Tag Archives: Medicare

Sometimes You Just Need a Lion on Your Side…….

Caregivers, Humor, , , , , , ,

I called the hospital today. Well, more accurately, I called the hospital billing department. The billing department is no longer in the hospital. The hospital is in Pennsylvania, where I live, and where my loved ones go to the hospital when they have a problem, medically.

The billing department is in Tennessee, where nobody, who goes to my hospital, lives or goes to if they have a problem medically or otherwise. Okay, maybe that ‘s not true, maybe some people go to Tennessee if they have a problem with say, country music, and want to see if it’s them or the music.

By putting the ‘billing department’ in Tennessee, it prevents all of us in Pennsylvania from actually going to the billing department to talk about a problem. That way no one has to discuss these problems face-to-face. So much easier, said no one, ever.

I called Tennessee today, and although the gentlemen was very nice, the problem was apparently unsolvable.

“I want to know if this bill, which started out at $4500 and is now magically down to $500 has been paid? ” I queried, for the third time in three months.

“Well, ma’am let me see. Now before I answer that question, even though you’ve given me the account number, can you give me the address on the bill, the date of birth of the patient, the date of the bill, the services rendered, the patient’s blood type and the name of their cat?” he asked ever so politely.

Okay, he didn’t ask for the blood type or the cat, but why not? My question is, why in heaven’s name do you put an account number on the bill if it means absolutely nothing in terms of information? Do you make more money by keeping me on the phone? Are you tracing the call just to make sure I’m not in Tennessee, but that I stayed in Pennsylvania where I belong?

We do-si-do all around the information, until we’re both exhausted and wish we had taken more square-dancing lessons, and finally, he says:

“Please ignore that bill ma’am the insurance company has agreed to review it.”

“Okay, but I have an estate to settle, so can I assume that the bill will be no more than the $500 you currently are requesting?”

“No, you cannot.”

Here’s where I want to find a cat, maybe a tiger or a lion, and release it into the wilds of Tennessee with the scent of this insurance company on its nose like a barrel of catnip.

“Um……….why would that be?”

“Well, what if the insurance company decides to take back all the payments they already made? Then the bill would be more.”

“Why would they do that?” I asked, “Medicare paid this over a year ago and this has been your fault for not properly submitting the balance to the other Medigap insurance carrier.”

“Well,” he replied, “we don’t know what they will do.”

‘Cause you don’t know what you’re doing……that’s really what I wanted to say.

But since he told me to ignore the bill, I’m gonna’ do just that. Probably forever.

“You Just have to Laugh…..”

©Cathy Sikorski 2016

 

You might be a Caregiver….Part One

Caregivers, Humor, Uncategorized, , , , , , , , , , , , , , ,

Just as I was sitting down to bring you the next installment of caregiving comedy, my computer decided the last laugh would be on me. Done, died, dead. With no warning, no goodbyes, no fond farewells, just dead.

These two weeks provided lots of time to come up with all the joys that caregivers experience. So in a huge nod to Jeff Foxworthy, I bring you the first installment of:

“You might be a Caregiver……”

  1. If you know Medicare’s phone number and website without Googling….You might be a Caregiver….
  2. If your search for an Assisted Living Community for your Mom starts to look like a nice vacation spot for you and your spouse….You might be a Caregiver
  3. If you cancel your dentist appointment to attend Ice Cream Social Wednesday at your Dad’s nursing home, because you want the ice cream….You might be a Caregiver
  4. If you know your parents’ Medicare number, AARP number, United Healthcare number but not your own cell phone number…You might be a Caregiver
  5. If you feel the need to correct WebMD about all the missed additional symptoms of a urinary tract infection….You might be a Caregiver
  6. If your iPhone calendar has words on it like ‘catheters’, ‘hearing aid’, ‘urologist’, or ‘dentures’…..You might be a Caregiver
  7. If going to the Emergency Room is like Cheers where they know your first name and how you take your coffee…..You might be a Caregiver
  8. If you took the black Sharpie to your husband’s underwear to mark it for the wash instead of your Mom’s for the nursing home…..You might be a Caregiver
  9. If you’ve had more knock-down, drag-out fights with Insurance Companies, Hospitals and Doctor’s office than Muhammad Ali…..You might be a Caregiver
  10. If everyone around you thinks you are speaking in tongues because you are constantly saying, PT, OT, UTI, or DME….You might be a Caregiver

And this is only the beginning, my friends. After all, this is a new computer, so there’s lots of room for humor here now!

“You Just have to Laugh……”

©Cathy Sikorski 2016

Medicare….not for the weak……

Uncategorized, , , , , , , ,

As I continue down this unrelenting path of caregiving, even in death, I can’t help but see the irony in statements that come my way like, ” what are you doing now that your brother-in-law has died?”

I’ll tell you what I’m doing:

“Hello, Medicare? I’ve now sent you a request for permission to speak to me as Executrix of my brother-in-law’s estate with all the supporting documents. I’ve waited the requisite 50 days for you to process it. I’ve waited longer than that because the first instructions I received were to take those documents to my local Social Security Office, which resulted in absolutely nothing, and now I have finally received a letter saying you will talk to me. Yay.

Medicare Person: What can I help you with?

Me: I’m trying to find out when a claim I have submitted will be paid?

Medicare Person: Why did you submit the claim Ma’am?

Me: Because the provider refused to submit it. They provide drugs and drug paraphernalia to the nursing home where my brother-in-law was residing at the time. They insist that they can only bill for the drugs to Part D Medicare and they have no authority to submit for the other items like IV poles, IV flushes and anything needed to actually administer the drugs.

Medicare Person (the THIRD Medicare person, because the first two couldn’t find the other conversations I’ve had and insisted that no such conversations took place). Yes, I’ve found the conversations you’ve had on April 4th , 11th, and 22nd.

Me: The last person I spoke with who connected me with you said she couldn’t find those conversations.

Medicare Person: Well, you’re both right. She can’t see these conversations, she’s in a different department.

Me: So, she couldn’t transfer me to you without wasting 30 minutes of my time and me insisting I speak to this department?

Medicare Person: I apologize for that Ma’am.

Me being Silent,

Medicare Person: Well, Ma’am I can’t find your claim. it takes 50 days to process.

Me: I filed that claim 120 days ago, and when your Medicare person CALLED ME ON APRIL

Provisions for speaking to Medicare
Provisions for speaking to Medicare

22 while I was standing in the middle of Times Square, and I popped into the closest restaurant and ordered a $12 glass of wine while on hold with your person, she told me that she was looking at my claim, it was paid to the nursing home and they would have to pay the provider. Then she proceeded to send me the wrong Medicare notices so I could prove to the nursing home, they owed the provider and the Estate of my brother-in-law was not liable for this bill.

Medicare Person: I can’t find that claim Ma’am. And so the only thing I can do is request a review.

Me: Okay

Medicare Person: I’m not allowed to request a review until 150 days has passed and it’s only been 120 since you filed the claim. A denial can take up to 150 days to process.

A missing claim is like a missing person. Maybe they went missing on their own. Maybe they are just at a friend’s house and forgot to tell you. Maybe they will use a credit card and then we can trace where they are and stop all this nonsense. But instead of waiting 48 hours, you have to wait 150 days. Imagine telling any person you’ve ever worked with that it will take 150 days to look at a piece of paper you sent them.

Medicare Person and I  then went on to discuss the many fun and esoteric ways that Medicare can screw up a claim.

Medicare Person: I know this is complicated and confusing Ma’am.

Me: I understand perfectly, everything you’ve told me. It’s not complicated or confusing to me, it’s just crazy! (Yep, I really did say that).

Medicare Person: Well, I know it seems complex, but we train for WEEKS to process this, so it would be harder for you to understand.

WEEKS? WEEKS? I’ve been dealing with Medicare for 25 years. And in all your weeks of training, the best you guys have ever given me is ridiculous, arbitrary waiting periods to process claims, a myriad of departments who don’t speak to each other, wrong information that has cost me precious time, and heartburn without the doughnut, wine or deep-fried food I deserve to go with it.

So glad your weeks of training have made you an expert.

I didn’t say any of that, I just got out my corkscrew and toasted the Universe for the never-ending supply of blog posts!

You Just Have to Laugh…………

© Cathy Sikorski 2016

Hello…it’s me….

Uncategorized, , , , , ,

I just returned from three weeks away to get a good head start on my next book.

I have been running from one person to another who just needs to see me. I don’t care how far technology has come, people want to actually see you. My mom, my friends, my book club, my uncle, my sisters, even my cleaning lady. And I want to see them.  It has made an impact on me. I realize that human contact, not just phones, or email or even Skype take the place of eye to eye, hand on the arm, hugs and kisses. Actually talking in person to someone can make your life better.

Never more so was this clear,  yesterday when I sat with my Mom as we made yet another phone call to the Veterans Administration. It was not frustrating or anger-inducing as I have recounted in the past, but it was a hoot.

It was reminiscent of a phone call I had made just days earlier to Medicare.

This was the Medicare call with a robot voice who was trying to get me to the right place:

Robovoice: Please state the purpose of your call.

Me: “Claims”

Robovoice: I heard ‘disability’ . Is that correct?

Me: “No, Claims.”

Robovoice: I heard ‘enrollment’ . Is that correct?

Me: “No, Ugh. I just want to talk to someone!”

Robovoice: I heard eligibility. Is that correct?

Lest you think I’m making this up, my friend was in the room listening, so she can confirm that this was a real conversation. I hung up and started all over again. My friend said, ” well there’s a blog.”

With my Mom and the VA however, we used this great service where they called us back rather than keep us on hold. In 10 minutes, a real person was on the phone answering our questions. She was kind, courteous and extremely helpful in leading us to the correct information.

The only problem was the phone connection was so terrible that she and I had to repeat every single sentence. I don’t know why, but neither of us got crazy over this. We just kept repeating. Finally, she said she could send me an email to make sure we had what we needed. Of course, do I have an easy email address? No, why would I?

This is how that conversation went:

Me: My email address is my name. I’ll spell it c-a-t-h-y

VA  lady: Is that J-R-P-P-I?

Me: No, it’s C, my  name is Cathy.

VA lady: Okay, Jathy

Me: No, it’s C, like in chocolate. (Now I know ‘military C’ is Charlie. I have no idea why I said chocolate)

VA lady: OH “C”! Okay you’re name is Cathy!

Me: Yes, My last name is Sikorski.

Hello? Hello?
Hello? Hello?

My mother sitting next to me says: “Oh God, this will never work!”

I just jump in and spell my last name : S as in Sam, I as in Ink, K as in Kitchen, O as in Olive, R as in Radish, S as in Sam, K as in Kitchen, I as in Ink. I don’t know the rest of the military alphabet. This is my  version.

VA Lady: Okay, I’ll send you the email.

Me: You will send it by mail?

VA Lady; No, the email, I’ll send the email.

I had no hope of this ever happening.

And five minutes later, there it was in my inbox.

If only we could have seen each other, it would have been so much better. But my Mom and I had a great laugh as we sat together at her kitchen table.

“You Just have to Laugh….”

© Cathy Sikorski 2016

Frost and a Sweat………..

Caregivers, Humor, , , , , ,

Two roads diverged in a yellow wood and I took both of them…

I was sitting around in my workout clothes, pretending to think about going to the gym. But I thought a tougher work out would really build my stamina.

I decided to try and tackle Medicare and the VA on the same day.  See tackling is a form of exercise.

First stop, the VA. Truthfully, after examining my own guns, I knew it was time to call in the big guns and went right to my U.S. Representative in Congress to get help. I was done pussy-footing around. I called my Rep’s local office and was met with immediate efficiency and comprehension.

Like an innocent child, who has a learning curve the size of the Earth’s parabola (I don’t even know if that’s a ‘thing’ but it sounded really big to me) I believed that help was on the way quickly, and all my problems would be solved post-haste. And by using Ye Olde English terms like ‘post-haste,’ I would surely be drinking celebratory sherry in the drawing room at the end of the day!

But before these kind people could step in, they asked me to call the local VA office. See, the Rep had friends in high places. He is actually on the Congressional committee that deals with the VA. I was instructed to call the VA office in town, speak to the director there and immediately call back the Congressional Aide to let her know the result.  This was the result.

“Oh, dear, I’m so sorry your mother is having a problem with her medical insurance. That’s terrible,” said the kind woman who answered the VA phone. “I will have the director call you as soon as he is available.”

I must admit, not 10 minutes later, the kind woman who answered the phone called back.

“The ( cowardly, okay she didn’t say that but the tremor in her voice said it all)director says he wouldn’t know where to begin to help you. This problem is too complicated and he’s never seen it before. So you need to call your Congressman right back to help you.”

This from the director of the local Veteran’s Administration Office. My workout was quickly becoming the use of one finger……the dialing finger. Why, which finger were you thinking?

Meanwhile back at the ranch, thinking it would take a while for the VA to return my call, I hopped on another line (hopping is also exercise) and landed on infinite ‘hold’ for Medicare.

After following their instructions three weeks ago by filing Executor papers at the Social Security Office, and calling each week to see if they ‘received’ the papers that were scanned into the computer right before my eyes, I am now told that I must follow a completely different procedure before they will talk to me about unpaid medical claims for my deceased brother-in-law.

By the way, not one person I spoke to at Medicare or Social Security both on the phone and in person….and there were dozens of these people………..actually knows what an Executor is or does. So that was fun to explain. Explaining can cause sweating and does require mental exercise.

There were more phone calls and more paperwork created as you can see:

Medicare Papers

Two roads diverged in a yellow wood (yellow..for cowards?)

….and I took both the difficult ones….. ’cause, you know, that’s where all the fun and cardio begins!

“You Just Have to  Laugh………….”

©2016 Cathy Sikorski

Don’t Worry…..We Will Take Care of You……

Caregivers, Humor, Uncategorized, , , , , , , , , , , ,

Last Friday my Mom called me, practically in tears.

“Roberta was so mean to me,” she said.

I’m thinking, “who the hell is Roberta?”.

“She’s from my medical insurance carrier. I called to ask her why a bill wasn’t paid and she said I should never have been given this insurance and I’m going to have to pay back every penny from the last 15 years.”

“And,” she went on with a worried tone, “you told me to NEVER pay a medical bill. So I don’t know what to do.”

“Calm down, Mom. We will get this worked out. It will be okay.”

My first reaction was this:

I did tell my Mom never t pay a medical bill because her insurance covers everything.

My mom has Tricare For Life Medical Insurance. This insurance is for Veterans and their families, spouses, widows, children. My Dad died in a helicopter crash as an Army pilot on October 10, 1961. My mother had five children all under the age of 10 and was pregnant with her sixth child. So I kind of think my Mom is entitled to this insurance.

The thing is, Mom never claimed this insurance until my step-father passed away in 1998. She didn’t even ask for it. She already had Medicare and AARP. But when she applied for her widows benefits after my step-father passed away, the Veteran’s Administration made her jump through all kinds of hoops with documentation and then gave her this insurance.

My mom is a Virgo.

Why does that matter? She has kept every single piece of paper that has ever come into her life. So she has every piece of documentation that transpired fifteen years ago with the Veteran’s Administration. She sent them her marriage certificate to my step-father and his death certificate.

Then, they put her on the wrong insurance.

And now they are threatening an 87 year-old widow, who raised her family of six children without a father, who never even made it to 30 years old.

After talking to seven different people at seven different government administrative places which most people never even heard of, we refiled all the documentation from 15 years ago.

Now we wait.

I know from the last 25 years of caregiving and jumping through administrative hoops that this story will not have an easy ending. There’s going to be reams of paperwork. There will likely be boatloads of nastiness. There may be a lawsuit. But in my best, Scarlett O’Hara voice: “As God is my witness….my mother will never pay one dime to fix this problem.”

It helps that I’m a lawyer.

I know you don’t think there could possibly be a laugh in here in any way. But as I was looking at some of the documents from her insurance company, I saw this:

Fun things to do while fighting with Insurance
Fun things to do while fighting with Insurance

Really?

Hmmmm…..

“You Just have to Laugh…..”

©2016 Cathy Sikorski

Kelly, Kelly, Kelly, Kelly…….

Caregivers, Humor, Multiple Sclerosis, Uncategorized, , , , ,

I have been trying for 3 weeks to get physical therapy for my brother-in-law. He is in rehab but has to stay in bed for healing purposes. My argument is that there’s no reason he can’t be doing upper body strength training and exercise to keep those muscles from getting weak.

I asked five different people and everyone was going to “get back to me.”

This is what happened when I was in the rehab center and  they actually did:

Nurse 1: “Gee I don’t know about therapy ,let me go check. I’ll come back and tell you.”

Nurse 2: “Well, we are nursing. You will have to talk to Physical Therapy. Go downstairs to the Physical Therapy room and ask for Kelly, she is the Director.

So downstairs I go. In the  Physical Therapy conference room are 5 people. They all have name badges. I talk to the one wearing the name badge ,”Kelly.”

Kelly 1: ” Well, let me look at the register. ”

She doodles around on the computer for a few minutes.

Kelly 1:”Hmmm.I thought I could tell you why your brother-in-law is not getting therapy, but I have no idea. I’m going to have to talk to my supervisor.”

Me: “Okay. I’m going back upstairs, you can get me there. By the way, who are we waiting to talk to?”

Kelly 1: “Kelly.”

Me:(very slowly and deliberately,so I get this right)”But…. aren’t…. you……. Kelly?”

Kelly 1: “Oh there are three Kellys.”

Great. Back to my brother-in-law’s room I go. I am greeted there by Nurse 2.

Nurse 2: “I found out that your brother-in-law doesn’t qualify for therapy.”

Now this is where they expect me to say, “oh,okay.” I don’t do that…… not ever, never. I say things like:

Me: “Why?”

Nurse 2: “I have no idea, I’m nursing.”

With that dandy tidbit, in comes the Social Worker, Courtney, one of the first five people I asked about physical therapy.

Courtney 1:  “We just had a meeting with Kelly(presumably Kelly2) and she said he doesn’t qualify for therapy.”

Me: “Crazy question here….why?”

Courtney 1: “Well because his surgeon said he can’t get out of bed into a chair yet.”

Me: “I know, I talked to the surgeon’s office and they don’t know why you translated that into, ‘he should turn into a useless vegetable with no muscle mass until his wound heals.’ Which is why I had the surgeon’s office call you to say he could have physical therapy of his upper body in his bed.”

SpicyNurse 2: “Oh yes. They did call me. That girl on the phone was rather ‘spicy’ demanding that he get physical therapy and that they never said he couldn’t have it.”

Spicy? Really, a doctor’s office wants their patient to get some appropriate care and that’s spicy????

With that I look at Nurse 2, she looks at Courtney 1, and well, there we are, in a spicy conundrum.

Me: “Get him therapy, now. I don’t care how many Kellys it takes.” Wondering if that was spicy enough to get something done.

That was yesterday…..waiting for a spicy response any minute now.

“You Just  have to Laugh…..”

©2015 Cathy Sikorski

 

 

 

Another One Rides The Bus…..

Brain Injury, Caregivers, Humor, Uncategorized, , , , , ,

For some reason, my friend, Lisa likes to be featured in this blog. So here we go.

For medical reasons, a traumatic brain injury, Lisa had  to give up her driver’s license several years ago. Eventually, she became quite savvy and capable of taking public transportation. In her small town, that means the bus. A perk, if you would like to call it that, of being on Medicare, is that you get to ride the bus for free. Otherwise it costs a dollar.

Lisa has been riding this bus for a few years now. Until recently, all she had to do was to show her Medicare card to the bus driver, and she was allowed to take a seat, gratis.

Apparently, there’s a new sheriff in town.

A few weeks ago she had this encounter with a female bus driver, whom she never saw before.

“Sorry, ma’am, but you need a special card to ride the bus as a Medicare rider.”

“No,” said Lisa, “I don’t. I have been just showing my Medicare card for years and that is sufficient.”

“No, you need the special card,” said the bus driver.

“Since when?”

“I don’t know. I just know  you need it.”

“I’ve never even seen ‘the special card’, “said Lisa.

“Well, I’ll let you go this time, but you need to get it.”

Lisa never saw that bus driver again. Since she didn’t know where to get the special card, she just let it pass.

The other day, as she was getting on the bus, there was a new young male bus driver, whom Lisa had never seen before. He’s holding a pamphlet in his hand as she ascends the stairs.

“How old are  you?”

Lisa, thinking he is complimenting her……as every middle-aged woman thinks when handing a Medicare card as ID, replies a bit quietly so as not to alarm fellow passengers who most likely think she is quite young:

“I’m 63.”

“Well, you’re barely that, I can see.”

Lisa is flattered,until he drops his bombshell.

“You can’t ride the bus for free. You have to be 65 years old.”

“I’m disabled and I’ve been doing it for years.”

dollar“Nope. Not allowed. Here’s the brochure. It’s a dollar.”

I’m happy to say here that my friend Lisa has come a long way since that TBI. Not only does she get around on her own. But after many years of trepidation just being out in the world, well, she doesn’t take crap anymore. Yay, Lisa!

“What’s  your name?”She demanded from this arrogant brute, who was so willingly ready to accost the disabled and the elderly.

“Well,ma’am,” he sheepishly replied, “if you don’t have the dollar today, you can pay next time.”

This bus driver was on a mission to save that bus company a dollar, or take a power trip every stop along the way, or who knows what, maybe her bus driver was Donald Trump in disguise and he was testing some of his new economic policies to see how to save government funds.

Never did give her his name…and…..weirdly, she hasn’t seen that bus driver again, either.

For a dollar…..did I say that already?…………..a dollar.

“You Just have to Laugh…..”

©2015 Cathy Sikorski

 

Send in the Clowns…..Don’t Bother, They’re Here

Caregivers, Humor, Multiple Sclerosis, Uncategorized, , , , , , , ,

I’m thinking about asking the wheelchair repair guy if he wants to do a comedy act together.

Before I left the country for 2 weeks, I called the wheelchair repair guy (let’s call him Mike, well, because that’s his name).

“Mike,” I said, “the wheel on my brother-in-law’s chair is torn to shreds. It makes the chair bump around like he’s driving the post-Apocalyptic pothole roads from the Winter of 2015. And he’s inside….on carpet. Please get it fixed ASAP.”

“Okay,” said Mike.

The problem here is, I believed him. I knew it would be fixed, eventually.  I just hoped that with a two week lead and a few well placed reminders by my assistant, it might be close to being done when I returned.

Mike obviously spent the time shopping for a big red nose.

When I noticed my brother-in-law bumping down the hallway on my return. I sighed that exasperated sigh that we all save for just such an occasion. My exasperated assistant let me know that she even contacted Mike with the very complicated schedule of when the chair was in use or my brother-in-law was resting in bed. This was due to the fact that Mike reminded her, no one can be in the wheelchair when it is being repaired. There was even a nice little 4 day period where BIL was in the hospital, so no one was using the chair. My assistant gave that little nugget to Mike as a bonus, if he wanted to send his guy over there at ANY time of the day or night.

I called 15, 16, 18, 19 and 21 days after my first call to find out why oh why, Magic Mike can you not get your sh*&%t together and get this chair repaired? Are you practicing your own comedy routine? Are you shaping up your abs for your next film role? What is so damn important that it takes 21 days to get someone out to fix this one little wheel?

“Hello, Cathy?”

“Hi, MIke, is the chair finally fixed? You said someone would do it on Monday or Tuesday and now it is Wednesday.”

Faster than Mike. Smarter too.
Faster than Mike. Smarter too.

“Oh, no, someone has to look at the chair first, determine what parts are needed, get insurance company approval, and then physician approval.”

We’ve gone from a comedy routine to a cartoon, as steam is now exploding out both my ears.

“So all those times you said you couldn’t come because he couldn’t be in the chair, was so that you could just look at it? Let me ask you something. Couldn’t someone just look at  the chair even if he is in it?”

“Well, I guess so. But you said he was in the hospital.” How this even makes sense, I don’t know. But I’m pretty sure “Who is on first.”

“Mike, we don’t let the chair go to the hospital with my brother-in-law. The chair has proven it doesn’t know how to behave itself in public places, so when he goes to the hospital we make the chair stay home, by itself. That’s why every time he goes to the hospital, we call you to let you know no one will be in the chair for days.”

“Oh. Well, we looked at it so it will get repaired when all the approvals come in.”

Twenty-one days to look at it. I wonder if I can start sexting pictures of the wheelchair in compromising positions when I need it repaired in the future, so that Mike can definitely say they looked at it?

“You Just have to Laugh………..”

© Cathy Sikorski 2015

 

The best laid plans……………

Caregivers, Humor, Multiple Sclerosis, Uncategorized, , , ,

I have literally spent more than 10 hours (probably more like 20) trying to figure out what new Medicare insurance plan to choose for my brother-in-law. He currently pays for his insurance through his former employer. They have chosen to get out of the business of supplying insurance carriers for their retirees, so by the end of May, all retirees have to choose a new Medicare Plan.

When I first got the booklet for this, I was sure it was a scam. These Medicare Insurance companies that ‘help’ you choose a plan are suspect to me. But I called his employer. All I wanted to know is if it was a scam. I didn’t want any specific information about my BIL or his account as a retiree.

I had to jump through a billion hoops (this is not included in the 10 hours above), prove my POA status, give them all my BIL’s vital statistics and THEN, they needed a PIN number. Somehow, the one I had was expired. So I asked for a new PIN which had to be snail-mailed to me.  I finally convinced the representative to at least just tell me if the Medicare company was a scam. She relented and said no, it was not a scam….but that was ALL she was going to tell me until I got my new pin number.

business-19156_1280Already, I’m exhausted. But I push forward. I go on the website. I enter every medication, every doctor and all the vital stats. Two hours later, they give me a proposal of 18 Medigap policies to compare with 26 Medicare Advantage policies and 20 Medicare Part D Prescription Drug Plans to add to the comparison. For those of you who may struggle with math, that is 64 plans I should look at to compare and contrast to choose the best one for my BIL. And choose, I must, because as of May 31, 2015, they will automatically cancel his current insurance.

This got me thinking, What if this information was sent to my BIL and he had no one to help him wade through it? First of all, it’s a website. There are  in fact, still some people, many of the  Medicare Age Variety who are not computer savvy, hell, who don’t even have a computer. Yes, snobby Medicare helpers, everyone on the planet doesn’t have a computer. Now my BIL is very computer savvy, but he can’t really type anymore.
And he doesn’t really read anymore, because comprehension and retention elude him often. And he for sure, isn’t going to decide to read through Medicare plans as a fun hobby.

I am considered an expert in this field of Elder Law issues, including Medicare Insurance. And I completely UNDERSTAND what I’m reading. I am expected to find the nuances and loopholes in 64 different plans that best serves my BIL. And even I find this daunting.

And once I choose I am in a quandary. This special circumstance where they are cancelling his policy is considered an opportunity for open enrollment with no underwriting. In other words, nobody is looking at the fact that he has a myriad of health issues which would kick him out of any health insurance otherwise. So once I’m there, I’m never going to be able to leave without a problem.

My point is this. I’m exhausted. My severly disabled BIL, on his own would have probably missed this whole need to do this and be without health insurance. How many retirees from this major Fortune 500 company are struggling with this project? Even though it’s a great website and the advisors are pretty good at their job…I KNOW WHAT I’M DOING, AND IT’S STRESSING ME OUT.  The choosing is a nightmare.

I know, three months from now I’m going to hear from the new insurance company that Oh that’s not covered, oh that has a huge copay, oh he can’t have that NEW drug that he wasn’t on when you chose this plan.

The only thing that makes me laugh now is laughter of relief. But don’t worry, I’m plotting revenge somehow and you will be the first to know!

“You just have to Laugh…..”

© 2015 Cathy Sikorski