In her words . . .
Client calls today, needs help with her mother.
Her 85 year old mother flew into Dallas from Albuquerque for the granddaughter's graduation. Mom proceeds to slip in her daughters house,
breaking her hip and pelvis.
She’s been inpatient for 8 days and needs
to be transferred to a SNF (Skilled Nursing Facility).
Daughter/Client and social worker at hospital cannot find a SNF to admit her. The problem? It’s a local (to Albuquerque)
HMO MAPD. And all SNFs want a guarantee of payment.
Client has called the carrier 4 times and gotten nowhere. So we call the carrier together. And…well…I’m less than sweet when they say no
coverage. And proceed to start quoting from the CMS Medicare Managed Care Manual and citing page numbers.
We finally get this crapola answer and email address, so the SNF can email the HMO and they can negotiate a rate for the SNF stay. (And no phone
number. Told the gal I wasn’t hanging up without a phone number to verify they had received and were working on the email)
Obviously this would have gone better with a nationwide carrier. Or a Medicare supplement.
But bottom line, any MAPD expects 85 year old American citizens to navigate dumpster fires in the middle of a health crisis.
And that’s why my mother has Plan G. #GAMedicarePlans
