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I work part time for a doctor who specializes in pain management. Yesterday, we had a 78 year old woman come in, who has never been to a doctor. It turns out that she's suddenly coming up with a rash of symptoms, has cataracts, possible osteosporosis and a variety of other ailments that can only be diagnosed with a battery of tests. So she only has Medicare part A and payed in cash. I tried to explain to her what her options were under Medicare but that she would have to enroll in Part B and Part D, if beneficial, first. Since my doctor is a specialist, he referred her to a GP as we are not equipped to do general exams but he asked me to explain Medicare to her.
I told her that to enroll in Part B, it would cost approximately $90 a month that would be deducted from her Social Security payment and that Medicare only payed 80% of the approved amount. She gasped when I said it. I even told her that she could get privatized Medicare that promises a lot more coverage including drugs but that no physicians in the area would accept them because of their poor payment record. She could possible qualify for Medi-Cal that would cover the 20% but would have to be destitute almost to get it, otherwise she would have to get a Medigap private insurance policy that can cost between $125 and $250 a month depending on her problems and what the insurance company feels she needs to pay. I think she has too much to qualify for Medical but not enough to pay for an expensive insurance policy.
I tried to explain to her how expensive the tests are going to be to get a diagnosis and that since she and her deceased husband had worked all their lives and paid into it that they were entitled to it. But it turns out that the $90 a month and 20% co-pay are more than she can handle. She said that she would pay the doctor cash. I tried to tell her it wasn't going to be enough to get the tests she needed and that they were very expensive. I then suggested to her to go to the ER and to ask to talk to a social worker who can probably come up with a way to pay for her care. She hugged me and left.
Yet I'm bummed out. I don't think she will get what she needs. She knows apparently that she probably is dying and wants pain medication to die peacefully, yet no one will be able to give her this without the right documentation that she needs those pain medications and for that she needs a thorough physical exam, a battery of tests and no doubt referrals to other specialists who deal with her specific ailments. I really tried to impress on her that she won't be able to pay cash for everything she is going to be getting. What this elderly woman needs is to be able to present a health care card to every health care provider she might need. She shouldn't have to worry about how it will be paid. I think she will just die alone and in pain and I can't do anything for her.
Our health care system stinks. :cry:
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