Balwant N. Dixit, Ph.D.

608 Ravencrest Road, Pittsburgh, PA  15215 USA
(412) 963-8023, e-mail:  bdixit@pitt.edu
Note: Balwant Dixit is now a professor emeritus in pharmacology at the University of Pittsburgh.

My wife, Vidya, my son Sunil and I flew to Washington DC on June 6th for a short vacation and checked into a hotel in Alexandria (VA), about a mile from a Metro station. On the first day we spent most of our time visiting the Holocaust Museum. We had to wait for two hours to get in, but it was worth the wait. The next day we walked from the Smithsonian Metro stop all the way to the Lincoln Memorial, a distance of over a mile. My wife, Vidya, suddenly came down with intense pain in her left leg; she could not even stand up and nearly collapsed. A park ranger came and tried to help but realized the situation was serious. She called DC EMS and Vidya was taken to the George Washington University Hospital (GWUH) emergency room. Initially admission was declined since Vidya’s insurance plan rejected the emergency room coverage as well as in-hospital stay. I had to sign papers agreeing to pay the bills in case our claim was rejected. I knew that since Vidya was never employed in the USA, she does not have Medicare A & B coverage on her SS#, although her “UPMC for Life” insurance ID card lists her SS#. I suggested to the admitting nurse that she try my SS# since Vidya’s Medicare A & B is on my SS#. It worked. Vidya was admitted for emergency care and given pain control medication.  X-ray and a few other tests were necessary for a diagnosis.  After about four hours, I was informed that Vidya needed to be admitted for additional care since she was not able to stand up or walk even a few steps. I wanted to stay in DC until a diagnosis was made, but could not find a room to stay after June 8th anywhere in the DC area or in nearby suburbs, except for one room in the Pentagon City for just two days and another room in DC for $550/night. Inter-hotel accommodation services were not helpful either. Hotels recommended by the GWUH were also full. Vidya agreed to stay in the hospital and Sunil and I returned to Pittsburgh on June 9th. Our “UPMC for Life” plan (a Medicare Advantage Plan) covers only the Commonwealth of Pennsylvania.  After four days in the hospital Vidya was transported by a fully equipped EMS ambulance with the help of Assist America from Washington DC to Pittsburgh (246 miles). All those who have “UPMC for Life” plans also get Assist America as one of the benefits for no additional payment.

What is Assist America? Assist America, a global emergency travel assistance plan, helps you when you have a medical emergency more than 100 miles from home and are not sure where to turn. I found out that Assist America will not provide services if a patient needs to be transported from one medical facility to another medical facility of similar capabilities, but Assist America will transport a patient from a medical facility to the patient’s residence. Assist America services are accessible 24 hours a day and free of charge to members. A single phone call activates Assist America services 24 hours/day, 365 days/year and is available from any location in the world — no exceptions. Communication specialists are available in any language — from Arabic to Zulu.  There are no costs and minimal restrictions. Assist America pays for all the services it provides. There is no financial cap on any of the Assist America services. Not all health insurance carriers provide Assist America as a benefit. More than 300,000 companies and schools do. One should call the host insurance carrier for more information.

When I contacted a representative of Assist America and gave him all the details about the condition my wife was in, he suggested that my wife would be transported by taxi cab with a driver but no other equipment such as a cane, walker, or wheelchair would be available to her, since it takes a minimum of 2.5 hours for a cab to come to Pittsburgh from GWUH.  She could either sit in the front seat or could travel “lying down” in the back seat. I suggested that he use MAPQUEST to find out the driving time and the distance.

He was surprised that the distance is 246 miles. When I suggested that my wife’s condition was such that she needed to be transported by ambulance, I was informed that I needed to make some other arrangements. So, as a standby, I contacted a private medical transport company which agreed to provide the necessary transport at a cost of $3,600. I then informed the representative of GWUH dealing with the situation that under the Medicare Act a patient can reject discharge if he/she feels insecure after discharge and from that point on all the hospital charges become the responsibility of the hospital. I advised Vidya not to leave GWUH unless a Medicare representative came to see her.  The situation changed very rapidly. The next day at 6:00 AM a representative of Assist America called and informed me that my wife will be transported to Pittsburgh by a fully equipped EMS ambulance.  It took almost 6.5 hours for the EMS ambulance to reach our home in Pittsburgh from GWUH. After her return to Pittsburgh Vidya underwent X-ray, MRI and bone scans and is being treated by two orthopedic physicians. Although no definitive diagnosis has been made, with physical therapy and other supportive treatment she has shown considerable progress.

What happened to Vidya can happen to anyone anywhere. One must be prepared with all the information to deal with such situations. I learned a lot. All throughout this time our assigned social worker from Longwood at Home was working with us to get everything arranged. When the ambulance arrived at our house, the Director of Home Care, a care giver and our social worker were there in the drive-way to help.  For the next 48 hours care was provided around the clock and from then on, care givers have been visiting us every day for 8 to 10 hours providing help as needed. All caregivers come on time and are well behaved and trained, and as of today (July 30th), over 250 hours of assistance has been given. Caregivers also helped in many household chores such as meal preparations (if asked), grocery shopping, prescription pick-up, taking Vidya to medical tests and to doctor’s appointments. They did regular laundry, cleaning dishes and vacuuming as well as garbage disposal and any other light housekeeping chores we asked for. Each caregiver wrote a brief report on Vidya’s progress, medications she took, her diet as well as all other activities she participated in. Such logs were helpful for the subsequent caregivers and also to the supervisor who monitors the services provided.  Becoming a member of Longwood at Home was the most rational decision we made two years ago. We did not have to file any claims, had no waiting time to qualify to receive help, and made no payment for any services we have received. In my opinion LaH is a much better option than having Long Term Care Insurance. We learned a lot from this unusual experience.   Unexpected adversity provides a great learning experience, but it has its own cost! In another issue I will describe in details Continuing Care at Home (CCAH) programs.

Acknowledgement: Grace Smith of LaH, Sudhir Manohar and Girish Godbole made useful comments. ♦ 