I'm lost. In the last 3 months my father has suffered a heart attack and most recently a mild stroke. I have to take care of what insurances he has, his doctor and specialists and follow up care. After talking to him since the stroke I can tell there is a slight declination mentally and he is confused about what he is supposed to be doing and how to handle it.
I don't know where to start and with what!! Who do I talk to? We can't afford an attorney. He has medicare, V.A. and B.C.B.S of Arizona. I don't know which one does what and/or covers what.
Do I have to have power of attorney to be able to talk to his doctors?
Do I talk to him alone or have somebody else present? It is critical that he keeps his dignity and that anything that has to be done won't be stripping it away. He is already scared and upset about the heart attack and stroke and the changes he's had to make so far.
How do I find out what is considered his primary insurance and do they have to have referalls for specialists?
All I know is that I have to do things my dad can't and I am so confused.

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Dear schultz109,
Secret Sister has some good advice. You need to check with the VA, as your dad may have some help through them. Some people have Medicare first and then "MediGap" through private insurance, so there are two agencies to work with. Likely, as SS says, it can be the other way around.

It's not horribly expensive to get a Power of Attorney and a Health Directive (POA for health care) that would let you help your dad more easily. It sounds as though he can give consent, though if he can't sign you'll need a notary as a witness.

Your sensitivity to his dignity and the loss he feels is wonderful. With your insight and caring heart, you'll do fine. Do try working with his doctor. See if your county Social Security office can give you direction in finding a reasonable attorney for these forms. It's going to be cheaper now than if you wait until things get more complicated.

The paperwork is mindboggling. Keep coming back as you are talking with people who have been there.
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Dear schultz109, if you feel lost, you came to the right place. There is always hope, and many answers available, if we keep asking, with persistence and perseverance. I understand feeling confused, facing a whole array of unexpected health issues and accompanying situations. You'll gain confidence as some of your questions find answers.

I think the simplest thing I did was accompany my parents to a routine doctor's appointment, and fill out a consent form "To assist with care," with both their signatures. Is your Dad able to understand and sign this simple consent? It gives the medical staff permission to talk with you concerning your father's private health information.

I believe the next step would be POA, which is done by an attorney, and costs vary. More knowledgeable people on this site can better direct you further. Welcome to this helpful place. You're not alone, and I hope you are comforted and find all your questions answered from among the wonderful people here.

I can relate to feeling confused, especially when plunged unexpectedly into a new position of responsibility; and unknown territory regarding both health and financial concerns. I think you'll find the help you seek, and many alternatives to choose from. Usually things work out better than we fear, with many people willing and able to assist you along the way.

My parents have both BCBS (as their primary insurance coverage) and Medicare (due to age). I think the BCBS covers things primarily, and Medicare fills in the gaps. Your Dad's billing department can answer general questions for you, and specifics once your father has signed for a Release of Information, providing he is able to sign his name. Does he still have that ability? I commend your for being sensitive to his dignity, which shows compassion, and will go a long way. Have you talked with your Dad about this? I would ask his wishes, first, following his desires, and go from there.

My parents were comfortable enough to have me accompany them right into the examination room during their Doctor visits, and I was able to ask their Physician any questions I had at that time. Their verbal consent allowed for this, and written consent gave me permission to all records, etc. With his permission, you become his Advocate, and have rights to ask all the questions you need regarding referrals, etc.

Hope that helps a little. Thanks for sharing your story and let us know how things are going for you and your Dad. Please take good care of yourself.
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If you live in Tucson, contact the Pima Council on Aging and they will send you in the right direction to begin sorting out the mess. If you live in Phoenix or northern Arizona, they undoubtedly have something similar. I believe the Jewish Community Center also offers some assistance on where and how to find help.
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Also, when you have Medicare and BCBS, Medicare always prevails and BC won't pay anything until Medicare declines to pay it.
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I have been the caregiver for my mother-in-law and my father before their deaths, and now am caregiver for my mother. I would get a Power of Attorney asap. When you make calls on your father's behalf, the first thing they will ask is "are you the Power of Attorney"? Ask your father if you can see where he stores his medical files, receipts, policies, etc., so that you can better understand what he has and how you can assist him. Also, he should have ID cards in his billfold with phone numbers that you can call for clarification and information on his policies, etc. If he doesn't have a will, now's the time to get one. You can always tell him that a will is the last love letter that he will give his family...and of course, a Living Trust is very important. I believe you can go to legal websites for these documents at a reasonable price.
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Dear Schultz109,
While most of the other advisers have provided you with excellent advice, I would like to point out to them that you need Emergency Responders right now--not the should have, could have. would have kind of advice they are offering. Remember that sometimes Love is as cold and hard as steel. This is one of those times. Here is what I would be doing right now in order:
1. Get POA and include a Living Will if your father is willing and able to answer the questions and sign the forms. POA is not an expensive deal but is essential.
2. Put your father's dignity on the back burner for now. He is already somewhat confused so why confuse him more with all kinds of choices he may not be able to deal with. If he becomes incapacitated before you obtain POA you will need an expensive lawyer to do just about anything connected with his treatment and the handling of his financial affairs--including writing checks from his account. Even simple matters like paying his bills will become a major hassle.

3. Most hospitals and VA Centers have Social Workers that specialize in helping families deal with these problems. Seek one out and if you find one trustworthy and highly recommended, reach out and let him/her guide you until you are comfortable making your own decisions.
4. Enlist the help of good neighbors and friends of your father. But ask them for specific things like looking in on your father's house while he is away or finding someone who can stay with your father when he is released from the rehab.
5. If there are any relatives around who you/ your father trust,get them to help guide your father in making the good choices YOU put in front of him. But do not get relatives involved in financial matters or The Will.
Finally, if all this sounds a bit harsh, remember that you are now in a state of role reversal. You are likely to be the adult in upcoming situations and your father will be more like a child. Love him and respect him as you would your child but do not expect him to lead you along the right path. If he could do so, he would not need your assistance with any of this--would he?
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Dear schultz
I am in the same situation you are. My dad had had three strokes and the last one left him with a verbal speaking and comprehension issue. I know exactly how you feel with being overwhelmed and feeling under educated. The comments prior to mine have some good advice. I agree in getting a POA. That was a blessing in dealing with a recent situation my mom had and I could not have taken care of her business without it. The other thing that gave me a huge piece of mind is getting an attorney. Search out for a ELDER focused attorney. I went to a free seminar about medicare and medicaid and found this attorney who was giving it and i got a free consultation and that was the start. I walked out of that meeting feeling like everything was going to be alright. I would get your name on his accounts or get on line banking where you can pay bills for him and manage his finances. Also the attorney can help with the documents for a health care sarogate, living will, and a will. I totally agree with previous comments about attending dr appointments. I go with both of my parents to any dr appointment they have. As a caregiver you have to understand what is going on medically especailly if you are administering meds. Also as with my dad, when he talks, he gets some stuff messed up when talking so I can clarify to the drs what is going on etc... The last piece of advise I give you is go to the internet and read up on medicare/medicaid and other govt programs available. If he is a VA he may have all kinds of support. You should also have a local agency for the aged. Get with them. The will point you in the right direction. And last but not least, keep in mind this will be a journey. You are in the process of learning a great deal of information so as I say eat the sandwich in small bites, dont try and shove the whole thing in your mouth at once. Come up with a check list and take it one thing at a time - one day at a time. Be kind to yourself you are going to need it. Keep me posted on how it is going and reach out for help. Ask lots and lots of questions to anyone you get your hands on that is in the elder business.
I promise you will be ok and get through this !
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