Dealing with Aging Parents - Medicare - Part 2

I cannot possibly cover Medicare completely if I blogged for a year about it. I will throw out some suggestions for you that I think can help you and your parents with it.

Make sure your parents sign up for online access to their Medicare info This lets them see when claims are processed and you can see any issues (and try to thwart them) before you would get information by mail. It is preferable to see if your parents will let you have access as well.

When your parents get ready to sign up for Part D (Prescription), have them go to medicare.gov to price polices. They can put in the prescriptions they use and where they get their medicines and this tool will present you with the best options (considering cost and location) for their Part D policy

Have your parents speak with Medicare and allow you access via phone to be able to discuss Medicare issues with Medicare representatives if need be. All they have to do is call the Medicare toll free number and answer a few questions to do this. It can be very helpful to have the ability to do this especially if they are ill or simply cannot understand the complexities of Medicare. You will need their Medicare number - they should have a card with this info on it.

   

Finally, I’ll throw out some specific situations we had issues with in case these might be helpful

My parents had primary insurance with mom’s employer (Lourdes) til the day she died with Medicare as the secondary. We didn’t know that we had to let them know that dad’s primary was now Medicare with no secondary once mom passed away. We figured it out when claims started being rejected for no apparent reason. Turns out you have to call a different group under Medicare to change that. The permission dad had given them to have me talk to them concerning his issues didn’t apply and I had to send them a copy of his Power of Attorney. Then there was a delay because the office was in New York City, and I tried to contact them during the week of Hurricane Sandy. It still took repeated phone calls and finally Lourdes Benefits sending them a letter saying that he no longer was covered by them to get the situation straight.

My dad was on oxygen. This is called DME (durable medical equipment) and covered under Part B. We found out the bizarre way they cover this when dad moved to Nashville to stay with my sister and nobody there would agree to provide his oxygen. Turns out Medicare pays for three years of oxygen supplies then the company covers the next two (not billing during those two years). Dad was near the end of his three years so of course no company wanted to pick up those two free years since they hadn’t gotten the paid three years. I talked with dad’s oxygen provider (Legacy Oxygen who was really good to work with). They explained the above to me and said they would work out a way to get tanks to dad. They couldn’t explain the Medicare logic to me though.

We would see claims that were regularly rejected for no apparent reason. In these situations, you should start with the provider (not Medicare). They can often tell you why and then refile. I was told multiple times – “Oh it’s Medicare, we are used to that”.

Expect to be on hold 10-30 minutes when you call. Also expect to get different answers to the same question. Always take down the time you called and who you talked to.

Hopefully this will be of some help to you.  

More on that Customer Service thing..

As you might guess, we visit Lexington a lot.  I've stayed in several hotels there, but our most regular stay is the Doubletree Suites on Richmond Road.   We really enjoy staying there for multiple reasons.

You get that chocolate chip cookie when you check in.  Usually when we get there we are hungry.  We don't want to spoil our dinner and the cookie is just perfect to tide you over til then.   

It's a very nice hotel.  The rooms are all suites and have large jetted tubs in them.

They have a really good breakfast buffet.  It does cost 12.95 but you if you are Hilton Honors Gold or Platinum member, you get two of these each morning for free.

There is a Sonic and Panera Bread within walking distance.  That's perfect if you feel the need for a dessert.  We've had cookies and milk shakes on the spur of the moment multiple times.  There is also a Chilis, Zaxbys, and Krispy Kreme within half a mile of the hotel.

Both the UK campus and Downtown Lexington (Rupp Arena) are within a ten minute drive

Best of all of course, is it is within a half mile of Josh's apartment!

One thing you do have to beware of is the atrium.  It's very nice but sometimes booked for events that can last well into the night.  If you have a room where the bedroom faces it, it can be bothersome.  If you go to bed early, you should request a exterior facing room.

I was there a couple of weeks ago visiting Josh for the weekend so we could see a Reds Cardinals game at the Great American Ballpark.  As you know, I am big on customer service.  Is it the one thing to me that can make a business stand out in the fierce competition for dollars today.  I had some really great customer service while I was there.  If you read my last post, you'll know that I got a new pillow that I just love.  I brought it with me. As I was checking out Sunday morning, I let the housekeeper know I was leaving the hotel in case she wanted to go ahead and start on my room.  I checked out and got in my car to go get Josh to get to North Lexington for Bible Study and Worship.  As I got ready to leave, I was surprised by the housekeeping lady next to my car window holding up my pillow.  She had come all the way to the back parking lot to chase me down with it!  I was so overjoyed that I had to give her a hug of gratitude and many thanks.  The next day I had my usual message I get from the hotel manager asking if I enjoyed my stay.  I told him about this and requested that he give the young lady accolades for her great customer service.  He assured me he would and seemed genuinely happy to know about this.

If you do go to Lexington, I'd encourage you to consider staying at the DoubleTree Suites on Richmond Road.

Fit for a King

One of the things I've wanted for years and years is a king size bed.  I am a big guy and I flop a lot.  Whenever we go on a trip, we always get a king.  I even get a king sized bed when I am travelling on my own.  We've had our queen size mattress for so long I cannot remember when we got it.  The capper was one day when Donna went to lay down and jumped up like something bit her.  We searched around and finally found one of the springs had poked itself through.  That let us know it was time to go mattress shopping.

I started reading online and it was much more complex than I ever would have dreams.  You have pillow-top, plush, and regular.  You have spring, gel and foam.  There are all sorts of different brands and it's almost impossible to compare mattresses (even across the same brand).  After a lot of reading, I went to a few stores and started trying to compare.  I finally gave up in frustration (this was last year).  We put a piece of electrical tape over the hole where the spring poked through.

We decided to revisit buying a king sized bed this year.  Mattresses generally go on sale around Memorial Day.  Donna got involved in the research this time as well.  She felt like she wanted a firm mattress (given her back issues).  I thought a firm would do for me as well.  We didn't want any of the gel or foam type mattresses since Donna gets hot in her sleep.  So, with that in mind, we began again.  Armed with a newspaper ad, Donna headed for a large local mattress shop.  The sales lady immediately steered away from trying to look at any of the sale mattresses she was interested in.   She kept pushing her toward more expensive models.  Donna finally just left in frustration.

We finally steeled ourselves to spend the Friday before Memorial Day going mattress shopping. I expected a long tiring day of that.  My only solace was were going to eat lunch out.  We started with Sleep Outfitters by the IHOP.  They had a big ad in the paper and looked somewhat promising.  When we got there, we went towards the back.  What I'd found out in my research was mattress stores were like a lot of shops, they put the more expensive showy stuff in the front.  As we headed toward the back and began checking things out, the salesman (Matt) came up.  We told him exactly what we wanted.  He asked us what our budget was and we told him.  We also told him we were interested in a firm mattress with a plush top (which almost seems like an oxymoron).  He took us to a mattress to try out.  It felt great.  Donna said she knew I liked it because she could tell from my posture that I was about to go to sleep.

The mattress was a model that was being discontinued.  Turns out that mattresses change models almost like cars.  We had to purchase a new frame plus box springs.  I found out there is no such thing as a king box spring. You get two extra long twins instead.  I really liked the pillow as well.  I am really picky about my pillow.  When I find one I like, I even bring it on trips.   Even with the delivery charge, we met our budget.  The set wouldn't be delivered til next Friday.  That was fine since we were going to have to shuffle our current beds around first.  Jonathan and I spent Saturday morning moving Josh's old twin bed to Jonathan's room and our old queen bed to Josh's room.

On Friday, the delivery guys arrived.  They hauled everything in and set everything up in less than 10 minutes. It was absolutely amazing.  It would have taken me hours to do that.  Then, Donna reminded me that she had a quilt put away that her and her great-grandmother had quilted together when she a teenager.   I'd never seen it spread out and it looked absolutely perfect (as you can see above). 

The bed feels absolutely wonderful to sleep on.  I honestly feel I am sleeping better (and so is Donna) on it.  If you are looking for a new mattress, I would strongly recommend you check out what they have at the Sleep Outfitter store.

Mr. Yancy goes to Marion (Kentucky)

I got a call last week saying I needed to go to Marion KY to sign closing documents to sell one of the rental properties dad owned.  Marion is quite a drive from where I live (over 60 miles away).  I had to sign the documents as executor, so I had no choice.  So, I left work Wednesday about 11:00am and started my journey.

I first had to get the keys to the home from our realtor's office (even though I had to go, she did not).  Then, I had to make a decision on which way to go.  I could go through Paducah or up the Interstate.  I chose unwisely and went with the Interstate.  I had forgotten that I-24 was one lane all the way to the exit I wanted to get off on.  It ended up taking about 20 minutes to go seven miles.  The trip after that was fine.   I ended up taking Highway 60 and going through Livingston County to get to Marion (in Crittenden County).

It had been years since I'd been to Crittenden County.    I remember going twice in 2001 to watch Ballard Memorial win a regular season and playoff game at Crittenden County.  I remember they had practically no bleacher space for visitors so you either sat on the ground or stood around the field the whole game.  I remember driving there to watch Jonathan's 8th grade team win in 2002.  However, I never drove past the high school so I didn't know what we in the actual city limits.   My destination was Farmers Bank so I would get to see what was actually in the city.

I found the bank with no problem (it's right next to the courthouse).  Marion reminded me of other small towns in Kentucky that I've visited (and always enjoy seeing).  I went in and met with the young lady handling the loan for the people buying the house.   She was very nice and we got through the paperwork very easily (less then 10 minutes).  She introduced me to her boss and we had a very nice conversation.  We laughed about the seeming reluctance of the Realtors to come to their city.   I finally asked them where I should go for lunch.  They mentioned a new Italian restaurant and a Mexican restaurant.  I'm not big on Italian and I had a dentist appointment afterwards and I didn't think Mexican would be a good plan before that.  They also mentioned a McDonalds.  I was surprised to find a McDonalds (and a Subway, Dairy Queen, and Pizza Hut) in Marion given it's population (a little over 3,000).  But I wanted to go somewhere different.  I had looked at TripAdvisor and the top rated place in town was the Marion Cafe.  So I decided to try that.

It was the next block over, so getting there wasn't a problem.  As I entered, I saw what I expected.  It was a basic home town cafe.  They did have wi-fi though.  I seated myself and a young man came to my table to get my drink order.  He asked about my new phone I was looking at (my new Blackberry Z10 from USEC) so we discussed that and the future of USEC (I have no idea).  I looked at the menu and ended up ordering an open-faced roast beef.  It was excellent.  It wasn't just shaved roast beef, it was real pieces from a roast.  The mashed potatoes and bread were good as well.   I had a little room for dessert so I looked at the dessert list.  There was a cake called HoHo so I had to ask about that.  The lady who asked for my dessert order told me they made a chocolate layer cake with cream filling between each layer and chilled it overnight.  They then poured hot fudge on top so that it solidified.  So, it was kind of like a HoHo (or it's Little Debbie counterpart I love - the Swiss Cake Roll).  I had to try that.  It did not disappoint, it was fabulous.  As I prepared to pay for my order at the table, I asked the young man for a little more tea, he offered to fix one that I could take with me.   I thoroughly enjoyed it.

I decided to take 641 back to the Interstate this time.  It went through Fredonia which is famous for the two things.  One is this store.   The other is the Western Kentucky Correctional Complex.   I actually have a memory from there and it's not as an inmate.  Years ago (in the 80's), I played for the WKYX/WKYQ softball "Some-Stars".  The very first games I ever played for them were there.  I remember a bunch of us riding over in the station van.  It was hot and we played a doubleheader against their B and A teams getting whipped each time.   I caught both games and I remember my legs were sore for days afterwards. 

The rest of the trip (through Eddyville to I-24 and finally to my dentist) was uneventful

Dealing with Aging Parents - Medicare - Part 1

Medicare is something that anyone 65 and over has to deal with. I can tell you it’s very confusing. I consider myself a relatively intelligent person and it’s confusing to me. I know my parents had a difficult time understanding it. Therefore, I do think that if you have older parents on Medicare, you can be very helpful in this situation. I will only speak to issues I directly dealt with. Volumes are written about how to do this but hopefully this will help you

First, I want to clear up a couple of fallacies about Medicare.

• Medicare is free – It most certainly is not. For your entire earning life, you pay for it. 1.45% of your earned taxable income goes to pay for it. Your employer kicks in 1.45% as well. If you are self-employed, you pay 2.9% (both parts). There is no cap (unlike Social Security taxes) so no matter how much you earn, you pay Medicare tax on it. Once you are using Medicare, you pay a monthly amount (that comes out of your Social Security normally) for Part B (I’ll discuss that in a minute). For 2013, it’s 104.90 a month for most people.
  
  
• Medicare pays for everything – No, it doesn’t. For a hospital stay up to 60 days, you pay a deductible of 1184.00 and for anything after that, you pay about 300 a day up to 90 days and then it gets into “lifetime use days” which I don’t even really understand. Your Doctor visits, lab tests, durable medical equipment (oxygen tanks and generator for example), you pay 20%. There is no stop-loss as is common with regular insurance policies so no matter how many of these type expenses you end up paying, you never hit a maximum. Finally, for prescriptions, you have a 300 deductible. Then, you pay 30% of “approved drugs” until you hit the “doughnut hole” (2970) when you pay 100% until you hit 4750.00.
  

Confused yet? 

Let’s talk about the parts of Medicare. Part A is hospital and strictly hospital. It’s not doctors, even ones that come and see you at the hospital. That’s Part B – Doctors, lab work, durable medical equipment. Part D is prescription coverage. Seniors generally apply for Part A and B when they turn 65. Part D you handle getting on your own. What’s Part C? Medicare Advantage (which I know nothing about).

I think that’s enough for one day. I’ll continue with some of our experiences and some recommendations in my next post.

Dealing with Aging Parents Finances - Part 1

Let me say up front this is strictly based on my experience in having both of my parents pass away in the past year. Yours may vary. Also, I am not a financial or legal expert. I am just trying to give some direction to others in this situation. I know having this information up front would have been helpful to me.

You may possibly run into the situation where your parents don’t want to even discuss this. It may be from embarrassment, the fact they don’t want to admit their mortality, or they simply can’t accept their children helping them (in a role reversal). Be patient with them. You may want to broach the subject by telling them about others you know who didn’t do this and how difficult it is to deal with in additional to the emotion of losing a parent (most people know somebody who has gone through this).

First, do you parents have a will? If not, they really need to get one. It isn’t as big a deal if both parents are living (assuming they own everything jointly or they are in a state that recognizes community property). If however, only one of your parents is alive not having a will can cause the assets of their estate to be distributed by law which may not match what their real intent was. The probate court will want the original copy of the will (I’ll discuss probate in another blog post). It also a good idea to read the will so that you’ll know who the executor is and have an idea of their directives. You can either have a lawyer do this or download from one of the several legal form type web sites. This can be complex so I would recommend a lawyer if you can afford one.

Secondly, each parent should have a Living Will. This will dictate what measures should (and should not) be taken in medical situations. This is especially important in situations where a parent may be close to death and not able to speak for themselves. The person assigned the responsibility for carrying this out in the Living Will should be someone who can think clearly in these situations and not allow emotions to change the actions stated in the Living Will. This document is a bit less complex that a will, so can probably handle getting a copy yourselves and having each of your parents complete one. In Kentucky, the signatures must be notarized. When a parent checks into the hospital, they will probably ask for a copy of this.

Probably the most difficult document to agree to is a Power of Attorney. This document gives the person designated as POA the ability to act for that person in financial matters. This includes signing deeds, real estate papers,etc. You can even sign checks for that person if need be. You need to have a level a trust with your parents to do this. You should request a durable power of attorney. This means the POA is in effect even should the parent become incapable of making decisions. This document can be done either by a lawyer or downloaded from a legal web site and completed. It requires notarization.

Finally, it is a good idea to know where you parents have their checking and savings accounts, any investments (401k, mutual funds), which life insurance they have and any property they own. You’ll need to know every bit of this to carry out an estate when they pass away. It also helps if one parent dies and you have to help the other parent in carrying out financial matters. You should send every one of these entities a copy of the POA. It can often take weeks from them to process this document. I didn’t realize this and it delayed things when trying to help my dad access some of my mom’s retirement accounts when she passed away.

Next time I’ll discuss the beast that is Medicare.

Where have you been?

I apologize to anyone who has been looking for my posts. I’ve had a busy few months with my dad passing away and dealing with the settling of two estates. My wife also had major back surgery and is recovering (very well I must say) from that.

What I said to myself is that I would do is post a series of blog articles on some of things I dealt with concerning my parents before and after they passed away. I know that these type things would have been helpful to me and I hope they can be helpful to people my age. Look for these to start soon and I welcome any comments you have. I will say that of course “your mileage may vary” especially if you don’t live in Kentucky. I am certainly not a trained financial or legal professional.