I See Red Tape

I have spent far too much of this week dealing with paperwork on behalf of my mother. She's 93 years old and suffers from dementia, so doing her taxes and paying her bills and managing most of life outside her assisted living facility is simply impossible.

While my brother deals with the medical side of her situation -- a not insubstantial matter in and of itself -- I'm handling the financial stuff, including gathering information for our accountant to work up her tax returns, as well as handling the influx of invoices from medical providers and explanation-of-benefits forms from insurance companies.

I'm not surprised when there have been mistakes made, mostly with inputting her various account numbers. Those I can correct relatively easily with just a phone call. But then there's the monster that is Medicare. It is a wonderful program that alleviates the financial distress most seniors would find themselves in without it. I'm impressed by how they seem to smoothy handle all the claims, pay the providers, and pass on the rest to third-party insurers who cover much of the rest of her costs.

But it only works if you have the required information. If you don't, you're going to bang your head against the wall trying to get it.

Yesterday, I needed to know something about my mother's Medicare account so I could fix a problem with one of her providers. The woman I spoke to at Medicare informed me that, because I haven't been authorized to access Mom's account, the HIPAA law bars her from sharing any of its details with me. I asked, "How do I get authorized?" She replied that if I could put my mother on the phone for 5-6 minutes and ask her some questions, that would do it. I explained that my mother can't concentrate on the same thought for more than 5-6 seconds, let alone minutes, because of the effects of this dreadful disease. I asked if there was an alternate route I could take.

The woman told me to look at a specific page on the Medicare.gov website via Mom's online account, where I could request the authorization form. I told her my mother had never set up an online account, and when I had tried to do it for her, it needed a piece of information I did not have -- the month and year her Plan A coverage began. So, could this woman please provide me with that date? No, I was told, because I'm not authorized.

I knew that would be the answer, but I continued, asking if there is a third option. She said yes, we can send it to the address we have on file for Mom. Since I wasn't sure they had her current address (she's only lived there for a few months), I asked, and of course I was told I'm not authorized to be given that information.

Trying to remain calm, I appealed to this woman's better nature. I told her I understand that the system is set up to protect the privacy of people like Mom (and me and you), but she can't be the only American suffering from dementia who needs help from a family member like me. How does Medicare handle this situation for everyone else? The woman replied that she was sympathetic, but this was the only available procedure.

Finally, I agreed to option three -- send the form to whatever address Medicare has on file for Mom, and I'll somehow get my hands on it, fill it out, and then figure out a way to have her sign it so I can send it back. Presumably, at that point (it may take as long as four weeks), I'll have the authority to talk to other human beings on her behalf.

Meanwhile, don't even get me started on the Social Security Administration, the IRS, the banks, and other institutions whose mud I've been stuck in for days. I spent dozens of hours just going through Mom's filing cabinets to uncover the secrets of her paperwork -- and that was when she was lucid, last summer. I can't imagine how much worse all of this would be if we had procrastinated.

I'm sharing all of this with you not merely as a way to vent my frustration. I hope you'll take it as a warning not to leave such matters until it's too late.

If you have a parent or any family member who is getting up there in years, sit down with them and go over their financial life. Fill out Power Of Attorney forms, write down all the information for their credit cards and bank accounts, plus their utilities, cable company, cell phone provider, pharmacy, doctors, medical equipment suppliers, insurance companies, accountant, lawyer, and anything else you can think of.

From my experience, there will inevitably be one or two that slip under your radar, leaving you to ask months later about some bill from someone you've never heard of. I found things like a medical service that charged her a hundred bucks every quarter (for over two years) because she had not opted out of their subscription plan. She knew nothing about it and drew no benefit for it, but they kept debiting it from her bank account.

Don't wait until your loved one is in such a bad mental state that they can't remember any of this. Do it now.