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My mom is at the very end-stage of Alzheimer's and I had to get her in the Emergency Room several times. Even with mom being unable to walk due to urinary tract infections, Medicare has refused to pay for her 911 EMS rides to the Emergency Room. The ER doctor even wrote as part of her medical diagnosis as threat to life. I appealed this -- several times-- to both Medicare AND her Tricare-for-Life and both are still refusing to pay for it. Is this some kind of death panel they don't want mom treated and just let her die??


Although I am power of attorney (POA), when mom eventually dies I refuse to pay thousands in ambulance services which Medicare and Tri-care are refusing to pay. Can the Ambulance services turn on me for payment? Do I have to pay for her unpaid medical bills when she dies? You are talking about several thousands of dollars when it is nearly $700 for a single ride to the Emergency Room.


What does Medicare and Tri-care expect from me??? Do they just want me to not get mom treated and let her die? I told them both when mom gets a UTI she is so profoundly sick she can't walk to the car, and I cannot lift her up and carry her out to the car. Medicare and Tri-care For Life don't care and just give me the run-around. Tricare even said I filed too many appeals and it was costly administrative time. Then I get a letter from them saying I have to refile the appeal. Seriously! I must have sent them at least ten letters. They are so messed up it is beyond description.


I only pray I do not live as long as mom since Medicare does not like paying for ambulance services. I think they just want a person to die. A friend told me I will not be responsible for her medical bills after mom dies even with me being POA since they are her bills -- just fax them her death certificate. I am wondering if that's true or if someone had something similar.

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What reason is given for rejecting the claim?

All insurers will reject a claim if they can, and it doesn't help to take it as an unfeeling, personal affront. But they do have to say why they're rejecting it and then you know what to challenge.

Your POA ceases on your mother's death, and you cannot be personally liable for her bills anyway. But her estate may be, and her executor would then use the money from her estate to settle outstanding debts.
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Here is how Medicare reads

"Part B covers emergency ambulance services if: An ambulance is medically necessary, meaning it is the only safe way to transport you. The reason for your trip is to receive aMedicare-covered service or to return from receiving care. ... And, the transportationsupplier meets Medicare ambulance requirements."

I guess they feel a UTI is not an emergency. Maybe if she had been kept overnight?

You will not be the one sued, Mom will be. If u aren't worried about her credit score, don't pay. Or in "good faith" set up a payment plan and pay what Mom can afford monthly, lets say $50. That goes for any medical bills. But get it in writing. Years ago my Aunt set up a payment plan and the hospital still sent her to collections. TG it was a lawyer. She told him and he said just continue paying him the agreement.

When Mom passes the debt is hers and the estate is responsible for the bills. No money the bills go unpaid. POA stops and the Executor takes over.

If Mom is low income, you may want to apply for Medicaid health insurance. What Medicare doesn't pay Medicaid does.
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Rabanette Jun 2019
UTI is a medical emergency in a senior with dementia, as it can cause serious personality swings and other serious side effects. It can cause aggression, anger, agitation, confusion, and disorientation.
Those would seem to be serious issues that could cause harm to others or the patient.
I don't know the ambulance trip is separated from the rest of health care. It's so frustrating!
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Can EMS change the ride to a non-emergency medical transport? The last two times I had to call for help I used our non-emergency number to call for a non-emergency medical transport. I had to answer a few questions but I got the transport. Those last two calls stopped the dispatch of the Fire Dept. to our house
and changed the codes for the ambulance.
I found out the hard way that I coud not just call the ambulance company for a transport. I had to call our non-emergency help number.
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cetude Jun 2019
When mom is in serious trouble, I called 911. EMS came in response. When she is sick with fever and unable to move..she needs a trip to the Emergency Room or she could die from infection which can easily turn into SEPSIS and DEATH. She has NO immune system left.
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I called 911 in December after my husband began slurring his speech after taking one dose of a new medication. I thought he was having a stroke, and I could not get him out of the bed. He was taken to the ER and released 6 hours later after receiving IV fluids to "flush" the medicine out of his system. I found him unresponsive in a chair 90 minutes after we came home (by now it was 2:00 in the morning) and so I called 911 again. This time he was admitted to the hospital and was there for five days, very very sick and I think this whole thing advanced his dementia by at least a year. After receiving many bills and finally calling both his insurance company and the ambulance service, I was told the EMT's had written I called 911 because he had urinated on the floor. I'm still trying to get this paid, but who needs all this on top of everything else????
If I ever have to call 911 again, I'm getting a copy of the medic's report asap.
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Countrymouse Jun 2019
That's a very good point, and also a very good example of how it's worthwhile drilling down to the detail of what's on file with the claim.

I had a similar experience with a GP's report, to which I ended up attaching a closely-typed page of addenda, corrigenda and clarifications - 20 questions, virtually every one answered wrongly or incomplete.

But wouldn't it be nice to look that EMT in the eye and say "well? Explain?"
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EMS will not come after "you" to pay mom's bills. They will come after you, as POA, for mom. Hopefully, you signed as "Cetude" as POA for MomCetude. If not paid they will file a claim on any estate there will be. Is there a transport company that would come get her instead of using ambulance and lights and siren? A non-emergency response?


Some areas have memberships to EMS services. In my area it is $50.00 a year. With that fee paid, any emergency transport is not billed, included in the membership. EMS here uses it as a fund raiser for much needed equipment, and well worth the cost!
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Medicare is refusing to pay because the situation was deemed by the EMS ambulance as a non-emergency situation (not medically necessary). Please read the Medicare definition of an emergency; like shock, unconscious, or bleeding heavily, or the patient needs skilled medical treatment during transportation.
UTI is a serious situation, but you could have probably brought your Mom to the Hospital ER without the ambulance; like a Medi-Car/Cab service with a wheelchair.
You should be able work out a payment plan with the EMS.
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cetude Jun 2019
Mom is homebound, unable to get in the car even when she's "well" due to advanced Alzheimer's. When she has a UTI she is critically ill. My eldercare attorney fixed it nothing will ever go into probate, so I do not believe EMS can get a dime off of her estate. I accessed the EMS report and the ambulence driver stated she was "stable" which she was not. If she were "stable" I would not have taken her to the emergency room and unable to get up due to her UTI. If the amublence personnel does not know how to chart, they are going to have to suck up the bill because I'm not going to pay her bills when she dies. Yes I am POA, but they are still HER medical bills.
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If you are certain that you signed all those paper...POA...then you have NO responsibility for any of those bills

if they attempt to harass your Mom (I guess you pick up the phone). Tell them. “It is not alright to contact Mom with phone calls...ever.” Let them write letters.

you will never be responsible for those bills.

once she has died....they can try to collect from her estate if there is one. They will know because they will watch the probate court calendars. BUT, again, you are not ever responsible for your Moms bills
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When this happened with my mom, I discovered that the ER and the ambulance service had both Ms filed the claim the wrong way with Medicare—one of those infernal “code” mix-ups. Sad to say, I never could get it figured out and Mom wound up paying $750 that was never reimbursed.
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If I remember correctly, I think moms medicare and supplemental insurance paid $100 leaving a $300 balance owed each time. I paid them $20 a month out of her very limited funds. Of all her bills I really wanted to make sure the EMS guys got at least something. I was still paying on previous trips when she’d need another one. I finally paid them all off during the Medicaid application/spend down when she had a little extra money due to being in rehab and not needing to pay her for apartment.
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Just a follow up comment. Tri-Care is secondary payer for Medicare. If Medicare does not pay, tri-care does not usually pay.
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Llamalover47 Jun 2019
Since Tri Care is apparently the Medicare Supp Plan, they should pay - UNLESS the "letter" of the plan dictates no ambulance rides per its contract.
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