Medicaid Won’t Pay for Essential Therapy for Oklahoma City Nursing Home Resident

Medicaid planning is important because Medicaid can provide important coverage for seniors requiring nursing home care and for certain other medical expenditures.

However, while qualifying for Medicaid may be essential to avoid significant financial loss, seniors should be aware that Medicaid may not cover everything they require to stay as healthy as possible and to maintain optimum quality of life. Just recently, Red Dirt Report told the story of a troubling situation in which Medicaid is refusing to pay for therapy a paralyzed Oklahoma City nursing home resident needs. 

The case shows the downsides of relying solely on Medicaid benefits, especially if you do not have a legal advocate to speak for you or help you fight for the care you need. A Medicaid planning lawyer can provide advice to seniors on how to qualify for Medicaid, ensure you get covered, and identify the other insurance coverage you may need for comprehensive care.

Parman & Easterday has a long history of helping seniors get their medical needs met. Give us a call today at (405) 703-9987 or contact us online to speak with a member of our legal team and learn how our Oklahoma City Medicaid planning and elder law attorneys can help you.

Medicaid Refusing to Pay for Therapy for Oklahoma City Man

The man whose story was reported in the Red Dirt Report is a resident of Quail Creek Nursing Home in the north west part of Oklahoma City. Before residing at this facility, he was in and out of various nursing homes after a fall in his shower three years ago left him paralyzed.

Medicaid pays for his residency in Quail Creek Nursing home as he has no family or outside support and no income or assets to pay for his care. He says he doesn’t know where he would be if Medicaid did not pay for him to live in the nursing facility.

While Medicaid is paying for his nursing care, however, it has denied coverage for physical therapy. He believes if he was able to receive daily therapy for his fingers, hands, and legs, his condition would improve.

Currently, he cannot feed himself and is not able even to operate the remote control for the television. He lies in bed for most of his day, dependent upon nurses aids, nurses, and friends who occasionally visit him. While he is wheeled to the TV room to socialize with other people in the nursing home, his life experiences are limited by his serious disabilities.

Two-and-a-half years ago, things were not as dire for him.  He was receiving daily physical therapy and was improving. He had gotten to the point where he could squeeze a ball, touch his nose, eat a french fry, and do other tasks. Unfortunately, Medicaid stopped paying for therapy and any help he gets now is provided for free by physical therapists. Therapists have said if he was able to receive therapy two or three times a week, his condition could improve. He tries to do exercises on his own, but this is very limited.

He says he would rather not continue to live if he is forced to live like this for the rest of his life. Unfortunately, with Medicaid budgets limited and with some Oklahoma lawmakers proposing cuts for Medicaid, it is not clear if he will ever be able to receive the therapy which could help improve his quality of life.

Legislators last year were talking about reducing Medicaid reimbursement rates by as much as 25 percent.  This has led to speculation that some nursing homes would have to shut down. The cuts were averted last year, but the threat of cuts and changes to Medicaid linger and these cuts could make life for patients like this man even worse.

Getting Help from an Oklahoma City Medicaid Planning Lawyer

Seniors need to do Medicaid planning to make sure they receive help from the government in paying for nursing home care and other medical costs, while also acquiring needed insurance for non-covered expenses.

Seniors should work with a Medicaid planning and elder law attorney to develop a comprehensive plan to  protect themselves so they can obtain the medical care they need. Parman & Easterday is here to help, so give us a call today at (405) 703-9987 or contact us online to find out more.