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Re: I can hardly wait to do this

By: micro in 6TH POPE | Recommend this post (0)
Tue, 27 Feb 24 2:59 PM | 28 view(s)
Boardmark this board | 6th Edition Pope Board 		Msg. 50622 of 60008
(This msg. is a reply to 50606 by De_Composed)
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I use Aetna for my medicare and I have never been denied anything. I also carry a continental life (division of Aetna) supplement that costs US about 35 dollars a month.

On that plan we have added coverages that are not done with the medicare like extensive cancer treatments, and my favorite, out of pocket reimbursements for hospital room charges..

For example, I just received a check yesterday for $1400 dollars from them for my time spent during the heart procedures stay at the hospital.. I have another one for five days I could file but haven't from the hospitalization due to Hepatitis E I contracted somehow up in Cleveland area.

Sudden risks of death is a big concern. What you have gone through is very serious. You should find out if your doctor accepts medicare patients and medicare advantage plans and which ones..

There are some really great medicare plans available. You need a real insurance pro that deals with just these plans who can show you the best ones for you guys . That is how mine does it. He is an expert in this and travels the whole state in that season doing clinics and seminars explaining these differences between plans in different areas of the state.

This stuff is better than most regular group health plans from employers. It costs ZERO to see your primary care doc. $40.00 co-pay for your specialist.

But I digress.

Yeah, the occasional jolt is a concern and leaves my hearts and left side chest wall sore and achy.. I can't lay on that side if I am sleeping due to that. Too much pressure and feels like the heart is being squeezed.

I guess there is a reason why they said I have congestive heart failure which means 5-10 years average life span for men.

I am happy that God willing I will make it to our 50th anniversary in October.. Where did that time go?

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The above is a reply to the following message:
Re: I can hardly wait to do this
By: De_Composed in 6TH POPE
Tue, 27 Feb 24 1:48 AM 		Msg. 50606 of 60008

micro:

Re: “One of these days I'll go back down to the cardiologist and have him check this out.. My CT scans are okay.. So what is up with the jolt ?”I'm sorry to hear about that.

When I wore my heart meter for two weeks, nothing was detected related to the symptoms I had described. But at a time when I'd felt nothing unusual, the meter detected ventricular tachycardia. My doctor said it didn't last 30 seconds - which would have put it into a different, more-serious class - but that it was still a potential risk. "A potential risk of what?" I asked. "A risk of sudden death." he said.

Okay. I guess that's a concern.

He said he wanted to do an MRI just to see what is going on. I received paperwork from my insurance company saying that it was denying the request due to insufficient evidence of a need but that the requesting doctor can appeal the decision within 14 days. A second letter said he can appeal within 60 days. The paperwork said that he'd been informed. I waited 14 days and heard nothing. I waited 35 days and heard nothing. I called my cardiologist's office and asked about it and they said, "You were denied? We were wondering about it. We received nothing!" So they filed a very late appeal and waited. The insurance company denied the appeal.

My cardiologist called to tell me and to say that he was just going to re-submit the request, including everything but the kitchen sink. TWO DAYS LATER I was called by my hospital to schedule the MRI. I told them I hadn't heard yet from my insurance company which had been balking at the request. They said, "Oh, they approved it already."

LOL. It pays to be persistent.

I'm not on Medicare yet. Good thing! I wonder how that would have gone. Is Medicare better or worse about approving expensive tests? I would think worse. After all, practically everyone who kicks the bucket is on it.

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