Insurance won't cover anymore rehab

Kristin · 12-27-2005, 04:38 PM

My mom has been in a rehabilitation/nursing home for the past 2 1/2 weeks. She has Health Net which has been covering her stay and physical therapy. She was diagnosed with mets in the spinal fluid which has her unable to move from the waist down. She has had 8 treatments so far and we are waiting on the results of the spinal fluid. We are hoping the treatment will start to work, and also allow her mobility again, however, since she has not shown any improvement in PT, the insurance will stop covering her there. I am so angry that they can do this. Don't they realise that she wasn't recovering from a car accident, it takes at least 6-8 treatments of chemo before it starts to work and then there may be improvement. The place is $380/day which is not pratical for anyone to pay even if they made a decent living. If anyone knows of anyone to talk to about this or if there is anything legally we can do, any advise is greatly appreciated. I am praying that she will show signs of improvement over the next week in physical therapy, but I know she needs to go at her own pace, not the pace of the insurance company. It is so fustrating, not only is this hard on my mom trying to get better, but now my dad has to deal with figuring out what to do next. Thanks for listening, it has been a difficult month, and I just have to have faith that it WILL work out.

Sheila · 12-27-2005, 06:30 PM

Kristen
I am so sorry about your Mom. If they are talking about moving her out, what about home health and PT at home. Also, I would talk to the Dr....he can override the insurance company if he says she is too sick to go home and needs the care ther....if there is anything I can do to help you, please let me know....don't give up...there is an answer to fight the insurance company.

Kristin · 12-28-2005, 08:42 AM

Thanks Shelia, I am meeting with the case worker from Health net next Tuesday. My mom's oncologist will write a letter stating that she should not be moved, etc. I just pray she starts to show some improvement between now and then. It is so difficult trying to stay strong for her, especially with the insurance company being this way!!!

Sheila · 12-28-2005, 07:38 PM

Kristin

DONT GIVE UP...Ask the Dr. for help...he CAN keep the treatments going and her where she is....the insurance companies will not go against what the Dr. prescribes...unless the want a lawsuit...be strong...you and your Mom are in my prayers.