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Davronica Asked February 2011

How do we help our parents see that they need to pay their medical bills?

They are both eligible for medicare, and so think that they do not owe anything, that drs and hosp services are covered in full. (There is no 2ndary ins.) My husband has POA, but not the checkbook, because at the moment they are still capable of general finances.
Any ideas on how to help them see the need to make arrangements to pay these bills? When they get these bills, one of two things happen, either they deny they are bills or say they are trying to be 'scammed' into paying. Some bills have already gone to collections, and one lawsuit has already been filed, and hearings begun. Has anyone else out there dealt with this????? We live in a small community and their non-payment is getting to be quite known and embarrassing.

toadballet1 Feb 2011
I don't know how old your parents are, but most of my Mom's generation remembers the depression where institutions could not be relied upon. Now, in their elderhood, things become more pronounced because they have a lot of time on their hands. My Mom, too, is always worried about someone "taking advantage of her" but wastes money on things she makes me buy her then tosses away.
We have had a family member who was taking advantage of her generosity. Strangely, she thinks this person is just "misunderstood."
If anyone has a good suggestion on how to get parents to face reality at this time in their lives, I would love to hear it.
I am so sorry that you have to watch your parents go down this slippery slope. I can see so much trouble ahead if they continue. But there is not much you can do. Maybe when the authorties swoop in and demand payment they will take it more seriously. So frustrating.

Davronica Feb 2011
We would like to help relieve them of the "burden" of bill paying as you say. But we are concerned. They already think so much of the world is a 'conspiracy' against them, and well, if a penny comes up miscalculated (by them) they accuse either institutions or individuals of cheating or stealing from them. I worry that if we get into the money problem too deep they will start accusing us of stealing. Suffice to say, my husband and I are in a community where those accusations are not treated lightly, and most of the community, while realizing the folks need help, don't realize their distorted view of reality.

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toadballet1 Feb 2011
My mother handled all her finances for years and did a great job. A few years ago, she became flustered with all the mailings from both medicare and her ins. co., so I took over her bill paying which I do online (a Godsend!!!)
So much paper comes into my home, too. I think modern life and technology just makes too many demands on everyone, not to mention the elderly.
Is there anyway you could relieve them of the "burden" of bill paying? If not, there will be so many complications due to lawsuits, discontinued care, and perhaps problems with their credit ratings.

Davronica Feb 2011
Thanks for the fantastic info. Didn't know about possibility of forgiven debt being taxable. Will look into that more.
Also will work on getting them set up with a secondary ins., MIL has no secondary ins; FIL has a Humana Medicare replacement; unfortunately nearest Humana accepted hospital is 90 miles away (quite a distance for a reg drs appt.) So we will be looking into the other options! Thanks so much to both of you - I was at my wits end!!

igloo572 Feb 2011
Wonderful info guestshop.

There is just so much misinformation out there. It's just amazing to me that most people do NOT know that Medicare and Medicaid are 2 entirely different programs and that NO insurance is 100%. No property or medical insurance does that.

But back to the ?.
Dav - can you see if you can get your parents enrolled in a secondary insurance program that works in their area. This could be a Humana or AARP program. Some have too cute names, like Silver Sneakers, Senior's First, etc. They really vary by region and work within a set group of doctors and hospitals. This would help out with the additional costs that Medicare doesn't pay.

If you can get them on this NOW. They may pay an extra as the open enrollment period just ended in December but in the long run it will be worth it. Social services at the hospital will have info on who's program they are in. Their current doc's may be part of one, call to find out.

Usually, they too don't pay 100% of the non paid by Medicare
but it helps. They do need to use vendor within their system otherwise no payment or discount. If either are on a federal or RR retirement annuity system, then they can get on BCBS secondary insurance policy that is deducted from the monthly annuity. It is pretty good and the medical providers love seeing it as they get reinbursed under 30 days which is quick.

If your parents live in Texas or Florida then no lein can be placed on their home as it is a protected asset by state constitution from a non-secured creditor. Secured creditors are mortgage companies, IRS and other federal agencies - they are the only ones who can place a lien in those states.

If this has been going on for a while, you may want to check their state's statute of limitations on debts before you intervene to pay on any of them. Some may be beyond the time, so you can forget about those. But be sure that nothing has been paid at all as the clock begins ticking on the statute of limitation from
the date of the last payment.

For example, there is a physical therapy bill for $ 1,000.00 dated August 1, 2008 which medicare paid Oct 1, 2008. The clock starts ticking down from 10/02/2008 to whatever is the year their state has for limitations on non-secured debt. If it is 3 years, then Oct 2, 2011 is the dead date for the original creditor to file for a judgement. But usually these get sold from the original creditor to another group after 6 months, so there ends up being collection agency after collection agency on the same debt. It can be hard to figure out who is the "current" holder.

You need to sit them down and go through everything as there will be just so much correspondence. Alot of the collection agency letters are written as if it is dire consequences. You really need to see what's what.

What about phone calls - I bet they are getting them daily. This has got to be really stressful for them.

As far as the banking, you might want to have internet banking ability on the account. So that you can monitor what's going on.
As POA your husband can do this. He probalby can speak to a senior VP or their branch manager to arrange for this. What is helpful is to have the POA faxed over to the bank while the phone call is done so that they can open it up for internet access while he is on the phone with them. From then on you can see where they are spending their $.

If you think this just is going to be the pattern for them, then I would suggest that they open a bank account that ONLY gets their social security check or any other protected retirement asset. This bank account can NEVER be subject to a seizure in a judgement as it is written into federal law as protected. But only SS $$ can go into this - NO co-mingling with other $$ or it can be seized. You can be listed a cosigner on the account too. If they can keep from spending any of this $ for their daily needs that would be good as it can't be touched by creditors.

My MIL was just beyond bad on home shopping network and small clothing companies credit card debt. Why they would even let her get credit is beyond me as she has no assets.....She would & could amazingly just ignore it.

Guestshopadmin Feb 2011
First question-do they truly not understand that Medicare does not pay 100% of bills? I have had to explain to elderly relatives that Medicare like any other insurance program does not pay for "everything". Many hospitals have social workers who have experience dealing with elderly or ill patients and families to explain the bills. Check with Department of Aging and Disability Services (or your state's equivalent) to see if they have persons that can help explain to your parents. If they are church members, you might ask clergy to intervene as trusted advisers. You may also want to review the bills to see if they were billed for services not rendered. With all the stories about Medicare fraud, your parents may think they are being billed (or may be in fact) for services not rendered. Explain to your parents that a judgment against them for bills not paid could cause your parents to lose their home if a lien is filed or restrict the medical staff who will be willing to treat them in future. It's not only embarassing; it could be life-threatening if no doctors or hospitals are willing to treat them if they are viewed as deadbeats. In today's economy, creditors are not willing to just write off expenses. And if they do, the forgiven debt can be declared as income to your parents and be subject to taxes. Ouch if your parents ignore that and the IRS. Stay involved and be persistent.

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