My mother received some bad news today while attempting to fill her prescription. Apparently my father has failed to pay both their Medicare and supplemental insurance.
My father who has a very rare form of cancer, is currently receiving treatments that cost close to 500,000. He is only half way through and needs two more treatments to have any improvement from his disease. My father has been extremely confused and has been lying about paying bills lately. My mother cannot call the supplemental insurance as it’s through my father’s previous employer and they will not give her information (only him). As you can imagine, he also will not assign anyone as a health care proxy and is being extremely stubborn about the lovely predicament he has created. Some of it is the disease but most of it is just his uncaring personality. My mother is ready for a nervous breakdown after finding this out today.
I’m not sure where to go from here. Will they be able to get back Medicare instantly or will they have to wait for the enrollment period? I though Medicare came directly out of their SS check, so I’m confused as to how this could have happened in the first place. Will Medicare drop you if you’re behind on payments for your secondary insurance ? Does my father have any chance of getting back his supplemental insurance with a preexisting condition that cost so much in treatment?
I cant let them go without insurance, and I fear my father may have put himself in an early grave by putting them in this situation. Please help!!!
This sounds really unfortunate and it sounds like private insurance, not Medicare. I am not sure how that works, my stepdad retired from the city with a pension and private insurance. At some point they were transferred to an advantage plan, maybe by choice.
If dad has already set up and defaulted on a payment plan the odds are low that it can be reinstated, I would ask if the entire back amount was paid up could they get it back. I had to beg and plead for my dad's insurance company to talk to me, he was in the hospital near death and they needed permission, he was unconscious. I kept calling back asking for help until I got a beautiful lady that could actually get that he couldn't give permission, but we needed help. I called about 10 times a day for a week before I finally got some assistance.
They can see from the claims how long he has been ill, maybe, just maybe someone will work with you.
I would sit down with mom and get medicare on the phone, if she was on the plan they should talk to her, she can give permission for you to talk. They may be able to explain how this all works and how to get Medicare reinstated.
Best luck! Insurance is a nightmare on the best of days, have plenty of time and some place you can be comfortable, it may take hours.
Does employer use a Medicare Advantage for their retirees insurance?
Does Dad pay a premium to his employer? Directly to the insurance company?
I suggest you call Office of Aging. Ask if there is someone who can help u understand what has happened and help straighten it out. Once straightened out, ask insurance company to do automatic withdrawal so this doesn't happen anymore.
With me and DH, an insurance premium is deducted from his pension. As a dependent DH has given permission for Benefits to talk to me.
He was issued insurance post retirement through his retirement plan and my mother was also able to keep it for a lifetime. It was fantastic insurance that covered everything including my father is almost $1 million treatment for his cancer. My mother was trying to fill her insulin yesterday and they were going to charge her over $1000.
My mother discovered bills that he was hiding and found out that he was months behind in the secondary insurance. He made a phone call after weeks of telling him to do so, and they requested $900 per month to catch up. He owes over $10,000, I don’t know how he was covered this long with no payments being made. They asked for $900 per month in order to catch up, and in typical fashion my father shorted them by mailing them only $650. Again, he lied and said he sent the full amount instead of consulting with his family who would have given him the money he was short.
I have an extremely sick father and a mother who is not in great shape either. I am so worried they will never get their coverage back.
Let's say he'd say yes. In that case, your mother tells your father that the insurance needs sorting out to do that. She then calls the supplemental insurance people, she hands the phone to your father, your father gives his permission for them to speak to her, and she can take it from there. If she keeps it simple and focused on *his* treatment, this might work.
Write her a list of questions. She needs to know when the premiums were due, and how to correct an error caused by the policyholder's illness. The important aim is to reinstate his policy and not get manoeuvred into taking out a new one which surely will not cover what is now a pre-existing condition but wasn't when he was first accepted.
Does she know who the supplemental provider is? Does she have a policy number? You might be able to gather useful information from their website. Don't forget that your parents won't be the first people to have run into this problem and there probably is a solution.
You say your mother was filling her prescription when this came to light - she doesn't have her own insurance? Is she okay for whatever medication she needs?
If you look at the medicare.gov website there are useful-looking contact numbers on there. The key is to find an adviser who can guide you through your non-standard situation. The bit to cling to is that your father did not intentionally or recklessly allow his insurance to lapse - this was the unavoidable result of illness and it should be made possible for you to backtrack to when the premiums were due.
Insurers like not paying, obviously, and they will give you the brush-off if they can; but be dogged and be clear and if there is a way you'll find it.
btw - for the purpose of all these discussions your father is not himself because he is ill. Hitherto he has always been a conscientious and devoted family man. He would never have put your mother and himself at risk in this irresponsible way.
With my health insurance from my retirement board if I did not show proof of Medicare coverage my retirement health insurance was going to be dropped. It took almost moving heaven and earth to get a letter stating I was covered by the date that the retirement board deadline. Thankfully I talked to someone at the SS office and she got the letter sent with 1 day to spare.
If your Dad has insurance through his previous company and if his retirement insurance plan is like mine, if he is no longer covered by Medicare it is possible that that may also be dropped.
Also when this is figured out see if the payments can be taken from his retirement check rather than paying for it.
(I get a bill from Medicare the cost is not taken from my retirement check..and I do not get a Social Security check so it can not be taken from that)
He was issue insurance post retirement through the his retirement plan and my mother was also able to keep it for a lifetime. It was a fantastic insurance that covers everything including my father is almost $1 million treatment for his cancer. My mother was trying to fill her insulin yesterday and they were going to charge her over $1000.
My mother discovered bills that he was hiding and found out that he was months behind in the secondary insurance. He made a phone call after weeks of telling him to do so, and they requested $900 per month to catch up. He owes over $10,000, I don’t know how he was covered this long with no payments being made. They asked for $900 per month in order to catch up, and in typical fashion my father shorted them by mailing them only $650. Again, he lied and said he sent the full amount instead of consulting with this family who would have given him the money he was short.
I have an extremely sick father and a mother who is not in great shape either. I am so worried they will never get their coverage back.
Maybe he doesn't want to fight the cancer anymore. Perhaps he is too tired. Ask him. Maybe he is scared. Open the conversation. If he says no, then, let it go. And have this conversation with mom too. Both together.
Cancer, dementia, ALZ. I am sorry, as one person on one of these blogs said, we don't get to choose. She mentioned pneumonia. one friend was a fire fighter. His buddy 47 years old was teaching exercise class and died of heart attack.
This day and age, end of life should be discussed. I was afraid to talk about it when dad died. I didn't have a choice with other family members after that. It was a given, this would come to all of us some day. It's not fun, but it is somewhat necessary.