Why doesn't Medicare pay for shower chairs?

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asked Dec 1, 2023 in Other- Health by Cynthia3499s (2,260 points)
Why doesn't Medicare pay for shower chairs?

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answered Dec 14, 2023 by Salmorejo (40,200 points)
The reason Medicare doesn't pay for shower chairs is because shower chairs are not considered to be durable medical equipment by Medicare.

Medicare only pays for durable medical equipment that is medically necessary.

The reason doctors don't like Medicare Advantage plans is because of the issues that doctors can face with Medicare Advantage plans.

The issues that doctors can face with Medicare Advantage plans is issues with referral and pre authorization requirements that can impede a patients needed medical care.

Drugs that Medicare does not cover are drugs used to treat erectile dysfunction, drugs that are for relief of cough and cold symptoms, drugs for hair growth or cosmetic purposes and drugs for fertility or weight loss, weight gain or anorexia.

Bed pads and other incontinent supplies are not covered by Medicare.

Medicare does not pay for any amount of adult diapers or incontinence supplies.

You will have to pay out of pocket for adult diapers and incontinent supplies.

Medicare does not pay for depends undergarments or depends or other incontinence supplies including adult diapers, adult pull ups, adult incontinence pads etc.

Medicare sometimes pays for incontinence treatment but not for incontinence supplies.

Medicare does pay for nursing home care but not usually full time care for longer than 100 days.

Medicare covers up to 100 days of care in a SNF, in a single benefit period, as long as you stay eligible.

What's covered by Original Medicare? For days 1–20, Medicare pays the full cost for covered services.

Medicare does cover some forms of transportation such as transportation that is deemed medically necessary such as rides to and from dialysis treatments.

But normal transportation such as to and from regular doctors appointments are not covered under Medicare.

Medicare does in some cases pay for incontinence treatment but not for incontinent supplies such as adult diapers, adult incontinent pads, pull ups etc.

Medicare is not the exact same thing as Medicare although Medi-cal is a type of Medicare for California residents.

Basically Medi-Cal is California's medicaid health care program so yes Medi-Cal is Medicare but only for California Residents.

Medicare is a federally funded health insurance program that is for people age 65 and over and Medi-Cal is also partially federally funded but only for California Residents while Medicare is for residents of any state.

In addition, the federal government currently pays 90 percent of Medi‑Cal costs for individuals enrolled as part of the ACA optional expansion, as opposed to 50 percent for most other beneficiary populations.

Federal COVID‑19 Policies Increased Caseload but Reduced General Fund Costs.

The ER is free with Medi-Cal if you need the emergency room services and it is a medical emergency.

However if you just visit the ER and it's not an actual medical emergency then Medi-Cal may not cover the entire cost of the ER.

Medi-Cal covers emergency room services for enrolled members of Medi-Cal and if you should your BIC to the emergency room staff then Medi-Cal will pay for the services that you receive.

The cost to go to the ER with Medi-Cal is $5.00 if you don't actually need the the emergency room service and if you do need the emergency room service then you may only have to pay $1.00 or may not have to pay anything with Medi-Cal for the ER visit.

If you get a medical or dental service or prescribed medicine then the cost is usually $1.00

Medi-Cal does cover CT scans that are ordered by the doctor.

The Medi-Cal reimbursement for the CT scans of multiple anatomic sites that are performed at teh same session and time on the same date are.

Medi-Cal reimbursement for the professional component (modifier 26) is 100 percent for the CT scan with the highest reimbursement price and 75 percent for all other CT scans.

Medi-Cal covers most medically necessary care which also includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment.

Medi-Cal also covers transportation to these services.

Free air on a CT scan means and indicates a perforated abdominal viscus.

The most common cause of the perforated abdominal viscus is a peptic ulcer.

People with this condition need urgent surgery.

A PET Scan is better than a CT Scan as it shows more issues than a CT Scan does.

However a PET Scan takes longer and is more time consuming than a CT Scan.

In emergency situations when doctors need to act fast the CT Scan is much better but sometimes the PET Scan is needed to show any possible additional problems.

A CT scan shows detailed pictures of the organs and tissues inside your body.

A PET scan can find abnormal activity and it can be more sensitive than other imaging tests.

It may also show changes to your body sooner.

Doctors use PET-CT scans to provide more information about the cancer.

The cost of a PET Scan ranges from $3,000.00 to $12,000.00 depending on what is being scanned during the PET Scan.

For example the costs of a PET Scan depending on the body parts being scanned through the PET scan is listed below.

Whole Body PET Scan $3,000.00 - $12,000.00

Heart PET Scan    $2,800.00 - $24,200.00

Brain PET Scan    $2,200.00 - $10,700.00

Skull to Mid-thigh PET Scan $3,200.00 - $12,000.00

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