A really good resource to look at as far as navigating the system (and a really cool program) is called Visions of Independence www.visionsofindependence.com. It is based out of Sharon, MA and is current serving the state of MA and is working right now to expand into RI. OTs work for them as contractors and go into the homes to see the patients with low vision. They bill Medicare for the 80% and the HMO is billed for the 20% copay (Blue Cross etc). The cap does apply as it is Med B, but they say that so far, it has not been an issue for any of their clients. The patient cannot be receiving home health services. Again, none of the adaptive equipment is covered.
One of the big issues is who "owns" (sorry for using this work and objectifying humans) these clients when it comes to actually making referrals? Meghan Franklin MS OTR/L -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jessica R. Gross Sent: Tuesday, January 30, 2007 9:57 AM To: [email protected] Subject: Re: [OTlist] Low vision and HMOs Ha! HMO's are not so vision-rehab friendly!! In NYC, HIP does not cover it at all. Some managed care Medicaid will cover it. The Commission for Blind and Visually Handicapped (your state agency might be named something else) will sometimes provide vouchers for students and adults who are going to back to work and have no other method of receiving vision rehab. Straight Medicare will also pay for vision rehab, but with more and more people getting pushed into managed care plans it is difficult to get reimbursed. I saw a patient from Aetna who was able to get OT covered, but his low vision devices were not. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Monday, January 29, 2007 1:13 PM To: [email protected] Subject: [OTlist] Low vision and HMOs Does anyone have a list of which HMOs cover OT in low vision rehab? Jenny -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************ ************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ************************************************************************ ************** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************ ************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ************************************************************************ ************** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
