AARP Hearing Center
Mom's 82 and lives a few hours away. She's mostly independent so I didn't see this coming, but the admin side of her life has slowly become a part-time job for me.
This week alone I've spent an hour on hold with her supplemental insurance about a denied claim I still don't fully understand, two Medicare letters I had to read three times before I could explain them to her, a prescription that ran out because nobody at the pharmacy seemed to know whose job the refill was and a specialist referral that's been sitting in my inbox because I haven't had a clear hour to deal with it.
I don't mind doing it. I just feel constantly behind and keep worrying I'm missing something important.
How do other people manage this? I tried a shared calendar with my brother but it just became another thing I have to update. Genuinely curious what's worked for you.
Since I have became what I think is an expert at Medicare coverage and all the ins and outs or I learned it really fast with research either on the CMS or Medicare site or various others then I didn’t have any problems but sometimes it was very time consuming but once I got the hang of all the exceptions to the rules then I got real good at it. That has taken years and then you have to keep up with all the changes that affect beneficiaries.
CMS.gov - Medical Bill Guides and Resources
Some people hire professionals that act as Patient Advocates.
CMS.gov - Find a Patient Advocate There are companies that do it too - I do not recommend that route for normal beneficiary problems.
There are other help sources also depending on what the need.
Medicare.gov - Get help with your rights & protections
SHIP says that they can help with billing problems but I do not know if they mean insurance type billings or treatment billings.
Many times the problem can be remedied - by reading the coverage documentation and understanding all the various rolls of the parts of Medicare + any supplemental coverage. Knowing your mom’s coverage is paramount and having the policies and know how they work and when.
I can also definitely help here too but all the details have to be given - like problem details, plan type, Medigap plan - all the details make a difference.
You have to keep up with the Annual Enrollment periods for (1) Medicare Advantage plans or (2) free standing Medicare Part D plans because they change yearly and so may the beneficiary’s needs - Annual enrollment is October 7 - Dec 15 EVERY YEAR. Before that begins every year, the whatever insurance company will send an Explanation of Changes to the current policy - so you need to review that to see if the beneficiary needs another plan to fill their needs. Even then, it is still best to review the options again during the annual enrollment just to make sure that the beneficiary has the best plan for their needs including price.
So a good basic understanding of Medicare is good to have -
Medicare.gov - Medicare and You - The Handbook
I also used Excel to create spread sheets to keep with the care and billings - what they were for, etc.
Using Medicare.gov to read about coverage is also great for normal stuff. If it gets outside of the everyday norm, like for special coverage or special billing methods for coverage, then I have to resort to CMS.
It can be done easily after you understand Medicare. the various plans and the coverage.
I’m a list person, and when I needed to deal with a lot of this a spiral appointment calendar helped as well. It’s exhausting and I feel for you. One day at a time is important as well as taking care of yourself. Seriously, because it can wear you down fast.