Dolores’s Story

“Dolores” was rushed to the emergency room by ambulance and hospitalized with acute pneumonia for more than a week. Despite Dolores’s obvious medical need for the ambulance, Medicare inexplicably denied coverage. Dolores appealed the denial, but never received a response from Medicare. After she was contacted by a debt collection agency, she reached out to Community Legal Aid for help.

CLA Attorney Rachel Brown worked with Dolores to track down her original appeal and to request that Medicare issue a decision on that appeal. As a result of Attorney Brown’s advocacy, Medicare reinstated Dolores’s appeal and concluded that her ambulance trip was medically necessary. Medicare paid the ambulance trip in full, unburdening Dolores from an expensive bill that she could not afford to pay.