I went to the meeting today at the Senior Advocacy Services and left there more confused than when I went in I think! Can this be possible
Ok I took my MIL off the Kaiser and have her on Humana drug coverage and straight medicare they were refering to a supplemental insurance by the names of Secure Horizons and AARP (both Im familiar with but need to know what all of you think is the best/better) My main objective here is to never have a billing. Is this possible that there is a deductible out there that isnt outrageous?
Oh yeah one more thing TORP refered to a POA as not the best thing, that it doesnt really help that much why is this does anyone know? Because now Im not too sure I want to go through with that now...

For some reason these posts are coming up backwards here...so newest is down at the bottom

This message has been edited. Last edited by: Bunnys_grl,

Oh, you mistook me! You absolutely SHOULD have the POA. But unless you are an only child, or have unusually supportive extended family, be absolutely certain to retain records and documentation of your transactions on her behalf. This would be for YOUR protection as the POA should a question arise, whether meddlers or perhaps some sort of proof needed if applying for medicaid when her assets run out.

But the POA does give you the right to make contracts on your mother's behalf and it is something you need to have.

We had unusual meddling going on, so if there is ANY CHANCE that someone might attempt to get your mother to sign something without your knowledge that she shouldn't sign and doesn't understand, there are additional steps that can be taken. We went the route of setting up her assets into a revokable trust with additional language saying that the trust can't be changed without prior notification of each of her children. That was enough for us as the issue was entirely about gaining control of her assets. You can also or alternatively get guardianship, but I'm pretty certain that requires a judge. At least, it does in our state. POA doesn't necessarily cancel your mother's right or ability to make legal contracts on her own, although you can usually get her back out of them if it can be shown in court that it was done fraudulently while she was not in her right mind.

If there aren't any sort of assets to be considered beyond a monthly income from social security and perhaps a modest pension, the trust isn't anything you would need. You might consider the guardianship, however, especially if she is in a nursing home or some other place where strangers could have unlimited access to her. Believe it or not, there are even salesmen who will get these little nursing home patients to sign for expensive equipment they don't need or insurance policies, or heaven knows what.

DISCLAIMER: I'm NOT an attorney or specialist in elder care or finance matters. I'm just giving you some things to ask about to make sure that you are protected.

Re the insurance: Can't help there. We've got straight medicare and a supplemental policy through the employer from which she retired. It has a fairly large deductible, but we don't pay for the insurance; it was part of her retirement contract.

Ok starting to get a little picture here thanks for that clarity.... as for the other issues my hubby is her (MIL) only child there is no one else and there are no assets to her name..does that make a difference? Does that still require a POA?

You need POA to sign contracts for her (e.g. her health insurance policy), to cancel contracts for her, to sign her checks to pay her bills, to get banking information, etc. Some folks get a joint checking account instead, which would probably work in your case since there's nobody else to inherit or anything. But that doesn't settle the contracts issue. So, yeah. I think you need one. It's a simple document, though, if you don't have one. You may even be able to find one on the internet or obtain it from her bank. It would have to be notarized as well, at least in my state it is. A POA makes your signature as good as hers on nearly any document, as I understand it.

You'll need medical POA (which is a separate document) to make medical decisions for her, instruct her doctor, etc. In my state, the doctor won't even talk to you unless he has her signed permission on file. This also permits you (or your husband or whomever she designates) to give permission for medical procedures, for example a surgery, if she's unable to sign the consent paperwork for herself. This is something that you *may* be able to get from a hospital as a form to fill out and have signed and notarized.

Have you checked with AARP? I haven't had many dealings with them, but they may have some sort of packet with information and/or forms for specific states. We used an attorney, so just did what he told us to do. I didn't have to find out all the reasons why.

(Re the trust: another issue we were having was a nephew who would remove things, especially heirlooms, from her apartment. Having them part of the trust instead of her personal property gave us the ability to leave her out of the recovery process. Don't people stink? It's just appalling how outwardly decent, churchgoing people will take advantage of the elderly and helpless, and convince themselves they have the right to do so.)

quote:

Originally posted by T.O.R.P.:
Don't people stink? It's just appalling how outwardly decent, churchgoing people will take advantage of the elderly and helpless, and convince themselves they have the right to do so.)

Honey you have no idea! Or Yes you do it sounds like! Yes I know how much they can stink! They are usually the ones that yell the loudest of how untrustworthy you are.
Been there done that! At the end of a day I am absolutely positive I can look at myself in a mirror. Can they say the same?
As for those forms I think they are on the internet Ill take a looksee for them. Thanks for the info on this it is much appreciated!

This is good information and I will print it out and show it to my dad. Did anyone else notine these messages came in a top to bottom order instead of having to scroll down to the bottom for the first reply that came in. I wonder why some posts do this?

Hey I hear you on that Angel! whats up with that sometimes right under the original post sometimes down at the bottom???? Why!

quote:

Originally posted by Bunnys_grl:
I went to the meeting today at the Senior Advocacy Services and left there more confused than when I went in I think! Can this be possible
Ok I took my MIL off the Kaiser and have her on Humana drug coverage and straight medicare they were refering to a supplemental insurance by the names of Secure Horizons and AARP (both Im familiar with but need to know what all of you think is the best/better) My main objective here is to never have a billing. Is this possible that there is a deductible out there that isnt outrageous?
Oh yeah one more thing TORP refered to a POA as not the best thing, that it doesnt really help that much why is this does anyone know? Because now Im not too sure I want to go through with that now...

The only way I can think of to NOT get a billing is to be on straight Medicaid, but I'm not 100% sure. Any private-pay supplemental requires a billing as far as I know -- for instance, I get a billing from BCBS every four months for Mom's supplemental. Secure Horizons is private pay, btw, as it's an HMO. I don't know about AARP.

As for the POA -- YES! If you're doing the finances, you're going to need it for banking if you don't already have a joint account. You'll need it for contracts, credit cards, the whole shebang. I definitely needed it when I had to untangle Mom's credit card mess a few months back, otherwise they, by law, weren't allowed to discuss anything with me.

TORP's got a lot of great advice, btw

quote:

Originally posted by angel0704: Did anyone else notine these messages came in a top to bottom order instead of having to scroll down to the bottom for the first reply that came in. I wonder why some posts do this?

Argh, that drives me RIGHT UP THE *#&#^@ WALL...I mean, most message boards are set up so that the most recent reply is right under the OP [Original Posting]. Why not the same here? ACK!

I just wish there was some consistency in how the most recent reply was posted. I'd rather just have it come in normal order of ...the original question,then the first reply, followed by the second reply ect. Instead of having to scroll down to the bottom for the first reply then read up for the reply's after that. And i've seen some post's have like 18 pages so then i'm really confused! This is off topic from the original post so i am done now

Bunnys_Grl: As long as your MIL is home and not in a facility, it's best to have a supplemental along with Medicare. (Secondary insurances make deals with Medicare where they take on the total billing for Medicare and then collect a portion of the total bill.) They are relatively inexpensive. Humana (supplement) is an HMO with a big list of covered meds. You want a secondary/supplemental coverage. Medicare pays 80%, your secondary pays the remainder. If ever she would need to be admitted to a hospital, I believe there's a standard deductible (outpatient and ems transport) regardless of the supplemental. Without a supplemental, you're responsible for 20% of all charges. If she ever goes into a nursing facility, you would then need to disenroll her from everything (after the Medicare allowed coverage for nursing which would pay the first 100 days if she's hospitalized first and stays at least 3 consecutive nights and then it becomes manditory private pay) and if eligible, would want to apply for Medicaid - best case scenario.

YOU WANT POA - there are no disadvantages to having this. What's yours, stays yours if this is your concern.

P.S. Regarding your second post here...she sounds as if she's eligible for Medicaid which is what you might want to start pursuing.

P.S.S. One more important thing to know is that you want a "durable" POA - medical and financial.

This message has been edited. Last edited by: SandyF,

Yes exactly the supplemental...but which one is what I was asking. See the last stay she had in kaiser they charged her 3500 (that was the total cost of days she was admitted) Medicare told me that by having Kaiser she negated her medicare coverage which would have picked up on the extra charges. And now with the by laws changing now we need the supplemental ins. I am trying to understand these with no luck. I dont want to have to get stuck with another bill like this last one so Im trying to figure out which one will pick up the 20% that we would normally pay out of pocket.
I spoke to someone at Secure horizons and they said there was a plan that we could get her on that had a deductible of 350 ond that would be the only out of pocket for us...But....now bear with me S.H. IS an HMO correct...like Kaiser???
(So now either I am getting lied to again here by these companies who just want business, you feel me so far) If it is an HMO like Kaiser then it goes back to...Negating the medicare benefits she is entitled to. Do you all see what I am saying now? Im getting lied to by these companies. Ill expound on this ok..
HICAP also has Kaiser as a supplemental on there sheets (Im looking at this right now as I type) They are recommending it as a supplemental to medicare benefits...but if you call medicare right now they will say it negates Medicare coverage.
Now do you see the dilemma I am facing

OK BG, I think I understand what's throwing you off track. First thing you want to do is make sure your MIL is enrolled in Medicare Parts A and B. (You've already got Part D covered). Part A is hospital coverage, Part B, doctors, outpatient visits. Was your MIL enrolled in Medicare when they denied hospital charges at Kaiser? Kaiser is a totally self-contained health care system so I’m wondering if it may have disqualified your MIL from Medicare benefits and she probably was just not covered at all during that time? The only way Medicare would have stepped in was if she had been admitted to a facility other than Kaiser because of emergency. (No Kaiser here in Fla BG). Secure Horizons and the other supplementals may offer PPO or HMO policies but NO, NO, NO….a completely different HMO from Kaiser..completely different and this is why I think you’re having a hard time understanding. Kaiser is a self contained, complete health care system...the whole nucleus. Not only are they the healtcare provider, they are also the insurers of their policies. Secure Horizons, Humana, AARP (to name a few) are insurance coverages that provide contracted medical professionals and the clinical facilities (one part of the nucleus)…very different than Kaiser. All Part B providers pick up the 20% except Kaiser which is not a supplemental coverage to begin with. I think that’s what is confusing you. These and many more offer supplemental B insurance which is what you want for your MIL and of course to disenroll her from Kaiser. Any of these insurances that offer supplemental Part B, all pick up the 20% and are nothing like Kaiser which operates within it's own system, not Medicares system which is why your mothers bill wasn't paid by Medicare then.

P.S. Sorry it took so long to respond. Speaking of chinese food.....I phoned in a great big order that we just got done eating BG! All I need now is a cup of coffee and a box of Sees

This message has been edited. Last edited by: SandyF,

Because I will be 65 in August I am in the process of looking into insurance to suppliment medicare.I have gone to an insurance broker to assist me.It does not cost me and they can do all the reading of the fine print.Also have to consider a prescription plan as not to have our government place me in their awful plan.

quote:

Originally posted by mae:
Because I will be 65 in August I am in the process of looking into insurance to suppliment medicare.I have gone to an insurance broker to assist me.It does not cost me and they can do all the reading of the fine print.Also have to consider a prescription plan as not to have our government place me in their awful plan.

Mae I know this...I dont know much but I know this when you sign up for medicare they give you the choice of drug plans right then and there you just tell them what pills you are on and they find the plan that covers it....Hah! see I do know something Other than being a little stinker!

Ok Sandi!!! AAAAAHHHHHHHHHH!!!!!!!
Now I get it!!!!!!!!!!!! Can you see that?!
I look like I just gave birth! To a medicare plan! Ok maybe not that funny but surely worth an ever lovin eye roll right?!
Oh thank god I am finally understood!!! And that means my friend that Mercury has finally went direct! No more confusion thank god!!! Smooth sailing until July 4th when it retrogrades again! For now lets parteee pass the chinese food the sock it to me Saki and lets smoke the night away!
Can you feel the love!

Ok if you think I was confused the other day you should see me now! I think Im going to entitle this post as.....
FYI......
Im sorry to say I have been lied to....Yes lied to...now for all of you out there that have Medicare part A&B Im going to make this an ongoing post so we will know once and for all what is truth and what is fiction....
I just got off the phone with Healthnet with the ruby plan also a plan called the green plan.
This was given to me by the Senior center volunteer (I figured they should know right?) Wrong. This plan Medicare has for the added coverage to take up the slack.... So not true!
The clerk (after explaining my MIL's situation and her needs and the fact we live in CA.) asked me to hold to put me to another Insurance specialist in CA. who proceeds to tell me that these plans just mentioned take over medicare (ie. negate some of their coverage) and that what Im looking for is to keep medicare and get a gap insurance. When I asked why she would be telling me something that might take business away from her company she said it was because she was a licensed insurance specialist and it was the law to inform me what medicare doesnt want me to know....Taaa Daaa! Could this be an angel in disguise or could this be another detour to h***....stay tuned for this one.
Ill get to the truth if it kills someone else!
Ohhh you thought I was gonna say me?! Not a chance! Who would take care of her upstairs!

My hubby,Larry is my POA for everything.I got everything in orfer right after I was dx.POA is a necessitiy.I also have a medicare supplement,it picks up what medicare does not pay.............

quote:

what Im looking for is to keep medicare and get a gap insurance.

BG - EXACTLY. You want to get a supplemental (gap) Part B insurance plan. Call AARP or Humana. These insurances make deals with Medicare to take over the billing on Medicares behalf. You should pay nothing towards any health coverage with Medicare and the right supplemental (gap), NOTHING when you have a supplemental except for the usuals as I mentioned, i.e. certain one time, small deductibles (ER visits for example).

quote:

When I asked why she would be telling me something that might take business away from her company she said it was because she was a licensed insurance specialist and it was the law to inform me what medicare doesnt want me to know.

What do you mean here? Medicare has no financial gain if this other coverage "negates" or overrides your original plan with Medicare. Wouldn't it be the other way - where this company wants your business and isn't giving you the full picture?
You need to call the different Part B insurance plans. All supplemental B plans are the same as far as coverage. The big differences are that some cost, some are very minimal prices, and some only offer HMO, not PPO. I'm not following why you're having such a difficult time getting a supplemental to your Medicare coverage.

This message has been edited. Last edited by: SandyF,

quote:

Originally posted by SandraF:

quote:

When I asked why she would be telling me something that might take business away from her company she said it was because she was a licensed insurance specialist and it was the law to inform me what medicare doesnt want me to know.

What do you mean here? Medicare has no financial gain if this other coverage "negates" or overrides your original plan with Medicare. Wouldn't it be the other way - where this company wants your business and isn't giving you the full picture?
You need to call the different Part B insurance plans. All supplemental B plans are the same as far as coverage. The big differences are that some cost, some are very minimal prices, and some only offer HMO, not PPO. I'm not following why you're having such a difficult time getting a supplemental to your Medicare coverage.

"She" is refering to the Insurance specialist in Ca. not medicare. While I get what you are refering to the bottom line here is that everyone even medicare was not telling the truth here medicare even lists Kaiser in their sheets as a "supplemental"
Now for me supplemental means it picks up where medicare leaves off...thats no the case here at least not in CA. Kaiser negates medicare coverage...so does this other plan that the Senior center refered me to, the "Healthnet plans" And what I was refering to up above when I asked her why they dont tell us this information the insurance specialtist said its because medicare doesnt want us to know this because they are trying to get out of being the primary payer.
Now do you get what I am trying to say here.

Im going to expound on this a little more... this is how its explained to me.....
Now lets say you have straight medicare and you (just for argument sake) purchase the kaiser senior advantage, healthnet,or secure horizons
they will give you a list of things the program picks up (now mind you Im looking at the same time what medicare doesnt pick up) and I choose accordingly. but the fact of the matter is when the hospital stay was over medicare didnt pick anything up at all nothing nada zilch. I call and ask medicare and the person says picking a healthcare provider negates any coverage that my mil would get from medicare...
Now if thats the case then why are they promoting these plans as supplementals???
They should be refered to as outside coverage and not supplementals.
If they are to advertise anything it should be gap insurance but they are not. They are trying to get away with not being a primary...

This message has been edited. Last edited by: Bunnys_grl,