Something happened to Medicare coverage on the way to 2014. I didn't see it in any newspaper or on any TV or Internet News. I met the Devil for the first time face to face, when I tried to get my bi-annual pair of diabetic shoes. First thing I found out that diabetic shoes are now dispensed at one pair per year rather than every other year.
That's the good news. The bad news was even though I have 3 different qualifying conditions of my feet and have received diabetic shoes through Medicare since 2010, I no longer qualify for therapeutic shoes.
It seems that a small change in the regulation excluded me. While I am on the diabetic spectrum because I have Insulin resistance or Pre Diabetes; the regulation wording was changed to authorize shoes for only those with Type I or II Diabetes. I wouldn't mind so much if they had also excluded me from having Neuropathy, bone instability, and foot deformity.
"Don't worry," said the indifferent receptionist at the 4rd new provider of durable equipment in as many years. "You can still have the shoes. It will just cost you $268." I laughed. I couldn't help it. That's twice my monthly medical budget. Not to mention that leaves me without my co-pays for other durable supplies, such as my sleep apnea equipment.
Not to worry though because after an Internet search, I found the exact brand and shoe that I got last time, for $89 from Foot Smart. The inserts were another $18.50. Maybe Medicare should consider Foot Smart for a provider next year.
Second sighting of the Devil occurred when I tried to arrange for home health care after my upcoming hand surgery. I live alone and will have my dominant hand in a cast over my elbow for 8 weeks. Several doctors and providers told me not to worry, Medicare does pay for care for elderly and disabled who live alone after surgery. WRONG. The wording of the regulation was changed to state that a patient must require skilled nursing care before Medicare would pay for any of the other assistance: dressing, meals, bathing, etc that would be impossible one-handed with my other disabilities. My hand, wrist and forearm will be in a cast, so no dressing changes, no medication hand-outs etc. Ditto staying in a care center unless I needed physical therapy, which won't start until I get the cast off in eight weeks.
"Why don't you see if someone from your church would come and take care of you," asked a helpful receptionist at the Home Health Service. Sure, ask for a volunteer for 4 hours a day in split shifts for 8 weeks from a church I haven't attending for 15 years.
Meanwhile, one handed, I can't open a jar, open a plastic bag or plastic storage container to microwave food. I can't button or tie clothing or shoes, I can't start a zipper. I can't dispense my pills for pain or my anti- reflux medication.
Not to worry though, because the routine chest x-ray for the hand surgery disclosed that my cancer has returned and I have masses in top, middle and bottom of both lungs. So I've out-smarted the Devil after all--unless they no longer cover Metastatic breast cancer which has moved to the lungs.