study. When I got home, I sent the email to the head of the study.

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