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I have been this way almost three years. My Dr. doesn't seem interest. I had broken hip surgery about three yrs. ago. I am still in pain ,i have balance problems and fall often, I live alone, i am 79 yr.old Can I go to a rehab with out a referal and will Medicare help me pay for it.? I have medicare ins. Can you give me some advice?

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Something else I just thought of....in my area some hospitals are providing "community education" and "community therapy" classes. One of the hospitals was focusing on balance and falling issues.

A doctor's consent is required, not for payment but rather to affirm that the patient is capable of handling this kind of class. You would have to pay out of pocket, but it's not as high priced as therapy at a physical therapy place.
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Marlene, in order to get physical therapy (PT), you would have to have a prescription from a doctor. Since you had surgery for a broken hip, I would make an appointment with the orthopedic surgeon who did that surgery, explain to him/her that you're still in pain, and ask for a script for (a) home care therapy, or (b) PT at an outpatient therapy facility. He/she probably would take x-rays of your hip to determine if there are any lingering problems so he/she knows exactly what's going on.

Did you have PT after that surgery? If not, what was the reason that you didn't? Have you seen the ortho surgeon since then?

You might also ask the surgeon whether the type of fracture and surgery you had would be such that you would continue to have pain.

You can't go directly to a rehab facility. It's my understanding that in order for Medicare to pay for a stay at rehab, you have to have been hospitalized for 3 days prior. However, given that Medicare rules change periodically, that requirement may also have changed as well.

You could (a) get PT at home or (b) go to an outpatient facility for PT. If you're mobile enough to drive or have transportation, I would recommend going to a therapy facility as you'll have a wider range of exercises and equipment to use, plus you can get what are known as modalities - ultrasound, TENS (deep electrical stimulation) which will do wonders for pain. I've had both; I actually really loved the TENS; it provided so much relief.

There is a limit on how much outpatient PT you can get; I believe this year's limit was about $1900 worth of PT, but don't recall specifically. What this means is that you'll be getting PT for a certain number of visits. Doctors can recommend continued therapy but in the one instance which we experienced, the PT facility didn't want to take the chance of Medicare rejecting the extension and wouldn't agree to provide any more PT.


You asked another question about getting information from your PCP, stating that you didn't want a family member to ask the information. Was this issue what you had in mind when you wrote the other post?
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Marlene; you seem to have posted twice; the second time you said that you are seeing your PCP on 11/9; but you also seem to be saying that your doctor doesnt' seem concerned about your lack of balance and falling.

I'm not sure that you need to go to in patient rehab; can you manage to go to outpatient PT? Your doctor can script that easily.
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