A month has passed since I began tackling issue after issue. I spent full days on the phone trying to sort out a never-ending pile of documents that made little sense. I made calls that were never returned…well, actually, one woman I had been calling got back to me more than two weeks later.

In the previous post I listed what was happening. The underlying problem is that one can’t get through to people, and that the people one wants, if not needs to get though to conveniently makes themselves unavailable. I have observed this over and over again.

PhotoArt: ©2017

I have felt trapped with a phone in my ear and a palpitation in my heart.

Picking through the rubble of the month, here is my report:

1. I have been purchasing the Ensure out-of-pocket. It is inconceivable to me that my mother’s physician’s nurse could be such a screw-up and never return the info to the managed care company. I can’t tell you how many times I have called and faxed. This has been going on for years. The supplier is waiting for the go-ahead for WEEKS. I have had to deal with three agencies in this process and rather than go berserk, this is the least of the issues now. I am sure that somewhere on paper this is a breach of contract.

2. I was able to clear up an issue with the pooled income trust. I believe things will be alright now. But of course this was not without endless calls and faxes of financial documentation to the trust and the managed care.

 

 

3. The issue of the papers that had been “lost in the mail” has been rectified.

 

 

4. The BIG ONE: I had a head-to head with John Hancock Long Term Care for which my mom has been paying for, since the policy was taken out in 1997, for care, should she need assistance in her later years. The issue isthat this huge corporation NEVER lets one know if their policy is about to expire. YOU must have the presence of mind to CALL them; to sit on the phone listening to muzak and hope that your call is answered in the U.S.

In October I called and got routed to the Philippines. The John Hancock rep there looked at my mother’s policy and assured me that she had “178 days of coverage remaining” which would get us to the “middle of April.”

I relied on this information. In March, about a month prior to what I thought was the expiration of the policy, I called John Hancock. I was told that:

“The policy expired February 25th.”

This was TWO months before expectation.

I got my wits about me and called back. Rep after rep told me my mother’s “policy had expired.” That was it. “There was no more money in her policy, it was exhausted.” And just like that, with the bull of stupidity, a corporate bull charging at me, defending its inhumane stance, I saw RED.

For days, I insisted on speaking to “as high up as I could go.”  I left a message with a supervisor and told her that:

“This is NOT about an expired policy. This is about your company’s policy of not keeping a client apprised of the expiration of their policy. This is about elderly people who have no more money, no more insurance. (Mind you, one young woman told me there was nothing they could do and I should look into MEDICAID.)

“This is about your company practices. YOU contracted out of the country. YOUR rep told me the policy would end in April. I relied on that. I believed that. Had I not called in March  (thinking the end date was in April) I would not have known that the policy had expired the month before. How does one make plans? This policy supplied two hours of evening care which my mother can’t be without.”

The supervisor promised to get back to me within three to five business days.

The phone rang. It was the same woman I explained everything to. She had spoken to her higher-ups. Her words to me were:

“Your mother’s policy is exhausted.”

And I swear, I saw beyond red. Now, I was the bull charging at that rep with all my strength, but I said,

“No, I am the one who is ‘exhausted’ dealing with John Hancock. “THE FACT THAT THE POLICY HAS EXPIRED IS NOT WHAT THIS IS ABOUT!”

“Oh, so what is this all about?” (I swear I had explained this over and over.)

Here we go again:

“I never received any notification in writing that the policy was terminating;
The onus was on ME to keep calling;
Your company subcontracted an out of country facility to take calls and advise customers. Your rep told me the end date. It was two months after the policy “expired.” John Hancock should make good so I can make arrangements and get help.”

I received a phone message last Thursday from the same young woman. Using her best upbeat voice she said that my complaint was reviewed and the good news is that “John Hancock has agreed to pay through the month of March.”

Now, I could have fought for the two remaining weeks that the Philippine rep assured me I had but I decided that this was a win that I had never expected. This huge corporation knew they were wrong and this was their way of admitting it. This was their way of smoothing feathers and making nice. This was their way of shutting me up. (I had taken to Twitter, after all, if the President can do it so could I). In numerous calls to John Hancock I tried to explain to the reps that no matter how many times they told me that the policy had been “exhausted” and that “there was no more money available,” that this was NOT a matter any longer of my mother’s policy, it was a matter of a huge corporation not giving notice until after the fact and not being humane enough to help out the little guy. Of digging into THEIR bloated pockets to do the right thing.

I won big.

*For now, I moved the morning aide who worked from 7:00 AM to 3:00 PM, to 8:00 AM to 3:00 PM. That one hour is now paying the evening aide from 5:00 PM to 6:00 PM, but 6:00 PM to 7:00 PM, previously covered is now out-of-pocket. Until …

5. There is another war going on. The managed Long Term Care that pays for that morning aide is funded by Medicaid. Assuming I had a few months to play with, my mother had an evaluation in March by a nurse whose report said that my mother displayed no health changes and couldn’t get more hours of help.* The report stated my mother resided in an assisted living facility and that is NOT true. No change in health? What about macular degeneration and blindness? What about the fact that she is now ninety-nine years old?

So, I was simultaneously dealing with this: a pile of papers in the mail made to intimidate, about a FAIR HEARING. I made call after call, left message after message, was misled several times as to whom I should speak, never got a call back. I was led to believe this could be settled “in house” which was not true.

Someone advised me to “fill out the papers and asked for a hearing.”

Finally, after a TWO-WEEK delay because a case manager misinformed me, I left more messages and again no call back until 6:00 PM one evening when I wasn’t home and then the dance began again.

I called a number on the forms, the best thing I ever did. I engaged a legal ombudsman to represent me at the “fair hearing.” The interesting thing I learned is that this organization is part of a group where my mother worked in the 1970’s to 1980’s. A service organization for the needy. “What goes around comes around.” (What my dear friend Annie in MA always used to say).

The hearing is Friday, April 14.

I am so done with this, this fighting for rights. The word “right” comes in with the built-in meaning of entitlement, to be treated the right way and with dignity. On this journey, I have oft observed just the opposite.

I began writing about this travel with my mother quite a while back. When she told me her life story, over and over again, I would hear about how people treated people with such grace and humaneness; in the post-war years, people tipped their hats, gave up their subway seats, traveled fearlessly at all hours. They dressed with class even if they were poor. They “made do.” They went without. They saved, they lived on less and were happy.

Now, everything seems to be about money.

I, observe the President of the United States.

If you mess with me, I’ll rant on Twitter.

 

 

 

This series starts here:
Part 1: And The Band Played On … a mother’s life, a daughter’s journey

The previous post is here

The next post is here