I just spent a month in a nursing home, thanks to cellulitis that prevented me from wearing my prosthetic leg (I’m going home tomorrow, thank Og!). My insurance (Highmark Blue Shield) has had no real problem approving my continued care here, including physical therapy. Room and board here alone are $10,000 month. I’m sure PT is on top of that.
And yet they just declined to pay for a walker sling, which is at worst $150 and is a durable medical device (which means that I can use it until it falls apart, which is quite a while judging from how much punishment the one that belongs to the therapy department has taken in two separate stays (yes, it’s the same sling I was using when I was here two years ago).
At what point do insurance companies balk? Especially when it makes little sense, as this one does? “We’ll pay insane amounts for an ephemeral service that is used up in practically the same second that it’s administered, but we won’t pay what’s pocket change for us for a device that’s going to last you years.” Where’s the cutoff and what’s the rationale?