From the Personal File: Medicaid Kranks Along

Sometime in the early spring, the knob that supports my walker handlebars snapped off. The maintenance man here at my apartment complex offered to repair it. After several days, he finally located a screw long and small enough to fit and installed it. In the meantime, the retailer who had supplied me with my original walker years ago gave me another without charge from a stock of used pieces.

This knobby issue was not to be the end of my troubles. The brake and cable on the left side sheared off leaving me with no brakes. Once again the retailer sat down for an estimate. Parts and labor were as formal as going to the automobile repair shop. The technique was about the same, the part wasn't too bad, but the labor (to attach a cable to the outside of the walker frame?) doubled the amount.

It looked like a new machine was the practical way out.

Enter Medicare and Medicaid. If you need a new mobility issue, there is a time limit. Tsk. Tsk. Tsk.  Well I definitely made the time line and I was entitled to a new "mobility device".  The next step was to get the doctor to write a prescription and fax to the retailer.

Glitch # 1. The retailer calls me and says that she can only give me a walker without a seat.

"What!"   She explains that my Medicare "mobility" party will only pay for part of my rollator.

Glitch #2. I called my visiting nurse again and found out that she was leaving for another position outside the politically supervised agency supplying me with services, but, not to worry, the additional sum would be picked up by her office.

Flash to July.  Now this has been going on since March.

My walker is now in pieces. It was merely dilapidated in March and by now it is dangerous.

Picture this: The brakes were gone, scotch tape wrapped and secured the cables away from the handles so I could grip them, one of the hooks of the wire basket attaching it to the walker had sheared off, the seat had broken off and now rested unsecured between two bars of the main frame, and the four hard rubber wheels were cut and ragged from rolling over Trenton's rough streets and cobblestones.

Glitch # 3. I called the retailer to see how soon I could pick up my replacement. The answer was not good. Since the script from the doctor, submitted to Medicare's "mobility" clearinghouse, left an amount not covered, they were not going to give it to me.

Glitch # 4.  My visiting nurse director had not yet assigned me to another case worker. I got a letter this week advising me that they were assigning someone.....well... I had to call on Friday.

Glitch # 5.  The worker answering the phone from another agency, (they had gone outside since they felt they were overloaded) who patiently explained to me she did not know what to do. (!) She was new to the situation and had to find out how to "handle" the situation.

Glitch # 6. When she found the papers to file or whom to contact, she would "get back to me".

I almost exploded. I explained to her that I cannot use a wheelchair due to my particular injuries, can't afford a powerchair ($60,000 for van, $10000 for lift, and $8000 for chair) and rely on my ten year old Hyundai and my Medicare walker to stay active in the community.

I also told her that my walker seat has served as my writing surface in class since desktops are not low enough for my peculiar situation....and that this past week was expecially hard for me. During my exam, the seat of my walker fell through the frame! My exam papers, calculator, pens and scratch paper went flying in a noisy jumble to the floor.

I was mortified.

Aside from being forty years older than the next oldest student, I try to stay out of the way with my walker, huddled against a wall in a front chair so I don't take up much room. There was no way that my situation could escape notice this exam day!  I was embarrassed and distressed. I was also frustrated...but by the time I could get home to phone, any office contact would be fruitless because most Trenton offices close at 4pm.  Needless to say, my call to nursing services commenced first thing the next day. 

As of this moment in time, I need a working rollator. I can use the frame to roll down the hall, but the seat is not attached and there are no brakes so it is not safe to use.

I guess I have no alternative than to wait until that Monday call with an update.

It started with a knob, and now is a heck of an example of how disconnected, (Yeah, Lord!) disconnected the system has become.  The total cost of a premium walker with seat and push bar is around $250. We are probably talking about $50 dollars difference between Medicare and Medicaid....so what the heck is the problem?  If they gave me a wheelchair, it would be in the thousands....

I wonder if nursing services might not want to replace the two case workers who left since they handled the problem by moving cases into other outside agencies....just wondering is this is after all an administrative economy move.

Just wondering....and things krank, krank, krank along. (That is the sound of my walker kreaking and kranking along...)

Oh, I offered to expedite things by advancing the difference between Medicare and the visiting nurse share and was told ......there is no provision to reimburse patients!

Man, this system sucks.

Seniors rock!