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Sunday, August 25, 2013

The Pleasures of Dealing with Bureaucracy

Earlier this week, Bob received a glossy brochure in the mail from the insurance company. The brochure read: Thousands of United Healthcare Medicare Advantage members save $104.90 a month in Medicare Part B Premiums! It's easy to see if you qualify! Then, in two large colored boxes:

To qualify if you're single:
Your gross monthly income must be under $1,456.25 with less than $13,300.00 in assets.

To qualify as a couple:
Your gross monthly income must be under $1,958.75 with less than $26, 5840 in assets.

And I'm reading this, thinking, wow, he now qualifies for this! I had heard about this program before, but last I checked it, he didn't qualify because his income was too high. So they must've changed the income guidelines. And I'm thinking wouldn't it be nice to not have to pay that $104.90 Medicare premium every month?!! We really could use a break.

The bottom of the brochure reads: Call today to see if you might qualify! so I call the toll-free number and I get connected to a "social service coordinator" and I tell this guy that we received this brochure from United Healthcare regarding saving $104.90 a month in Medicare premiums and it looks like my husband qualifies for this program. And I tell him right up front the amount of Bob's SSD check and ask him if he needs my husband's United Healthcare member ID number.

He tells me no, that he's already got that information, and then he rattles off Bob's full name and address, and I'm figuring, okay, Caller ID and United Healthcare's computer system must've picked up that information and put it on the guy's computer screen already.

Then, he tells me that he cannot talk to me, that he must talk to Bob.

I tell him that I have authorization on file to speak in my husband's behalf, because my husband has aphasia and does not speak well.

He tells me that authorization is with United Healthcare and he is not with United Healthcare but with a company contracted through United Healthcare. So that authorization does not apply.

So I tell him, I have power of attorney, too.

He tells me that I will have send a copy of the power of attorney to their office before they can speak to me.

I tell him that document is 15 pages long. Which means I would have to hire a sitter for my husband, go photocopy 15 pages of a legal size document, then buy a legal size envelope and go to the post office to have it weighed and mailed to you, and you want me to do all of this just to talk to you?

He says, yes.

I tell him, really, I just want to know how to apply for this program, because it looks like he now qualifies as the income limits have changed.

And he tells me, that in order to apply for this program, he (the social service coordinator) must determine first that he (Bob) qualifies.

So I say, well, my husband can give you verbal permission to talk to me. Would that work?

He says, yes, that would work.

I tell him, you'll have to ask him "yes" and "no" questions. He can answer "yes" and "no" questions.

He tells me that he cannot ask "yes" and "no" questions. That Bob must be able to state his full name, date of birth and his address before he can give me permission to talk on his behalf.

So I tell him that's not possible, Bob is never going to be able to say all that stuff.

He tells me to write it all down on a piece of paper and have Bob read it to him.

Which is not going to work. Not at all. I know this. And I tell him, in so many words, that's not going work.

He tells me in that case, I'll just have to copy off that POA document and send it to them.

So now I'm a bit frustrated, so I tell him that I'll give it a try and give me a minute. So I get a big piece of paper and write in large letters Bob's full name, our address and his birthdate. I tell Bob I'm going to give him the phone and needs to tell this guy this information. Bob says, "I'll try."

So I hand the phone to Bob.

I'm sitting next to him, pointing at the words on the piece of paper. Bob listens on the phone, and he tries to say his name but all that comes out is the last syllable of our last name.

Then Bob says, "Three. Three. Three." which,  by the way, has nothing to do with our address. And then Bob says, "Avenue".  Which is actually one part of our address. And then he gets tongue tied and just starts making strange noises....

Then there is a pause.

And Bob says, "Nineteen twenty." Which has nothing to do with anything.

And Bob says, "Yes" and hands the phone back to me.

I say, "Well, that didn't work."

The social service coordinator says, "He tried."

I figured that was the end of it and now I would have to send off the POA papers--when the guy surprises me and asks for Bob's monthly check amount.

I tell him the amount. Which, by the way, I had already told him at the beginning of the conversation. But I tell him it, again.

Then he asks if Bob has a copy of his benefits statement from Social Security.

I tell him, yes. Do I need to get it out? (Thinking he needs some number or something off of it.)

He says, no, he just needs to verify that Bob has "read" it. (Like, yeah, right...)

And then he tells me that Bob does NOT qualify. That his income is too high.

And I tell him that according to the amounts listed on the brochure he DOES qualify.

That's when he tells me that the brochure has THE WRONG INCOME AMOUNTS on it,


So then, just the other day, Bob gets a letter from United Healthcare which states We have received notice that one of your addresses may have changed. And he needs to contact their office with the new address. And I'm thinking, what the f--? Because our address hasn't changed. Heck, we've lived in the same house for ten years.

So I call United Healthcare and, I hate to admit, I am not the nicest person in the world. Because, what is their problem? And where'd they come up with this weird information? Probably the same place they found those income amounts for that brochure.

Anway, the customer service rep tells me that they were notified by a certain government agency that Bob had a change of address. And she gives me the government agency's number and tells me that I should call them right away, otherwise Bob might be in danger of losing his benefits.

And I'm thinking, jeepers! Because we need those benefits. So I call the government agency, and after being on hold for 45 minutes, which gives me plenty of time to think, I decide I am not going through that whole fiasco I did with that social service coordinator.  If Bob's benefits are at stake, I have to get to the bottom of this and there is no time for copying and sending 15 pages of POA documents because the mortgage is due on the first and we are down to $56.00 in the bank account.... So I go into a survival mode and do what must be done. Which is this: I become Bob.

I mean, my voice is on the lower end of the scale. And I figure if I just speak slowly and try to keep very monotone and don't screw up and say the wrong thing like "my husband"....

Finally, an agent comes on the line and I give her Bob's social security number.

And she looks up the file and asks, "Is this Robert? Or someone calling on his behalf?"

And I actually I tell her I'm Robert. And, truth be told, I can't believe I'm doing this.

And I don't think she believes me either, because she asks me for our address, phone number, then PLACE OF BIRTH, then MOTHER'S MAIDEN NAME, which makes me quite nervous but I sail through those security questions without a hitch.

Then I tell her, very slowly and in a monotone voice, about United Healthcare saying they were notified by this agency that our address may have changed and they said that MY benefits might be at risk, and that "my wife and I" have lived in the same house for over ten years and we certainly have not moved and I want to make sure that there ain't a problem here, etc. etc.

And halfway through my speech, I am horrified to realize I am suddenly speaking with a Southern Accent! That I am saying things like "ain't" and "mighty fine" and "you all" and "yes, ma'am" and "much obliged" and GA! Where did THAT come from?

And, after all of that, I find out that that agency hadn't notified anyone of any address change...

As if life isn't hard enough---so do I really need to deal with all this bunk?

Speaking of which, Bob's foot surgery has been rescheduled for September as his pre-op lab tests showed he has a UTI and he's been prescribed an antibiotic and we have to redo the pre-op tests this week. And the doctor's office did not inform me of all of this until AFTER I took Bob off the warfarin and started the lovenox shots. The reason for the delay in calling me? They LOST THE FAX from the lab....

Enough said.


Theresa Loder said...

Hi Diane
Oh my never ends...
I don't know if this will help you but my United Health Care guy helps us out a great deal

His number is 813 766-4755
Name is Fred Ramentol

If you have to leave a message he will get right back to you...he is very accessible

Tell him what happened and that I referred you....
Hope he can give you some answers

Prayers and hugs

Jenn said...

cue the circus theme music. good grief

Anonymous said...

I don't know which is worse....dealing with insurance companies to sort out a problem, or dealing with state or federal government agencies. In either case, I think they are the reason I only have 1/3rd the hair on my head I used to have.

Hugs, Dan

Barb Polan said...

I'd have been Bob too. Nice job. And the Southern drawl was a good touch. Maybe you were better off slow and mellow instead of quick and ranting (which is what he would have gotten from me).

I hope it all works out.

Praying for you.

Anonymous said...

I'm still "backreading" (that's a real word, I'm sure of it...) about you and Bob.
Just wanted to thank you for a much needed laugh out loud at your "Bob impersonation". And your "southern hospitality" sent me over the top into laughing so hard I had tears rolling.. So hard the bed shook and my poor hubby who was sleeping cracked an eye open and looked at me like I'd lost my mind!

As a fellow caregiver to my hubby, a guy I love with all of my being, a guy who has MS, Addisons disease, and is a stroke survivor, I tell you I'm much obliged for the laugh.