Re: Why Doesn't Medicare Pay For Pulmonary Rehab in cases of IPF?

[Guest guest]

Thosmagna,

I'm so sorry that you are having difficulty getting Medicare to pay for rehab. I'm starting a second round of pulmonary rehab on Wednesday that Medicare has approved and agreed to pay for. Is there someone in your pulmonologist's office who can help you appeal this decision.

Pulmonary rehab is most assuredly not just for those with COPD. We can benefit tremendously and I would encourage you to fight this ruling if at all possible!

Beth

Moderator

Fibrotic NSIP 06/06 Dermatomyositis 11/08

To: Breathe-Support Sent: Monday, September 7, 2009 9:03:56 PMSubject: Why Doesn't Medicare Pay For Pulmonary Rehab in cases of IPF?

My Pulmo recently ordered pulmonary rehab for me. After waiting several weeks for my appointment @ UMC Tucson,I received a call the day before I was to start & was told "medicare will not pay for rehab for me,because my FEV1 numbers are too high." I do not have COPD, my problem is IPF (I do not have trouble getting air into and out of my lungs, my problem is getting O2 from my lungs to my blood stream and to the rest of my body.) Apparently pulmonary rehab is only for those who have COPD! Sorry about the RANT, as I know no one here can resolve this issue. I'm 77 y/o on O2 24/7 for 4 1/2 years w/ IPF: thosmagna

[Guest guest]

I don't know any of your numbers so can't make any definitive statement

about your situation. FEV1 and FVC would be used toward determining

need. However, a lot depends on the doctor finding a way to properly

document your need and what the rehab is expected to accomplish. The

rehab facility may be able to help in that regard too by providing his

office with their experience.

Rehab is not only for COPD but can be prescribed for many things if all

the details are done well and the need and benefits clearly shown. Don't

accept the first " no. "

I don't understand your statement that you don't have trouble getting

air into your lungs but having trouble getting oxygen from your lungs to

your bloodstream. Getting oxygen to your lungs is the key to getting it

into the bloodstream.

>

>

>

> My Pulmo recently ordered pulmonary rehab for me. After waiting

several weeks for my appointment @ UMC Tucson,I received a call the day

before I was to start & was told " medicare will not pay for rehab for

me,because my FEV1 numbers are too high. " I do not have COPD, my problem

is IPF (I do not have trouble getting air into and out of my lungs, my

problem is getting O2 from my lungs to my blood stream and to the rest

of my body.) Apparently pulmonary rehab is only for those who have COPD!

Sorry about the RANT, as I know no one here can resolve this issue. I'm

77 y/o on O2 24/7 for 4 1/2 years w/ IPF: thosmagna

>

[Guest guest]

Dear Thomagna, Yeah, have your doc resubmit request. It seems "they" finally get it after submitting paperwork for the third time. Anyway. that seems to be the way it works with our insurance company. Like they say the squeaky wheel gets the grease. God bless you! PJ in OH, 54, IPF '09, Sjogren's '95 Why Doesn't Medicare Pay For Pulmonary Rehab in cases of IPF?

My Pulmo recently ordered pulmonary rehab for me. After waiting several weeks for my appointment @ UMC Tucson,I received a call the day before I was to start & was told "medicare will not pay for rehab for me,because my FEV1 numbers are too high." I do not have COPD, my problem is IPF (I do not have trouble getting air into and out of my lungs, my problem is getting O2 from my lungs to my blood stream and to the rest of my body.) Apparently pulmonary rehab is only for those who have COPD! Sorry about the RANT, as I know no one here can resolve this issue. I'm 77 y/o on O2 24/7 for 4 1/2 years w/ IPF: thosmagna