Three quick stories that can save you stress, peace of mind and MONEY!!
CRISIS TIME IS NOT THE RIGHT TIME TO PREPARE
Happily married couple for decades. Successful husband and bread winner. Wife raised their family. Life was rolling along as planned until husband’s health took a turn. They were Retired by this point in life and he was the ONLY person that had the data about their financial house, including their healthcare coverage.
After a year of battling this health problem, husband became bed ridden and unable to communicate. Wife did not know the circumstances she would be facing until too late. She had to reconstruct their financial house and healthcare from clues. She did not know passwords, accounts, names of plans…things you need to know.
- Share your Financial House data with your Spouse or if you are not married, share with someone you trust with your life choices.
- Complete a Medical Durable Power of Attorney (MDPOA) process FOR BOTH OF YOU so you can speak on the others’ behalf in crisis. Not all States handle this the same. Here is the COLORADO link. https://cdphe.colorado.gov/palliative-care/advance-care-planning-for-patients-and-families
- In my field I have two PLATINUM GOLD resources that can help you navigate: Andrea Wacker with Legal Shield and Shalah Mae Zimmerman – Mobile Notary (719) 491-3718. Do not hesitate! Call them now and get on their calendars to get this into motion.
ONE STEP SAVED $7,600
New Medicare Beneficiary visits doctor and discovers there will be three procedures that must be done. Asks Doc to get the authorization IN WRITING before scheduling. Doc office assures Beneficiary they are “good” so the procedures are scheduled and completed. All is good.
Beneficiary goes on a month-long vacation and returns to a bill for $7600 from Doc office.
Calls them to ask why they are holding a bill for the procedures to which Doc Office says, “Carrier did not approve them.”
Luckily, Beneficiary had this authorization IN WRITING and held her ground: that was NOT their problem and she is not paying that bill.
Doc office tried to negotiate but failed. Someone had a job at the Doc office to get authorizations and THEY LIED ABOUT IT. The Carrier was in the clear: they had not given authorization. The Beneficiary was in the clear: had it in writing that it was covered. I can only assume that the Doc Office administrator that lied is not working there any longer.
- Do not accept procedures without Prior Authorization. Get this in writing. Don’t be frustrated that you have to do this. You will be glad you did!
PROOF IS EITHER IN THE PUDDING OR IN WRITING
Beneficiary called her Supplemental Company three times to make sure she was covered for a trip to Canada to visit friends.
Three times, she asserts, she was told she was covered. She is the type of person that plans!
With peace of mind she visits Canada and on one of their excursions she falls off her bike crashing. This landed her in the hospital for a lot of procedures and a week in-patient stay. Now, remember, Canada isn’t going to accept Medicare. How it works: she gets the care she needs, pays the Canadian bills and brings receipts home for reimbursement. Which she did. Her Supplemental Company DENIED HER REIMBURSEMENT completely.
She (understandably) felt betrayed and asked,
“WHY did you deny my claim when I had three conversations confirming my coverage would follow me to Canada? You confirmed it!”
and their response,
“PROVE IT.”
NO DICE, she could not…and now she is paying tens of thousands of credit card debt.
- Again, get things IN WRITING.
- Keep a journal of all of your conversations with carriers. The date, time of call, reason for call, the individual people’s names you talked to, any “record or service number” connected to the call, record the call if you can, notes of outcome from the call. This type of meticulous documentation is very useful in proving you did and said what you did and said! Guess what the percentage of people is that KEEP RECORDS LIKE THIS? Better yet, just ask 10 of your friends or family if they do. I don’t have a scientific study to give you a perfect response but I’ve met with 250 people this year and 5 of you keep close track of all correspondence.
DISCLAIMER!
I wrote the above at 80 miles per hour. Pardon the errors and typos. AI is losing its mind with suggestions on changing and re-working my post. I have three days left to help people get their Medicare House in order for 2025.
Open Enrollment closes on December 7th at midnight.
CALL YOUR BROKER AND GET YOUR PLAN REVIEW DONE.
Call your loved ones on Medicare and check on them. You can confirm what your / their plan is for 2025 by calling Medicare (open 24/7) at 800-633-4227.
Sarita Shoemaker 