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bburke155 Asked January 2016

Can anyone direct us to the appropriate agency to assist in recouping out of pocket expenses for transportation to dialysis from NH?

I am 74 years old and my wife is 64 years old. I have ESRD, collect SS retirement and my wife receives social security disability.  I have Medicare Pats A&B, as well as a Colonial Penn Medicare Supplement plan. My wife has a Humana Medicare Advantage Program for health insurance coverage due to age. My wife is my primary caregiver and we live alone. My wife suffered an emotional breakdown in June of this year and had to be treated in a mental health facility and a skilled nursing facility. Since I am unable to take care of myself totally or provide myself with transportation to and from dialysis, family arranged for me to be temporarily admitted to a skilled nursing facility so I could have found the clock care, physical therapy, medical and nursing support. The facility did not have dialysis service on-site and I had to be transported by private ambulance to and from dialysis treatments three times per week at an out of pocket expense of $225.00 per week. A significant amount of research on my part has led me to believe that if the SNF did not provide on-site dialysis treatment that they should have covered the cost of transportation to and from dialysis treatment. This used up a significant amount of retirement savings. We have also relocated to a senior apartment community at a significant increase in monthly expenses since both of us have been released to home and no longer require home health care at this time. We are wondering if there is any way to get reimbursed from the SNF or any other source for that transportation cost incurred. We only want been compressible I was an inpatient resident of the SNF. Can anyone direct us to the appropriate agency to assist in recouping these out of pocket expenses for this transportation? Thank you so much.

freqflyer Jan 2016
burke, here is a booklet regarding what Medicare does pay regarding ambulances. https://www.medicare.gov/Pubs/pdf/11021.pdf

bburke155 Jan 2016
Col Penn pays secondary to medicare A&B and pays only on medicare approved services. Why would they cover this expense?

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pamstegma Jan 2016
You have to read the contract with the SNF very carefully. I doubt if they provided medical transport, it was more likely done with an ambulance service, which should have been covered by Colonial Penn. Start your inquiry there.

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