Quote:
Originally Posted by cyclelops
My orthotics are replaced every two years....no sooner. Shoes are not covered, but splints and braces are....after a copay.
I imagine if the law STATES something specifically, then the lawyers stick to the law. To them it is clear and they don't like ambiguity.
You can be a burr under their saddle, but just don't invest emotionally or financially. Thank God it isn't chemo or life saving surgery.
Law is not justice. Law is not fair. Law is not ethical. Law is what some governmental body agreed to....just think about women and the vote. The law once stated that people of a certain skin color were 3/4ths of a person...and remember the Salem witch trials?
It stinks after you invest so much energy, and it seems totally illogical to not cover it for PN from any cause...It depends on which disease lobby gets to the law makers first, or most generously.
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Actually, this SCREAMS of discrimination. To differentiate between Diabetic Neuropathy, and Peripheral Neuropathy is well, DUMB!!!
Even the judge said 'are you telling me you won't pay for Alan's inserts because he's NOT a diabetic?" and the insurance company said; "yes, don't blame us, blame medicare guidelines".
So, besides appealing, I am going to try and reach someone who writes the medicare guidelines and have them them say something to the effect:
"People with neuropathy (no matter what the reason), if their doctor says it's a medical necessity and they need custom shoes and custom orthotics, then this should be covered under Medicare (or some such wording).
I'm flying blind here, I know, but this will impact a lot of people who can only wear custom shoes. The only other recourse is a wheelchair.
And I find that very sad.
Take care,
Melody