56 days gone without a trace

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Noticed some messages of replies to threads I post in, and others of "where are you". Problem is, I 've been in a local rehab center getting my busted left knee rehabbed. They have a crappy Fortinet hardware firewall on the building, so I could get email, but could not reply or post on my forums.
Anyway, I experienced the ultimate stupid accident. Went to the local corner gas/snacks/beer/armed robbery store on the corner two blocks from my apartment. Had a craving for some chocolate and a Ginger Ale, of all things. Slipped my American Arms 22LR PX-2 in my back jeans pocket and took the walk. It was about midnight on June 7. Got home with no problems.
Pulled the pistol from my back pocket, dropped the mag (it's a Walther style semi), and jacked the slide to eject the chambered round. Hand slipped, and even though my trigger finger (right handed) was parallel to the slide, one of the others hit the trigger as the slide slammed shut. BANG I shot myself in my left knee - in the big bone, luckily, but the damage was done. 32gr HP.
Surgery the next morning at the crack of dawn, and now, 56 days later, my Medicare/retirement insurance cancelled me, saying I was back to normal. Yeah, right...
So, now I am back home. My left knee hates it, for now. PT is not close to finished. Only major improvement is I haven't had a cigarette in 56 days, and am not really craving one, yet.
We shall see.
Glad to be back, and though worse for wear, something I never expected going into my 75th year.
 
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I had a cop friend that shot himself through the kneecap with a Glock 45. He was walking 12 hours later, using a walker and a straw through his leg as a drain. By day 2 the walker and straw were gone and a cane was all he used. Did he ever take a ribbing, not on the shooting but on letting people see his white legs in shorts.
 
"... and now, 56 days later, my Medicare/retirement insurance cancelled me, saying I was back to normal." What does this mean?
It seems that now my Medicare Part C (before I retired the provider was my regular health insurance), and Medicare, stated that I was finished with Occupational Therapy (whatever that is) and back to the physical condition I was before the accident. The cut-off is usually around 21 days (so I was told by rehab staff), but oddly I made it to 35 days before the first notice. A doctor somewhere overruled the first discharge at 35 days. Second one came 18 days later, and I had less than 36 hours to file an appeal. This time, I was turned down. All parties at the rehab center, and online at Medicare, said the odds of getting the second reversal was little to none... I bailed, as a second review could take up to 14 days (was told two weeks was not unusual), and I would end up being billed back to the release day (Friday - one day of grace), and owe nearly $8,000 for 14 days service...

There are big kinks in long term care now, especially if you are there to try to rehab and recover. Seems if you are less crazy than full institutionalization, or not yet sick enough for hospice, the corporate places which now run healthcare will keep you going for a long while.

An aside that probably added 10-14 days to the first 35 day stretch - a week in, I caught a bladder infection. Never had one before. Six days of deep painful antibiotic shots in my hips. Got a clean bill of health from my original surgeon. Then two days later I had a different bladder infection, and now an I.V. in my left arm, with antibiotic drips every 8 hours for the next 7 1/2 days. Hard to do PT with a plastic line in your forearm...

My apologies to the staff for pontificating, but this has been a terrible summer lead up to a milestone birthday.
 
It seems that now my Medicare Part C (before I retired the provider was my regular health insurance), and Medicare, stated that I was finished with Occupational Therapy (whatever that is) and back to the physical condition I was before the accident. The cut-off is usually around 21 days (so I was told by rehab staff), but oddly I made it to 35 days before the first notice. A doctor somewhere overruled the first discharge at 35 days. Second one came 18 days later, and I had less than 36 hours to file an appeal. This time, I was turned down. All parties at the rehab center, and online at Medicare, said the odds of getting the second reversal was little to none... I bailed, as a second review could take up to 14 days (was told two weeks was not unusual), and I would end up being billed back to the release day (Friday - one day of grace), and owe nearly $8,000 for 14 days service...

There are big kinks in long term care now, especially if you are there to try to rehab and recover. Seems if you are less crazy than full institutionalization, or not yet sick enough for hospice, the corporate places which now run healthcare will keep you going for a long while.

An aside that probably added 10-14 days to the first 35 day stretch - a week in, I caught a bladder infection. Never had one before. Six days of deep painful antibiotic shots in my hips. Got a clean bill of health from my original surgeon. Then two days later I had a different bladder infection, and now an I.V. in my left arm, with antibiotic drips every 8 hours for the next 7 1/2 days. Hard to do PT with a plastic line in your forearm...

My apologies to the staff for pontificating, but this has been a terrible summer lead up to a milestone birthday.
So, your insurance company didn’t cancel your policy, they just closed the window on future claims they would pay on the initial injury, it sounds like.
 
Phenix, you are correct. No further payment to the corporate extended nursing facility. If they are still making a profit on you, they will stand up for your continued care. If a new person in the bed space makes more profit, then no support and out you go.
Insurance is covering 100% of home health and physical therapy, bought me a walker, safety rails for my toilet, and an adjustable height rollator so I can get to and from my car to Walmart, etc. Nice benefit for an old man. The home health care nurse said I'm moving around much better than she expected, considering the time frame.
 
Phenix, you are correct. No further payment to the corporate extended nursing facility. If they are still making a profit on you, they will stand up for your continued care. If a new person in the bed space makes more profit, then no support and out you go.
Insurance is covering 100% of home health and physical therapy, bought me a walker, safety rails for my toilet, and an adjustable height rollator so I can get to and from my car to Walmart, etc. Nice benefit for an old man. The home health care nurse said I'm moving around much better than she expected, considering the time frame.
Good luck on your recovery.
I had a liver transplant on 15 April and double-hernia surgery on 6 June of this year so I have had some mobility issues myself, but am almost back to reasonably normal now. For some reason my legs are still weak from lying around so much after the surgeries, and my knee and pelvis/upper leg joints are stiff and sore. May have something to do with the 8 different kinds of pills I have to take every day. Fortunately, the doctors and case workers are gradually reducing most of the dosages.
I have been extremely lucky as far as insurance coverage goes. A liver transplant and related after surgery costs usually run around $900,000.
The to-date summary EOB packet from Humana we got two days ago says the total cost for both surgeries are around $690,000, with us owing possibly $3,000 out of pocket. I have Tri-Care For Life insurance as well, so they may pick up most of that as well. BTW, I was only on the wait list for 11 days, and I have the rarest blood-type there is.
As no particular fan of some insurance company practices,I have to say I was shocked when a Humana rep called me 3 weeks prior to the transplant to say everything would be covered, even travel and most lodging expenses. Barnes Jewish ( we are not Jewish, but I have nothing against them at all ) Hospital is a 4 hour drive from home, and we were required to stay in the St. Louis area for an additional month after discharge so they could have me close for twice-a-week nurse monitoring visits.
Am waiting to see if there will be any negative policy repercussions from Humana after all the dust settles.
 

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