Case Study : Rudy
Rudy was in his late 70's and was completely dependent upon an electric scooter which was on its last legs, so to speak. Its cost had been covered completely by Medicare four years earlier. Now, however, Rudy belonged to a senior HMO, and they refused to authorize payment for a new scooter. Fearing that he would be confined permanently to bed without one, he spent $5,000 of his own savings. In our view, his HMO was out of line and we assured him he was due a complete refund from them.
He wasn't up to doing battle with an HMO by himself, so we helped. We filed an appeal with the HMO. They reversed their decision, and promised to refund the cost. In fact, it took more than a year, and many, many phone calls before they actually sent him a check.
Rudy was referred to Aging Solutions by his financial planner. We provided a total of five hours of service over a year.