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Medicare Issues

kartay_69kartay_69 Member Posts: 5
edited March 2011 in General discussion

Trying to find out if anybody else has had issues with the Medicare prostheses reimbursement program. 

I bought my second prostheses in July 2010, with plans to claim the cost back after the two year period from my first reimbursement had expired in Seotember. The Medicare information pamphlet from March 2010 stated that one can CLAIM once in a two year period, so I didn't think it would be an issue, as this is exactly what I had planned to do (also, the only reason for the early purchase was that the first prostheses had deteriorated).  However my claim was rejected on the grounds that I PURCHASED the second prostheses within the two year period.  I appealed this decision, based on the incorrect pamphlet wording, which was dismissed with a standard form letter expressing regret, etc.

I am currently on my second appeal; my greatest ally is that Medicare has changed the pamphlet, alterning the word "claim" to "purchase".  In fact, the letter from Medicare rejecting my appeal states "in a review of program communication materials....information of timing....was amended to further clarify the program's policy." Great for future users of the program, usless for me.

Anyone else had the same problem?

Comments

  • TonyaMTonyaM Member Posts: 2,713
    edited March 2015

    Hi Kartay,

    I wonder if the store from where you bought it could change the date for you? So what happens if it deteriorates before 2yrs?does it have a warranty-I must reread the fine print.Seems unfair.

                               Tonya

  • Sarah 51Sarah 51 Member Posts: 303
    edited March 2015

    Hi Tonya and Kartay

    My prosthesis definitely has a 2 year warranty as I remember thinking how handy that was cos if it deteriorated I could get another before I had to apply for another one. I have an Amoena prosthesis but am sure they must all carry the same warranties. I would go back to the shop where it was purchased and get them to contact the makers.

    Good luck

    Sarah

  • TonyaMTonyaM Member Posts: 2,713
    edited March 2015

    Sounds like a good idea,providing your cousin wears a prosthesis and she was in the flooded area,Now that 2 years are up can you get your free medicare prosthesis and keep the other as a spare?or sell it on ebay-people buy anything on ebay!! Just have to keep thinking outside the square!

                            Tonya

  • TonyaMTonyaM Member Posts: 2,713
    edited March 2015

    Sounds like a good idea,providing your cousin wears a prosthesis and she was in the flooded area,Now that 2 years are up can you get your free medicare prosthesis and keep the other as a spare?or sell it on ebay-people buy anything on ebay!! Just have to keep thinking outside the square!

                            Tonya

  • BardoeBardoe Member Posts: 57
    edited March 2015

    Just wondering if you may be able to get it repaired?

    using silicone or other type glue as opposed to tape?

    Bardoe

  • kartay_69kartay_69 Member Posts: 5
    edited March 2015

    Nah it's toast, lol!

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