Re: OT for a retired person?
OT deals w/adaptive skills for daily living. Retired or not, folks need to get around, reach for and retrieve things, wash, dress and feed themselves, use a bathroom. In my area, OT also may deal with helping patients after joint replacements and vascular surgery after their PT sessions are ended. No patient has the ability to demand PT/OT, although they can ask. It is solely at the discretion of the MD, who, in turn, is subject to the protocols of the institution.
My husband is a medical massage therapist in private practice. He sees these people, often on referral, after their PT/OT ends. There is a cap on number of sessions allowed per patient/per incident. PTs and OTs are subject to restrictions by the referring MD, such as limited area to be treated and limited time per session. These restrictions have been in place for a long time. The PTs themselves are fine with someone seeking private sessions.
The major hospital for our area charges $350/massage done on premises and the patient is responsible for the $60 copay. This makes a $50 private massage session affordable. However, the hospital-based MTs are not paid $350 or even $50.
Many PTs here are in private practice and can accept insurance. Massage is not covered, so I don’t know what the insurance pays. However, MTs must code the session if there is a cafeteria allotment and reimbursement on the employer-provided insurance. Only one or two codes are acceptable for reimbursement and they do change yearly. These sorts of insurance allotments are usually limited to a set amount per year.
Everyone keeps explaining to me how wonderful and necessary OT/PT is, but no one is explaining how we can pay for it. In medicine, there is something called Triage. You deal with the life-threatening stuff first. Nothing in PT/OT is life-threatening. Neither is ED treatment or a host of other things that have been piled on top of Medicare over the years because we had the prosperity to pay for it.
Those days are gone. The workforce is shrinking and the non-productive portion of society is growing. People expect health care in their final years that exceeds their total lifetime income and no one is allowed to question it. Then, they shelter their wealth through clever trusts to keep Medicare from recouping any of the losses. How do we expect to save this country with that level of selfishness coded into our system?