Dealing with Insurance Companies

kareast

I do all of my mother's business affairs, including setting up insurance, as I am sure most of you do as well.

I received a letter from her prescription drug company about a pharmacy not being in network.  I didn't know what that was referring to, couldn't find out anything online,  so I called the company. This is for a plan which I set up, which has my address for mailing on it, my phone number etc.  They would not speak to me unless I was with her and she gave permission OR we send in power of attorney documents. 

They let me set up the plan, send them the money, but then when I need to deal with them to represent my loved one, we have to jump through hoops.   I understand having to send power of attorneys to certain organizations, like financial institutions, but for something like insurance I do NOT understand it. 

Anyone else have thoughts on this?

Thanks. 

harshedbuzz

kareast-

As inconvenient as it is, they are protecting her as their client. Even if you set it up and they mail paper to your home address, you are not the customer.

My mom doesn't have dementia, but struggles mightily with technology. She has listed me as a secondary contact which gives me permission to discuss some of her accounts without her OK- phone, cable, electric, one of her banks, the investment company. We access a lot of things related to SSA, Medicare,  and her pension together online which I could presumably do without her permission though I would not at this point. 

If you will be acting on her behalf, send the POA in to be vetted by their legal department. It's probably a good idea to contact her medical providers, bank, investment firms, etc. proactively so you have access when you need it. 

I know this is super annoying. My Medicare supplement is through the company from which my husband is retired; he has to give his permission for them to talk with me even if I call about something related specifically to my care. 

HB

Quilting brings calm

It’s all part of the HIPPA rules.  I never had any issue  with discussing my spouse’s claims with my insurance company until then. Now they won’t talk to me about him without him.  

I ran into the prescription insurance issue with my Mom when her dementia issue started with a UTI.   We got her in the hospital and the hospital pharmacy was trying to deal with the prescriptions she was on for some reason.  I don’t remember  the exact issue.  I just remember I had to talk with the prescription insurance and they wanted mom to give them permission.  At that point she didn’t even know where she was, or anything else due to the urosepsis.  But she gave them ‘ permission’ and they were happy.  

Your mom ( or you on her behalf) must have used a pharmacy that the prescription insurance doesn’t have a contract with.  Therefore they are either paying less for the prescription. Or refusing to pay for it.   If you got her a Medicare Part D plan, Medicare.gov will tell you whether that pharmacy is  preferred in network,  standard in network, or not in network. 

Jo C.

I am almost ashamed of myself, but not really - necessity was the reason and even discussed this with our Pastor.

My mother who had advanced FTD could no way address her needs for pharmacy, insurance matters, or financial matters or any matters needing addressing.  She could not conduct any business or grant permission - she would have been all over the board and that would have engendered far worse dynamics to be required. I had her DPOA, but that did not suffice for some companies and they would want extensive paperwork with lengthy delays.  Not acceptable.

 So  . .  . when needing to cancel a credit card, needing to order pharmacy, needing to do much of anything on the phone - I simply became my mother in voice. 

 I knew her SS number, her health insurance number, her Medicare number, knew her mother's maiden name, addresses banking numbers, etc.  I called and said this is Mrs.Jane Doe calling, (pretending I was my mother), and got all business taken care of; no fuss no muss and no lengthy hoop jumping, delays or failures. 

 This saved us so much time and failures that my step-brother did the same for his father who was far into his Alzheimer's disease.  Same results.

I would never have done this for a person capable of speaking for themselves and after having several very negative outcomes realized I was going to have to adjust the approach to all of the phone business or have perpetual negative consequences and delays.

Just one person's experience, and am not at all recommending people go out and do this, especially if the LO can speak for themselves even if haltingly so.

J.

terei

As with Jo C, I used this approach with every entity I had to deal with.  I called and said ‘this is (mom’s name) ‘ + had most things taken care of with no issues.  Make sure you can rattle off birthdate, SS # + address + you wont have an problems at all.

Unless they ‘know’ you + all your circumstances(local clinic etc) this is the easiest way to handle these things.  I had DPOA for years + had to use it occasionally, but took the easy way if I could.  So sue me.

Jo C.

Oh terei, we are both going to heck in a handbag!

However; all was based on necessity and done in the best interests of a LO who could not do for themself.

Never did I ever touch a penny of my LOs limited assets or asked to be paid back for anything; in fact, we purchased quite a lot and simply as family provided it with no expectations of ever being reimbursed. It's family after all.

J.