Tag Archives: Veterans Administration

With Facebook Friends like this…Who Needs Enemies?

Two years ago, 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 to 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 widow’s 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. The VA put her on the wrong insurance.

So two years ago, they began threatening an 87-year-old widow, who raised her family of six children without a father, a man never even made it to 30 years old, that she would be thousands of dollars in debt to them because of their mistake.

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.

I wrote much of this post two years ago.  And much of the problem has been resolved after mountains of paperwork and dozens of phone calls…one that occurred while I was drinking in Times Square. Hey, if they call, you answer, because they may never call back.

I said this two years ago, probably after the drinking incident in Times Square:

 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.”

There’s one small problem that persists. The government agencies just can’t agree and  are trying to collect $687 from my sweet ol’ mom that they think they are owed from overpayments. I still have people in all these agencies working on it and I have not yet caved to paying money to make it go away, but still…..I am amused by the latest missive from one of the insurers trying to collect funds:

Fun things to do while fighting with Insurance
Like us On Facebook……Indeed.

Hmmmm…..I’m struggling with that friend request.

©Cathy Sikorski 2018

 

Call Me, Maybe…..for Quality Assurance

My Publisher  Extraordinaire campaigns for everyone to just ‘Be Nice.’ I would like to take her advice and suggest we start with our Veterans and their families.

Last week the Veteran’s Administration hung up on me. Granted, I wasn’t giving the guy what he wanted….but he HUNG UP ON ME….AT THE VETERAN’S ADMINISTRATION.

Those of you kind readers who follow my blog, know that I have been in a kerfuffle with the VA since January when they unceremoniously stopped my 87-year-old mother’s health insurance. They discovered a mistake they made 15 years ago, by putting her on the wrong insurance. So they just cancelled her policy. They didn’t bother to fix their mistake. They didn’t  bother to put her on the correct insurance. They didn’t even bother to tell her that they cancelled her insurance.

So, as I told you in the past, my Congressman Representative Ryan Costello (R-PA) (well actually his amazing administrator, Lisa Reynolds) helped me quickly and efficiently fix the problem. If you’re having problems with the VA or any other governmental agency, I

Your current Congress might be more helpful.
Your current Congress might be more helpful.

highly recommend you ask your Congress person to help you. Really. Don’t waste too much time trying to fix it yourself. You will be quite surprised and, hopefully, happy that  your Representative or Senator has staff who are there to help you. Try it. That’s what we pay them for, to work for us.

All that being said…..please VA don’t hang up on us. Even if you don’t like what we are saying, don’t engage in the rudest form of behavior.

I wasn’t yelling, complaining or even causing trouble. I just wanted to refrain from filing additional paperwork with the VA, if they didn’t need it, thereby making everyone’s life easier.

This is what went down:

“Hello, this is Bob from the VA, we are returning your call as requested.”

“Hi, Bob, I was calling for my Mom who has a complicated case that goes back 15 years.”

“Well,” said Bob. ” what do you want me to do? Look at 15 years of claims?”

“No, Bob,” I replied, “I just want to look at one provider, if you can search by that to see if you have already processed that claim,  I won’t resubmit it.”

“Okay,” replied Bob with a bit of exasperation, “What’s your address?”

“Do you mean my Mom’s address? Because she is the insured.”

“No,” replied Bob, getting a bit testy, “I want your address.”

“Well see Bob, that has caused problems before, because my Mom and I don’t live together and………….”

He said: “When you’re ready to give me your address, you can call back.”  And he hung up the phone.

I tried to call back, but there was a 13 minute wait time which is standard procedure when you call the VA.  Which is why Bob was returning my call in the first place, three days later.

Then I just thought, okay. I tried to help. I’m just gonna’ file this and make you do the work twice. And I may begin to implement my new practice where everyone I call for this kind of business I say before the representative can help me:

“This call is being recorded for quality assurance.”

I’ve tried it a few times. It brings silence and confusion. But no one has been rude or hung up on me since then. I say we all try it…….you know, for Veteran’s sake!

“You just have to Laugh…….”

©Cathy Sikorski 2016

Hello…it’s me….

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

Fairy Tales Can Come True……………..

Last Wednesday I got the phone call every girl dreams of. Yes, George Clooney invited me to his lake house on the Amalfi Coast!

No, it was better than that. My Congressman, Ryan Costello of the 6th District of Pennsylvania, through  his amazing assistant, Lisa Reynolds called me to say my mother’s problems with the Veterans Administration are well on their way to being solved.

As a caregiver, we list this in the miracle column.

If you have followed my past few blogs about this journey wherein I am trying to get the VA to correct their mistake from 15 years ago and get my Mom back on to her proper medical insurance, you know it has been nothing less than a”clusterf#$%k.”   That quote, by the way, directly from a VA customer service rep who thought he had put me on hold, and that moment was ever so much better than any Muzak.

Since January 9, I have already spent countless hours on the phone and faxing, scanning, emailing and snail-mailing documents to various demons of the Veteran’s Administration and Department of Defense hoping against hope that I could stave off a medical insurance disaster before it happened.

In the interim, my husband suggested I call our Congressman. I was thinking about that very thing. Since my  husband gets Congressman Costello’s newsletter, he noticed that he has a position on the Veterans Administration Committee. So, what the heck! Ain’t that what we pay these guys for?

I spoke with the ever-so-kind Lisa Reynolds. I faxed her all the documentation that I was constantly sending out to the Federalis. And for some odd reason, I just let her do her thing and waited to hear from her, probably because I continued to inundate myself with phone calls and wild goose chases to the VA.

On Wednesday, Lisa called to say that the Congressman has gotten my  mother registered with the correct medical insurance back to 2002!! Hooray. Happiness, Joy, Exaltation.

Not so fast………………..

“That’s the good news,” she said. Uh oh.

“The only glitch is, your mother has to submit all those incorrectly paid bills, for the last 15 years, to the new insurance with in 180 days or it will not be covered and she will be responsible for those medical bills,”

Oh gee whiz, that sounds so easy, like , I don’t know, gathering all the pine cones in the forest for the last 15 years and then shoving them up their ………… sorry, I got distracted looking for a metaphor.

“But we have until August,” Lisa exclaimed.

Yay?

Yet, she most assuredly told me that she would assist me in getting all that information from the old insurance company to send to the new one. Mind you, these are both arms of  Veterans Administration insurance. It’s not like it’s Aetna and United Healthcare. They are both Veterans medical insurance.

But they are not allowed to talk to each other. Only we can talk to them and then transfer information back and forth. I found that out in my 10,000 phone calls between all these quasi-agencies.

But I can live with this. I can do it!

RYAN COSTELLOSo I want to right here, right now, give a formal thank you to my Congressman, Ryan Costello, who I did not vote for, but who has restored my faith just a bit in the system. He worked for his constituents, regardless of their party affiliation to solve a real problem in his District. I am grateful for his attention to this problem and for his associate, Lisa Reynolds for tackling this crazy issue in record time.

See, people it can be done. People who don’t agree on everything can help one another and get things done. Wow, what a concept.

And it never hurts to laugh while helping….And dream of George Clooney’s House on the Amalfi Coast….

“You Just have to Laugh………….”

©Cathy Sikorski 2016

 

Want a Laugh? Call the VA……

Although my caregiving duties have changed some, I still, like many a dutiful daughter have to deal with issues of the elderly.

As I warned you a few weeks ago, my Mom is steeped in a battle with the Veterans Administration.  They reneged on her insurance about a month ago. This insurance is for widows of Veterans. My mother was placed on this policy 15  years ago. She’s used it for all her health needs since then, until that  fateful day when they discovered their error. For points of clarity, my Mom was put on Insurance Plan A and should have been placed on Insurance Plan B.

As you can imagine, in the world of government bureaucracy, this is no easy fix. Nobody knows what to do or how to repair this problem.

What they do know how to do is create all kinds of havoc that sends little old 87 year-old ladies into shock and apoplexy.

They have begun to  take back all their insurance payments over the last year or so, thereby causing my mother to receive bills from all her medical providers day after day after day.  You may not know this about the elder generation, but if they get a bill, they pay it. Case closed. Even though these bills will eventually be paid by Insurance B, this generation can not abide being beholden to anyone, especially their doctor.

After yet another three and a half hours on the phone with fwo divisions of the Veterans Administration…Insurance A and Insurance B customer service, and  DEERS   (Defense Enrollment Eligibility System) a department from the Department of Defense, I had my Mom actually hear a customer service rep tell her not to pay any bills until this is resolved.

The first guy was named Kirk. He asked me if I had spoken to him three days ago. I assured him I had not since I was out of the country.

“Hmm” he said, because I ‘m sure I had a call from some lady about this same problem, which I never heard of until this week.I guess Insurance A is running a review of all their insureds to see who is on the wrong program…hahahha..”

Yeah. Hilarious.Oh, and by the way, I think my mother may have inadvertently started this shake down of widows from the VA about a month ago.

Person number 2 , after our second 20 minutes on hold, was David. He, too, was flummoxed by this account of our woes and told us that he could only suggest we call DEERS, because It looks like DEERS needs to confirm that my father died on October 10, 1961.

Person number 3. after a very brief 10 minute hold was Bill. Bill was ever so kind. He could see that this was a grand problem. He couldn’t understand why the two insurance companies,under the VA would not accept a death certificate (yes, my amazing, organized- with-every-shred-of-paper-ever-touching-her-fingers-Mom has  a death certificate from 1961). Then Bill searched the records and said because the ‘incident’ (meaning my father’s death on active duty) was so long ago they would have to put in  a request to …you guessed it….the Veterans Administration, to confirm my Dad’s death.

One more transfer to another department of the VA, with a lovely 20 minute wait to Stuart.  It was almost taking as long to explain this journey as it was to be on hold, but explain it I did. And, this is a true story, mind you, while searching the data base of all the information under my Mom’s name and my Dad’s name, I think Stuart thought he put me on hold. Alas, this is what I heard in his exasperated voice:

Only I KNOW the ANSWER...she said.
How do you spell “Cluster$#!!

“What a cluster fuck!”

Yep, I burst out laughing, ’cause well, yeah…indeed.

The journey continues with me filing some documents they’ve asked for, waiting for a confirmation that my Dad has been dead for 55 years to come from the Veteran’s Administration to my Mom, so that we can then send it to the VA insurance.

That’s how it has to be done they tell me. The VA can’t send it the the VA, the widow has to do it. And at least a few more weeks of comedic material for a blog called..

“You Just have to Laugh…..”

©Cathy Sikorski 2016

Frost and a Sweat………..

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……

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