Patient’s plight points to pitfalls

Sunday, November 30, 2008

When Shirley Holbrook, 72, decided to move from her home in rural upstate New York closer to family in Ohio, selling her house was the easy part. Holbrook, who suffers from COPD and congestive heart failure, nearly struck out when it came to lining up a new oxygen provider. Holbrook is a Medicare beneficiary who reaches her 36-month cap on oxygen reimbursement Jan. 1, 2009.

HME News: What happened when you tried to find a new oxygen provider?

Shirley Holbrook: Nobody wanted to touch me. They didn’t want to give me a new machine and then only get three months of payments from Medicare. They didn’t even want to deliver oxygen to me.

HME: Had you already heard of the cap?

Holbrook: I got a letter from my oxygen company, Associated Healthcare. At the time it didn’t sink in and we weren’t planning to move. I didn’t understand the repercussions. Apparently, neither did the people who passed the law.

HME: What did you do next?

Holbrook: I was in a panic. The house was sold and we had put a down payment on a condo. I called my senators and congressmen. But I got most of my help from my local provider up here. They came up with (a provider that would take me on).

HME: What would have happened if they hadn’t?

Holbrook: We could scrape along for a while. I have supplemental insurance, too. They pay 80% of what Medicare doesn’t pay. But I still wouldn’t have had anybody to service my machine. Good grief. We’re better off financially than a lot of people. I still have some brain cells. I get out as much as I can, and I can fight with my congressmen.