Denied treatment by Medicare anyone?

@nannybb Just one word - Appeal! Read the information they provided and do it right away.
I have not had your procedure, but have had several other denied claims. All but one was reversed on appeal, after more input from the doctor and me.

You sent an appeal? My doctor has already given all the clinical facts and appeal to Medicare. What frustrated me was according to the dates on the letter my doctor knew at least two month ago and did not tell me. I was assured they would get back to me after the last procedure to go on to the (hopefully) last one. It takes forever to get an appointment with the pain specialist. Even a video call. I wanted to get her take on all of this first. Does this mean the doctor's office did not get a referral before the procedure?

I suspect that you are in one of the states falling under the administrations new plan to make life more difficult for seniors https://www.elderlawrillc.com/6-states-to-pilot-prior-authorizations-for-original-medicare/ This is a big change for original Medicare. A change that delays services to seniors, while pretending to accelerate care. Private insurers have long wielded this money saving (I'm looking for a word more neutral than) trick.
While most appeals will succeed, wasting more of medicare's declining funds, many will just suffer.
This is the very money saving policy that cost one CEO's life. Washington, Arizona, Iowa, New Jersey. Oaklahoma Texas In California I recently received a notice that a doctor or hospital cannot collect charges for a service if they have neglected to secure prior approval. I don't know if that applies in other states.
Your doctor's office should appeal by your request. We would all be better served by opposition to this new 6 state trial.
I have friends in Iowa suffering excruciating waits for care.

My doctor has already sent an appeal. I'm sure they would just as soon hope to save money by putting seniors on the MAID list like Canada. I don't say that lightly either. Many have not heard of it. America needs to wake up. There is definitely something going on. I've never faced so many delays and foul-ups. I worked in Healthcare years ago. SO different now. But that was also Fl. I'm in Oregon now. Big mistake in moving in many ways. Not meaning to get political...just talking healthcare.

@nannybb, just to clarify. Medical assistance in dying (MAID) in Canada and other jurisdictions is a process that the patient chooses providing they meet criteria of mental competency, have a grievous and irremediable medical condition, and is 18 or older (among other details). It s not a money saving scheme or a list that anyone "puts seniors on".

@gently, Iowa is not one of the 6 trial states per the article you have linked.

babe2004, thank you. I do get Iowa and Ohio mixed up.

@gently I would agree with this. Six states are trying this with certain procedures.

I am very concerned about this. I have sent this email to my Representatives. Hopefully other people will speak up before it's everywhere.

I am writing to express my concern about the expansion of prior authorization requirements within Original Medicare.
While reducing waste is an important goal, prior authorization often creates delays in treatment, adds administrative burdens to already overextended medical practices, and inserts additional barriers between patients and their physicians. Decisions that should be made in the exam room increasingly become subject to paperwork, reviews, and waiting periods.
For older adults and those living with chronic pain or disabling conditions, delays are not merely inconvenient. They can prolong suffering, postpone recovery, and increase anxiety at times when patients are already vulnerable.
Programs such as these also contribute to the growing depersonalization of medical care. Patients deserve a healthcare system that trusts qualified physicians to make appropriate treatment decisions and allows them to focus on care rather than bureaucracy.
I urge you to carefully examine the impact of expanding prior authorization requirements and to prioritize timely, patient-centered care.
Thank you for your consideration.

@nannybb in order for a Medicare beneficiary to be held responsible for any cost related to any procedure the doctor performing the procedure must have you sign a form indicating that you may be held responsible for any cost not covered by insurance prior to the procedure. If this was not done you are off the hook.