October 1, 2010

The Case for a Healthcare Advocate: The Financial Gerontologist Blog

In this busy world of ours we all know how important it is to have timely information to make wise choices.

 

Today, we gather information from the Internet, newspapers, magazines and other periodicals. Typically, we just reach for the telephone. There are, however, some contemporary challenges that come with using this venerable device. Whether we are calling about insurance coverage (health or property and casualty), credit card information (stolen cards, limits and payments) or just to make an appointment with a physician, we frequently get caught in "voice mail hell." (I'm sure there are many other adjectives that could be used for this, but we need to keep it printable!).

Anyway, frustration is an every-day reality when you are unable to speak with a "live human being" about a problem and instead get tangled up in one of those labyrinthine voice-mail menus. That common frustration and resentment is magnified when it is a older person trying to get details about their medical coverage for a particular test or just renewing a prescription.

I recently had this experience with my 89-year-old father-in-law.

The phone rang and it was Dad, who was in a state of alarm and confusion. It was a call for help. He had been trying to reach the outpatient department of a local hospital to schedule a CAT scan. The woman scheduling the appointments checked Dad's records to verify his insurance coverage and then proceeded to tell him that he had no medical coverage.

Dad took out his insurance card from his wallet and called the member services number ... and then it happened. The poor man was made to endure 20 minutes in voice-mail hell. He struggled, pressing every number he could in a vain effort to reach a "live person" who might be able to provide assistance. Finally he just hung up in total exasperation. That's when I got the call for help.

I assured him that he was covered under Medicare, his primary carrier, so he definitely did have medical insurance. He also has coverage under a supplemental health care policy that's part of my mother-in-law's retirement plan. I told him this policy would be in force since the premium payments are deducted directly from Mom's pension check.

In an effort to take the edge off of the situation and get him to relax, I got directly involved. I spent about three hours on the phone trying to ascertain what had happened, but predictably there were no easy answers. Going back and forth between Mom and the representative (since the rep would not speak with me because I was not listed as a contact person) it finally emerged that Mom's coverage through her company had been changed to another carrier.

The representative on the phone was kind enough to connect me to an actual person at the new insurance company and we obtained coverage information and new cards for Mom and Dad. While I had this "live one" on the phone, I asked her if there was any way Mom could appoint a "patient advocate" who could intervene should another situation like this one arise. She told me that a special form needed to be completed and signed by Mom and Dad authorizing me or my husband to act on their behalf with the insurance company.

I would recommend that anyone with elderly parents or grandparents inquire with the insurance company (or with any other relevant service provider) if they have an "authorization to release information and/or designation of a representative." This way, you are able to act efficiently on the elderly person's behalf and make their life (and yours) a little easier.

NOTE: A form of this type is quite different than a health care proxy or durable power of attorney, which need to be completed with the assistance and guidance of an estate planning attorney.

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