Hospice company says only Medicare and denies comforts such as PureWick and airbrushing saying that Medicare doesn’t allow without getting the items and passing the bills to Medicare so Medicare can pass them to GEHA. How can I make this work?
I don't think Medicare covers the costbof the PureWick system anymore. Just read u may get the catheters thru part B.
Medicare pays for supplies like Depends, chuxs and wipes. They pay for the drugs needed for comfort. Durable equipment, like a hospital bed, oxygen, ect. A nurse who comes in a couple of times a week and an aide 2 or 3x a week for bathing and any xtra hours u may be able to get.
You need to call the secondary insurance to see if they cover the PureWick system. I guess u can't bill to them directly because they are secondary and seems Medicare no longer covers them. By buying it and submitting paperwork to Medicare they have to refuse to pay and then send it onto the secondary to see if they will cover it.
If Mom is bedbound a catheter can be used. Not sure if I understand the need for airbrushing? Are u talking about make-up? Medicare is a health insurance. No health insurance would cover this. Hospice should give you a list of what is covered. Anything not provided that u feel Mom needs will have to come out of her pocket.
My experience with each of my in-laws was that Hospice and all related equipment and services was 100% covered by Medicare. It was the best possible experience under trying circumstances.
Donna, when my late husband was under hospice care in our home for the last 22 months of his life, he was initially under my BCBS plan along with his Medicare, and the hospice agency we used billed both BCBS and Medicare for many months until I dropped my husband off of my insurance and he was then strictly under his Medicare. Everything was still covered 100%, but I know that Medicare has strict limits in what they will pay for said services from hospice, and with having additional insurances for them to be able to charge, they(hospice)in the long run make out better as they are able to recoup more money than if strictly dealing with Medicare. It's a bit of a racket for sure, but know either way your mother will receive the same and hopefully the best care possible from hospice. Wishing you the very best as you take this final journey with your mother.
Ok so your mom is FEHIB so either she or your dad was a fed? And they have GEHA as their secondary to their Medicare, is that it? Dealing with this I have some experience with as my dad was a fed and they had BCBS (not GEHA) and I will say coverage was beyond excellent with almost next to zero copay when it was all about the usual health care coverage for physician, out patient, clinic / hospital coverage, lab and pharmacy stuff as the sheer # of fed retirees was huge for their service area for those that stayed on Original Medicare with the Blues coming in as a traditional secondary health insurance provider.
But hospice is different as it is Medicare Part A benefit only - in my understanding - and as such it has vendor agreements set up with hospice groups / agencies under Part A coverage to provide the in home services (of coming into your folks home 2-3 maybe 4 times a week). That is what I think is going to be the problem for GEHA in that they may not have vendors set up to be paid under Part A system. Does this sound like what is happening?
Fwiw hospice is self directed, so mom can switch hospice agencies.
Medicare pays for supplies like Depends, chuxs and wipes. They pay for the drugs needed for comfort. Durable equipment, like a hospital bed, oxygen, ect. A nurse who comes in a couple of times a week and an aide 2 or 3x a week for bathing and any xtra hours u may be able to get.
You need to call the secondary insurance to see if they cover the PureWick system. I guess u can't bill to them directly because they are secondary and seems Medicare no longer covers them. By buying it and submitting paperwork to Medicare they have to refuse to pay and then send it onto the secondary to see if they will cover it.
If Mom is bedbound a catheter can be used. Not sure if I understand the need for airbrushing? Are u talking about make-up? Medicare is a health insurance. No health insurance would cover this. Hospice should give you a list of what is covered. Anything not provided that u feel Mom needs will have to come out of her pocket.
Everything was still covered 100%, but I know that Medicare has strict limits in what they will pay for said services from hospice, and with having additional insurances for them to be able to charge, they(hospice)in the long run make out better as they are able to recoup more money than if strictly dealing with Medicare.
It's a bit of a racket for sure, but know either way your mother will receive the same and hopefully the best care possible from hospice.
Wishing you the very best as you take this final journey with your mother.
But hospice is different as it is Medicare Part A benefit only - in my understanding - and as such it has vendor agreements set up with hospice groups / agencies under Part A coverage to provide the in home services (of coming into your folks home 2-3 maybe 4 times a week). That is what I think is going to be the problem for GEHA in that they may not have vendors set up to be paid under Part A system. Does this sound like what is happening?
Fwiw hospice is self directed, so mom can switch hospice agencies.