Jean MacDonald’s Story

Jean’s back pain had become too much to bear—her doctor decided it was time to see if a physical therapist could help.

And it did. Over the course of next several weeks, Jean received treatment from her new physical therapists 11 times and her pain was improving. That’s the last of the good news in this story.

“Not long after starting treatment, I received word from Medicare that they would only cover the first 6 visits of physical therapy. By that point, I had almost doubled my allotment as was very concerned about the mounting out-of-pocket costs I was facing.”

Jean and her team appealed the coverage and were successful in gaining permission for a few more treatments, but by the time that victory came the war was over.

“By the time the appeal came through, all the progress I had made was lost. I had to start from square one again, and never I made it all the way through to complete the therapy.”

Because of issues with prior authorization, Jean is still dealing with her severe back pain, something made even more bothersome by the knowledge that easily consistent physical therapy could have a real, positive impact on her quality of life.

David Pridniaarchive