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Healthcare Maze when Caring for a Senior Family Member

Healthcare Maze when Caring for a Senior Family Member
July 16
11:57 2018

People are living longer today than they have for many centuries. It’s not uncommon for parents in the 50s and 60s to be caring for their parents who are in the 70s, 80s and 90s. In many cases, providing the necessary care and support of elderly parents falls on their senior children and many will tell you that it’s not an easy task, no matter how prepared they thought they were.

Take the case of Karen Humphreys, who lives in northern Kentucky. Her father, 84-year-old Lee Ampfer is an Army veteran and retired from Cincinnati Bell where he worked as a lineman. In January, Ampfer fell and suffered a brain bleed. Ampfer had insurance and having power of attorney for her father, Humphreys called Anthem Blue Cross and Blue Shield on behalf of her father.

In February, Ampfer’s doctor diagnosed him as having dementia and prescribed that he have around the clock care.

Humphreys described her ordeal, saying:

“I talked to so many people at Blue Cross Blue Shield that I didn’t believe them. I said, ‘You’ll pay for this?’ I was kind of in shock. That was on January 23. I called them back on January 24 and I made them tell me again.”

“She’s telling me, ‘Well, that might not even be covered.’ I said, ‘What do you mean it might not be covered? So now you’re really backing out?’”

Since her first call to the insurance company, Humphreys says it’s like being trapped in an endless maze as she spent many hours every day fighting for her father’s healthcare needs, many of which the insurance company say they are not paying. She described it as being a full-time job, just trying to get everything sorted out for her father. By the end of June, her dad’s healthcare, including the 24-hour care, has cost $65,000 out of pocket.

Humphreys commented:

“I don’t have a money tree in my backyard. I don’t know what they think I’m going to do.”

Not knowing where to turn, Humphreys turned to the investigative team of reporters for a local news station and once the reporters contacted Anthem Blue Cross and Blue Shield about Ampfer’s situation, the insurance company finally came through and have provided a resolution for Ampfer and his daughter.

But not everyone has a local news investigative team to turn to and even then, things aren’t always resolved. That’s why it is highly advised that seniors and their caregivers take the time to talk to their healthcare providers and find out exactly what they are covered for what isn’t  covered. It’s also advised to meet with an attorney who can help draft legal documents to protect seniors and their caregivers in the event a similar experience happens to them

You have to remember that most insurance companies don’t care about the people they cover. All they care about is getting your money and trying their best to deny as many claims as possible

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