In 2018 my spouse was in a skilled nursing care facility after an extensive surgical procedure. Under the provisions of her policy (Medicare Advantadge) she was covered for 20 days with NO out of pocket.
For the last year we have been appealing through the insurer a claim from the skilled nursing center (that started at $2,500) and is now down to $1,000.
Supposedly this cost to us is for something that has only been described as “sub acute care” for a 7 day period during her stay of 18 days. The thing is that she received absolutely no form of care that was not commonly administered to other patients in the facility. In point of fact she was essentially left to attend to herself with assistance from an aid to go to the toilet.
I believe this cost to us is part of a widespread practice of Medicare and Insurance Fraud.
How can I fight this?