Mom and Dad 1944

When we are young and just beginning to fly through life, we rarely think about health care, retirement, savings. My parents are children of the Great Depression; they never lived beyond their means and managed to save a dollar here and there. When my mother was working, she had Blue Cross/Blue Shield, and it continued when she retired in Florida. And then there was Medicare. For some reason instead of choosing straight Medicare, she chose an HMO, Humana. Maybe it was cheaper, maybe the coverage was decent at the time, but she was confined to Humana participating physicians and hospitals and her Blue Cross/Blue Shield, which was the superior in coverage as the secondary policy, never kicked in.

Mom on her honeymoon

I had no idea that her policy was so poor. It seemed adequate for many years but adequate isn’t enough, especially when you have been paying for a better policy and it can’t be tapped due to some strange rule and especially when your needs are greater. Now she is faced with paying a $50  out of pocket co-pay for a rehab center where she is miserable, when her coverage could have been greater had she had “straight Medicare.”

The bottom line: one has to dis-enroll. They only let you enroll/dis-enroll during certain periods of the year: I missed it by four days.

I spend most of my life on the phone orchestrating my mother’s life from my command center. I spoke to many healthcare workers who verify that “straight Medicare” is the way to go. I spoke to my mother’s former employer. He was aghast that she had that policy. He had me call his insurance rep to see what he could do. I spoke to more people than I could count. I leapfrogged lists of names and numbers. Everyone told me something else. Once person told me that if my mother was in a rehab center the social worker could intervene and dis-enroll. I called Medicare and was told that there was no way I could dis-enroll at this time,  I called Humana and was told conflicting information by two representatives. They found a few loopholes, like a change of residence address would be a reason to change insurance, but nothing fit. We were stuck.

Yesterday I spoke to the social worker at the current rehab and asked her the same question: could she intervene? She suggested that the advocate could help my mother call Humana directly and tell them she wants out.

So that is what happened this morning and my mother was asked to write a letter and fax it which the advocate helped with. That sounded like the request had possibilities.

Keep your fingers crossed. Maybe someone is watching over us and we’ll end up with better coverage.

If you have healthcare insurance you are lucky. If you have the best possible insurance you are blessed. And if you are like my Mom, paying all these years for something she couldn’t use because of red tape, may your situation be resolved and fast.

And may you be in good health.

[This series is linked: see “continued here.” Also, below the line there will be links for the previous post and the next.]

continued here

The series starts here