My sister is 65 years old and she had rotator cuff surgery done. They have special facilities which covers your surgery costs. If Medicare doesn't cover it, you can opt for those facilities. It was very beneficial for us as they also have the best orthopedic care in long island.
Some rehab facilities actually recruit elder folks. You'll find these at aging expos, sometimes at AAA annual expos and sometimes at smaller community ones.
Having used both private and hospital affiliated rehab facilities, I'd go with the hospital ones any time, especially the ones right on a hospital campus or in a hospital clinic or other facility specifically affiliated with the hospital.
Two of the ones I've gone to at the time had special programs by which a patient could return for either 1 or 2 months after completing insurance paid therapy and work out on his/her own for $25/month. That's a bargain by any standard. A doctor's approval might be necessary for an older person; for me, I just signed up and paid.
Another one wanted about $100 for another month of therapy, 3x what I could have paid had I chosen a hospital affiliated PT program.
Another advertised at a senior expo that they also offered patient paid follow-on otherapy at a reasonable price (something around $50/month if I remember correctly), but balked, hedged and wavered when we got to that point. They won't be getting any more of our business.
My mom had rotor cuff surgery when she was in her late 80's. She was Medicare & a high option federal BCBS for her secondary. Both required a secondary review of her health status as part of the pre admit. Also the ortho MD required that mom get evaluated by a gerontologist. Not her old internist either but a gerotologist within the system (health science center with medical school) he was affiliated with. Surgery was pretty straightforward & covered 100% between the 2 insurance programs. But surgery is only just part of it. There will be rehab too. Doing the PT & OT afterwards was pretty challenging for mom. She did it about 6 months and really I think that if she did not have the federal BCBS who paid for most of the rehab (PT & OT), I don't think she would have found a rehab group who would take her.
Really speak with your secondary insurance to see what they will pay for in rehab and for how long (like do they just take the report of the PT or do they do their own evaluation). You may have to pay a lot of the % of the rehab costs. If you don't "progress" in your PT/OT, you will get discharged from insurance too. My mom was driven in rehab as her goal was to be able to roll her hair and hold a mirror to see the back of her head too. Think if you could reasonably do the rehab needed.
According to data from the Centers for Medicare and Medicaid Services, it costs Medicare $5000 to $7000 for an arthroscopic rotator cuff repair. Medicare will cover it if you are healthy enough for surgery. A reverse total shoulder arthroplasty costs approximately $15,000 to $17,000 or more. Unfortunately over 50% have failures or complications. Medicare says NO, too risky for the patient. A reverse total shoulder implant ranges from $10,500 to $13,000 or more, depending on the manufacturer; the Medicare reimbursement doesn’t cover the cost of this procedure either. If you have supplemental coverage, check with your insurance company.
Um, why wouldn't it? I don't understand what factor age plays...or maybe there's some new regulation of Medicare?
Best thing to do is ask your physician - if he/she performs surgery, he/she likely has someone who boards surgery and/or deals with Medicare. Then you'll get reliable answers.
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Having used both private and hospital affiliated rehab facilities, I'd go with the hospital ones any time, especially the ones right on a hospital campus or in a hospital clinic or other facility specifically affiliated with the hospital.
Two of the ones I've gone to at the time had special programs by which a patient could return for either 1 or 2 months after completing insurance paid therapy and work out on his/her own for $25/month. That's a bargain by any standard. A doctor's approval might be necessary for an older person; for me, I just signed up and paid.
Another one wanted about $100 for another month of therapy, 3x what I could have paid had I chosen a hospital affiliated PT program.
Another advertised at a senior expo that they also offered patient paid follow-on otherapy at a reasonable price (something around $50/month if I remember correctly), but balked, hedged and wavered when we got to that point. They won't be getting any more of our business.
Really speak with your secondary insurance to see what they will pay for in rehab and for how long (like do they just take the report of the PT or do they do their own evaluation). You may have to pay a lot of the % of the rehab costs. If you don't "progress" in your PT/OT, you will get discharged from insurance too. My mom was driven in rehab as her goal was to be able to roll her hair and hold a mirror to see the back of her head too. Think if you could reasonably do the rehab needed.
A reverse total shoulder arthroplasty costs approximately $15,000 to $17,000 or more. Unfortunately over 50% have failures or complications. Medicare says NO, too risky for the patient.
A reverse total shoulder implant ranges from $10,500 to $13,000 or more, depending on the manufacturer; the Medicare reimbursement doesn’t cover the cost of this procedure either.
If you have supplemental coverage, check with your insurance company.
Best thing to do is ask your physician - if he/she performs surgery, he/she likely has someone who boards surgery and/or deals with Medicare. Then you'll get reliable answers.