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2 On Your Side: What does healthcare do for you? A look into the industry from seniors needing care

7 hours 54 minutes 39 seconds ago Sunday, May 18 2025 May 18, 2025 May 18, 2025 10:59 PM May 18, 2025 in News
Source: WBRZ

BATON ROUGE - What does your health care do for you? Several families who have reached out to 2 On Your Side say their health care has not lived up to their expectations. Each case involves a person who is above 80 years old and has served the community and country in different capacities.


DONNA CHARETT
"Who goes without bacon? I don't know a single southerner that's going to go without eating bacon," DeAnna Charett said.

She jokes, but bacon is one of the foods her mom, Donna Charett, can no longer enjoy. She's unable to chew meat, which includes her favorites like steak, chicken and sometimes ground beef.

"I sort of gum it," Donna Charett said.

Donna has six teeth, two of which are capped. Over the last decade, the rest of her teeth have been pulled.

"One by one, something went wrong with everything," she said.

Partial dentures gave her gum pain and were too painful to use, so she stopped wearing them. Those same sensitive gums are why she hasn't gone to full dentures. Instead, she has been requesting implants.

"Even if the dentist here says she needs them, the V.A. is going to buck it. They're just not going to do it," DeAnna Charett said.

The journey to make that happen has been a long one. Donna Charett joined the Navy at 18 years old and was stationed at the Pentagon in her early 30s with the Army Reserves. She has health care through Veterans Affairs.

Donna Charett wants teeth so she can eat.

The V.A. has been in contact with WBRZ and continues to work with Donna Charett. Recently, DeAnna Charett received word from a dentist's office that submitted a request to the V.A. for implants, but they had not heard back. Another dentist's office says it was organizing paperwork for another request for implants. The Charetts are anxiously waiting to learn more.


JOHN HILLMAN
At 92 years old, John Hillman loves to sit in his favorite chair and watch the birds in his backyard. He keeps the feeders stocked with bird seed. His late wife, an East Baton Rouge School Board employee, carried their health insurance.

Hillman has been happily receiving care at Ochsner 65 Plus for several years, visiting with doctors every few weeks for checkups and ailments. Recently, his insurance with UnitedHealthcare changed to a Medicare Advantage plan and it's no longer accepted at Ochsner 65 Plus.

"We don't care if you're 92 and spent three years here, go find somebody else!" Hillman recounted.

In the 1950s, Hillman served two years in Germany with the Army and pays for his health insurance through social security. He'd like to be seen regularly by a doctor to make sure his pacemaker is working fine and the swelling in his legs is in check. Hillman got an appointment to see a new primary care doctor in June 2026.

"Yeah, I'll give you an appointment in '26... if you make it!" he said.

Hillman has another appointment in July 2025 to see a specialist, but he'd like to go back to the doctors he knows. Instead, Hillman will have to wait more than a year to meet someone new. He wonders if his insurance is for the birds.

United Healthcare and Ochsner both responded to Hillman's case. UnitedHealthcare responded with the following:
“Ochsner informed us it will no longer see people enrolled in UnitedHealthcare Medicare Advantage PPO and Group Retiree PPO plans as an out-of-network provider at its four Ochsner 65 Plus locations, as of Jan. 1, 2025. All other Ochsner provider locations continue to see people enrolled in these plans, which give our members the flexibility to see care providers out of network for no additional out-of-pocket costs beyond what they would pay to see a network provider.”

Ochsner tells WBRZ it's not aware of any changes on their end and insurance companies regularly review their provider networks and communicate any updates directly to their members. Ochsner says if a patient has questions about their coverage, it's best to reach out to their provider.

Hillman received a call from UnitedHealthcare following WBRZ's inquiry into the matter, but it has not changed his situation.


ELMER KNAB
In early May, Elmer Knab fell and broke his hip. He had a partial hip replacement and his doctor recommended inpatient rehab. Knab's family agreed, given his active lifestyle and the 13 stairs to his front door.

Before surgery, Knab didn't need any assistance getting around and was happily cutting trees, doing yard work and helping others.

His insurance, Humana Medicare Advantage, said Knab didn't meet the criteria for an Inpatient Rehab Facility and the care was denied, offering a Skilled Nursing Facility instead.

Melissa Fontenot, Knab's granddaughter, reached out to 2 On Your Side about the issue they were fighting with insurance. They appealed to Humana three times, but the decision was upheld.

"We believe that based on his desire to mow his grass, climb the stairs, get in the pool, drive the RV, and go camping, we wanted him to be able to get back to that point," Fontenot said. "Everything that the doctor told us would need to happen, insurance said no."

Knab worked for the Denham Springs Police Department in the 1960s, a charter member of Denham Springs Fire Department, served as a Civil Defense Director of Livingston Parish, and as a charter member and volunteer of Livingston Parish Fire Protection District 5, where he also served as the fire chief.

Knab opted to do inpatient rehab anyway at Baton Rouge Rehab Hospital, paying out of pocket to get the care he thinks he deserves.

"How do you walk into a room and tell somebody, 'Look, your grandparent is X-Y-Z and it doesn't matter that they have been here 43 years and they've always been a phone call away, they're not anymore because we're not going to give you care that the doctor thinks that you need?'" Fontenot said.

She's not ready to give up on her "Gramps," and neither is he.

Humana has been in contact with Knab and his family to address their concerns, but due to HIPAA and other privacy laws, it is unable to discuss specifics of the situation. Humana did share that decisions regarding admission to Inpatient Rehab Facilities are based on specific criteria, which Fontenot mentioned. Humana says some patients who do not meet criteria for this level of care may meet the criteria for other types of care, like a Skilled Nursing Facility. 

A spokesperson for the insurance company says, "At Humana, we are committed to working with our members to ensure they receive care appropriate for their unique needs. If they have concerns about a coverage decision, we will assist them with the appeals process to find the best possible solution."

During that appeals process, Fontenot says their request for what they considered the "best possible solution" was denied. 

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