The Cost of Medicare

I’m one of the old people who makes the cost of Medicare skyrocket. I’m on dialysis. If I don’t get my blood cleaned three times a week, I will die. It costs $3,000 a month.

For the past year and a half I’ve received dialysis through a graft under the skin in my left forearm. Each time I went to dialysis, the technician stuck two needles into the graft, one to pull blood out and run it through the machine, the other to send clean blood back into my body.

In March the doctor noticed some difficulty in pumping the clean blood into the vein. He sent me to the vascular clinic in Dallas, where Dr. Frank Rivera inserted a balloon into the graft to open the blockage. He sent a bill for $8,221.25. Medicare approved payment of $2,263.69, which seemed reasonable to me. Medicare paid $1,810.95; my insurance paid the other $452.74. The doctor agreed to accept the Medicare approved amount. I paid nothing.

That was in March. Then, when I went for dialysis on June 19, the vein was completely blocked, and I could not receive dialysis.

On June 21 I again went to the Dallas clinic, where Dr. Rivera operated on my arm without giving me any pain medication as he inserted another balloon. It only took an hour, but it was torture. And it didn’t work. When I went to dialysis the next day, the vein was still completely blocked.

The nurse sent me to the vascular clinic in Plano, another Dallas suburb, where Dr. Jeffrey Siegel operated on my arm without anything to deaden the horrific pain. Again, it didn’t work.

The next day I saw my surgeon. Dr. Cook said, “Why didn’t they send you to me in the first place?”

This week I received the Explanation of Benefits, statements from my insurance company for payments to the vascular clinics. This time Dr. Rivera billed $12,420.75. Medicare approved the full amount. Medicare paid him $11,716.22, and my insurance paid $704.53.

Dr. Siegel sent in a bill for $12,474. Medicare paid $12,427.30, my insurance $46.70.

For the two surgeries, which caused me trauma I am still struggling to overcome, and which did not correct the problem in my vein, Medicare paid a total of $24,143.52.

Is anyone shocked by these charges? Each procedure took less than an hour.

So far Dr. Cook has operated twice, once to insert a catheter in my chest where I will receive dialysis until my arm heals and a second time when, unable to relieve in blockage in my lower arm, he inserted a new graft in my upper arm. Both operations were done under complete anesthesia in the hospital. I have not received copies of the bills, but I know they will be horrendous.