Re: Medicare Info re Hip Replacements?

[Guest guest]

I don't think this is true as I know that Medicare has reimbursed for hip resurfacing operations which are not "recommended" for people over 60.Generally the metal/metal is not considered necessary for older patients because there is not the high likelihood of their needing a revision. Also (and this is just a generalization), their activity level is generally not going to be compromised. Therefore many very reputable OS feel comfortable putting in the poly (especially the newer cross linked poly) on older patients.However, Medicare covers a broad range of ages -- one can be 65 and theoretically have 20 or more active years ahead -- versus someone who is facing hip replacement in his/her late 70's -- or even older.However, I would certainly see more than one OS -- I would do this even if Medicare weren't an issue. It's just common sense when dealing with major medical procedures.On Jun 23, 2007, at 12:34 PM, Terry wrote:I've consulted with the doc that does most of the hip replacements in my area and asked him about the metal-on-metal, larger-diameter replacements that seem to offer the promise of being more long-lasting and offering a greater range of motion than earlier models.He said that Medicare would never pay for them and something to the effect that if he installed one in me he would "lose [his] license." That doesn't make sense to me, but in any case I'd like to know if there are Medicare rules about what sort of hip replacements are allowed, etc.I tried calling the Medicare 800 number, but was put on hold indefinitely and don't have much confidence in what the people on the other end of such calls tell you anyway. And I've been unable to find any information on Medicare's web site.Can anybody tell me what Medicare allows and doesn't allow (when it comes to hip replacements) or point me in the right direction?Thanks.Terry

[Guest guest]

See an new OS!!! He is simply not correct.

Two friends have recently had MOM thr paid for by medicare one at 80 the other

74 yrs. Six weeks and three months ago respectively.

Sound more like this OS prejudice rather than fact. A situation I would avoid

like the plague. If he feels free to distort this, what else might he be willing

to distort?

Sent from my BlackBerry® wireless device

Medicare Info re Hip Replacements?

I've consulted with the doc that does most of the hip replacements in my

area and asked him about the metal-on-metal, larger-diameter replacements

that seem to offer the promise of being more long-lasting and offering a

greater range of motion than earlier models.

He said that Medicare would never pay for them and something to the effect

that if he installed one in me he would " lose [his] license. " That doesn't

make sense to me, but in any case I'd like to know if there are Medicare

rules about what sort of hip replacements are allowed, etc.

I tried calling the Medicare 800 number, but was put on hold indefinitely

and don't have much confidence in what the people on the other end of such

calls tell you anyway. And I've been unable to find any information on

Medicare's web site.

Can anybody tell me what Medicare allows and doesn't allow (when it comes

to hip replacements) or point me in the right direction?

Thanks.

Terry

[Guest guest]

Please find a new surgeon. Medicare does indeed cover this if it is

recommended by your doctor. He also would never in a million years

lose his license for installing this device in you. If you are

active and want that range of motion you should pursue this idea

with a surgeon who is not such a putz.

Deb

>

> I've consulted with the doc that does most of the hip replacements

in my

> area and asked him about the metal-on-metal, larger-diameter

replacements

> that seem to offer the promise of being more long-lasting and

offering a

> greater range of motion than earlier models.

>

> He said that Medicare would never pay for them and something to

the effect

> that if he installed one in me he would " lose [his] license. "

That doesn't

> make sense to me, but in any case I'd like to know if there are

Medicare

> rules about what sort of hip replacements are allowed, etc.

>

> I tried calling the Medicare 800 number, but was put on hold

indefinitely

> and don't have much confidence in what the people on the other end

of such

> calls tell you anyway. And I've been unable to find any

information on

> Medicare's web site.

>

> Can anybody tell me what Medicare allows and doesn't allow (when

it comes

> to hip replacements) or point me in the right direction?

>

> Thanks.

>

> Terry

>

[Guest guest]

I've consulted with the doc that does most of the hip replacements in my area and asked him about the metal-on-metal, larger-diameter replacements that seem to offer the promise of being more long-lasting and offering a greater range of motion than earlier models.He said that Medicare would never pay for them and something to the effect that if he installed one in me he would "lose [his] license." That doesn't make sense to me,

I agree. It seems that sometimes doctors just make up things. I could see Medicare not paying more than the amount they've decided new hips should cost, so that you might have to pay the difference, but lose his license??? That reminds me of the time when I went to a hand surgeon to ask for cortisone shots into my Heberden's nodes (very painful nodules that develop in the distal joints of the fingers). She told me it would be "unethical" and got mad at me. Then I found a doc in my doc's clinic who 'loves to shoot cortisone into anything" and did it for me.

Have you tried going to the site of the company that manufacturers the hip you want to see if they have a physician locator?

Ann

but in any case I'd like to know if there are Medicare rules about what sort of hip replacements are allowed, etc.I tried calling the Medicare 800 number, but was put on hold indefinitely and don't have much confidence in what the people on the other end of such calls tell you anyway. And I've been unable to find any information on Medicare's web site.Can anybody tell me what Medicare allows and doesn't allow (when it comes to hip replacements) or point me in the right direction?Thanks.Terry

[Guest guest]

At 07:30 PM 6/23/2007, Ann wrote:

>Have you tried going to the site of the company that manufacturers the hip

>you want to see if they have a physician locator?

Yes, I did, and the doc I went to is one of the ones listed (on the DePuy

site, http://www.jointreplacement.com ). That's one reason I'd like to see

just what the Medicare policy is when it comes to hip replacements.

>I tried calling the Medicare 800 number, but was put on hold indefinitely

>and don't have much confidence in what the people on the other end of such

>calls tell you anyway. And I've been unable to find any information on

>Medicare's web site.

>

>Can anybody tell me what Medicare allows and doesn't allow (when it comes

>to hip replacements) or point me in the right direction?

>

>Thanks.

>

>Terry

>

>

[Guest guest]

>

> Please find a new surgeon. Medicare does indeed cover this if it is

> recommended by your doctor. He also would never in a million years

> lose his license for installing this device in you. If you are

> active and want that range of motion you should pursue this idea

> with a surgeon who is not such a putz.

>

> Deb

Well said, Deb

[Guest guest]

Perhaps you should inform DePuy of his conduct??

Chris

>

> >Have you tried going to the site of the company that manufacturers

the hip

> >you want to see if they have a physician locator?

>

> Yes, I did, and the doc I went to is one of the ones listed (on the

DePuy

> site, http://www.jointreplacement.com ). That's one reason I'd

like to see

> just what the Medicare policy is when it comes to hip replacements.

>

>

> >I tried calling the Medicare 800 number, but was put on hold

indefinitely

> >and don't have much confidence in what the people on the other end

of such

> >calls tell you anyway. And I've been unable to find any

information on

> >Medicare's web site.

> >

> >Can anybody tell me what Medicare allows and doesn't allow (when

it comes

> >to hip replacements) or point me in the right direction?

> >

> >Thanks.

> >

> >Terry

> >

> >

>

[Guest guest]

The only way I can see him losing his license is: if he

is already doing something illegal with Medicare billing and using the more

expensive hip may cause some kind of audit.

[Guest guest]

I got hold of a person at Medicare because their coverage booklet is very vague about what they cover. This person said that Medicare decides AFTER your doctor sends the bill whether they'll cover whatever procedure you had done. She said she had talked to several people for whom Medicare covered knee replacements, and had never talked with anyone for whom Medicare had refused knee replacements.

She said "ask your doctor if Medicare has covered X procedure in the past". It's the only way to find out ahead of time. So I guess you'd be taking a risk having a knee replacement with the one who said they don't. Maybe he just doesn't like what Medicare pays.

Here's something really frightening: Medicare will cover a lipid panel ONLY ONCE EVERY 5 YEARS. How stupid is that? Or is it that they hope you just have a heart attack & get off the Medicare rolls?

Ann

Re: Medicare Info re Hip Replacements?

Perhaps you should inform DePuy of his conduct??Chris> > >Have you tried going to the site of the company that manufacturers the hip > >you want to see if they have a physician locator?> > Yes, I did, and the doc I went to is one of the ones listed (on the DePuy > site, http://www.jointreplacement.com ). That's one reason I'd like to see > just what the Medicare policy is when it comes to hip replacements.> > > >I tried calling the Medicare 800 number, but was put on hold indefinitely> >and don't have much confidence in what the people on the other end of such> >calls tell you anyway. And I've been unable to find any information on> >Medicare's web site.> >> >Can anybody tell me what Medicare allows and doesn't allow (when it comes> >to hip replacements) or point me in the right direction?> >> >Thanks.> >> >Terry> >> >>

[Guest guest]

I also called my gap insurance and they said yes Medicare does cover joint replacements. Their policy is not to commit themselves up front in case the doctor bills it wrong.

And the lipid panel thing is only restricted to every 5 years for people who aren't at risk. Whew!

Ann

Re: Medicare Info re Hip Replacements?

Perhaps you should inform DePuy of his conduct??Chris> > >Have you tried going to the site of the company that manufacturers the hip > >you want to see if they have a physician locator?> > Yes, I did, and the doc I went to is one of the ones listed (on the DePuy > site, http://www.jointreplacement.com ). That's one reason I'd like to see > just what the Medicare policy is when it comes to hip replacements.> > > >I tried calling the Medicare 800 number, but was put on hold indefinitely> >and don't have much confidence in what the people on the other end of such> >calls tell you anyway. And I've been unable to find any information on> >Medicare's web site.> >> >Can anybody tell me what Medicare allows and doesn't allow (when it comes> >to hip replacements) or point me in the right direction?> >> >Thanks.> >> >Terry> >> >>

[Guest guest]

The first surgeon I saw about replacing my second hip wasn't comfortable doing the MOM surgery, I guess it requires more expertise. He was very honest about his experience level and referred me to my original surgeon, the one that replaced my first hip 2 years ago. Could be that this surgeon has too much ego to admit that he's not experienced enough to do a MOM. ???????

In a message dated 6/24/2007 9:30:55 AM Pacific Daylight Time, realtyrs@... writes:

See an new OS!!! He is simply not correct.Two friends have recently had MOM thr paid for by medicare one at 80 the other 74 yrs. Six weeks and three months ago respectively.Sound more like this OS prejudice rather than fact. A situation I would avoid like the plague. If he feels free to distort this, what else might he be willing to distort?

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