Hospital threatening collections.

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Hi - My dad will be 90 in January. This past year he was in the hospital 4 times. Hee had 3 ambulance trips, and a bunch of doctor's visits.

Of course, we have been inundated with bills. He has no income besides SS. He doesn't own any property, and his only assets are about $3000 in the bank, and a car with 165,000 miles on it that currently cannot pass a safety inspection. He also has a $5000 VA death benefit policy.

I should also point out that he cannot cook for himself, drive himself, or be alone anymore. Anytime I am not able to be there, he has to hire paid help. The costs for restaurants / caregivers/ companions/ transportation have left us shellshocked. He is spending $1000 plus most weeks, including his many medications, and has depleted his savings.

At the advice of friends he has been paying each of his creditors at least $10 a month. Many of the smaller bills have been paid off. Most of the larger creditors have been fine with it, too. They understand he is on a fixed income and know he has been very ill.

Two of them though, have been a big problem. The first is an ambulance company that took my father 3 miles from his doctor to the hospital. From what I can tell they were paid about $550 by insurance and billed my dad an additional $167. They demanded immediate payment in full, when I asked them to send me a breakdown of the costs, and why it was so much?, they immediately sent to collections.

The second is a hospital. They have sent as many as seven separate bills in a month. My dad has paid $10 on each one, two have been paid off. The remainder total about $850, I'm guessing, because when I called them they would not verify that there will be no additional bills pending...

So, I told them about my dad's finances, and that he could continue to pay $10/month on each of the outstanding bills, and that would be $40 a month total.
Nope. They threatened collections. They don't seem to understand that he owes money to numerous other doctors and services too. They just want all theirs NOW.

My dad needs a hospital bed, and other things for six months now. His doctor has tried to get insurance to approve them, they keep saying they "aren't medically necessary." The cost for everything would be at least $8000. My dad is very uncomfortable and hardly can get any sleep because of COPD and pain, but he is willing to without the bed and other things because he is trying to pay all of his creditors. He has even asked me to sell his car, or offer it to the hospital to settle his bills there.

I don't know what to do. I am already supporting him as much as I can, or he would have NO money for these bills. My friend tells me that if the hospital sends him to collections he should refuse any further payment and work on the bills that aren't in collections, so his credit doesn't get dinged any worse? I have no idea what to do any longer.

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Erwin, how does your Dad feel about Chinese food, or has he ever tried it? In my area we have a wonderful inexpensive carry-out with variety of food, and the food is very good. To cut down on the salt, ask for very little sauce.

My parents [in their 90's] never had Chinese food until I bought some home for them to try. At first my Mom was very leery of it, but once she tried it she was surprised. My Dad finished his whole plate :)
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One thought...see if you can pay the neighbor lady to do some casseroles frozen as individual servings. If she can do a week or two at a time, might be a good thing.
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Thank you - everyone!

I have made some progress with dad the past few days. He agreed to accept a recliner instead of a medical bed, and it has eased some of his complaints the last two nights.

I was also given a number for the transportation service. I spoke to someone there who said they don't know if they serve this area, but they are going to get back to me next week. I hope they do - it is $1.00 each way to WalMart! I can't do better driving him myself.

I had NO IDEA the VA covered any part of transportation costs - and I had asked! So thank you on that!!! You BET I WILL ask them again. If they paid even half of what it costs my dad to get there it would be a HUGE relief.

Regarding the food, he is adamant he will not eat food that he doesn't like. He will eat the casseroles that one of my friend's mom makes, oddly enough, because it reminds him of my mom's cooking. Go figure...

Insofar as the rest of it goes, he is pretty stubborn, mainly because he feels he been treated unfairly. He tells me that he had worked at five "good jobs" in his life. From these, he had earned two pensions and one 401K. The 401K, and my parent's retirement savings were wiped out when my mom had a heart attack.

The two pensions were raided by management under guise of a court order supposedly to ensure the companies stayed open - they both closed. He is extremely bitter about what he considers outright theft.

When I spoke to him about his bills, he pointed out that he has paid several of them off already, and despite his age and illness has been paying everyone. In his opinion, if they want their money faster - too bad. He also tells me that his car, and his death benefit should handle any unpaid bills upon his death.

He told me more, but I'll post that later. I'm getting tired.
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Apply for dad to be on Medicaid. In fact, I am surprised he's not on it.
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Erwin, it's time for some tough love and firm stances. You volunteer to give up your time and risk declining health when you help him. He in turn should recognize and appreciate your sacrifice and be more willing to cooperate. He doesn't get to have things his own way all the time.

And, believe me as well as anyone else who offers the same advice, make a stand now before his refusals become even more adamant. You just don't have to give in to all his demands - it only gets worse.

Raise that issue with him; you're both in this situation together; there has to be some give and take on his part in order to ensure that you're able to care for him emotionally and physically. Don't be afraid to be firm and to refuse to go along with some of his self centered mandates.

So, that means that he stops digging his heels in and refusing to cooperate.

If the meat is too tough to chew, he might have a swallowing problem. Start cutting his meat in little pieces, avoid ham (which is harder for someone with a swallowing problem to chew). Add gravies to ground meat.

Keep a log to see what causes him to choke or cough, if that's happening.

Did you investigate paratransit as I suggested? The transportation costs you're paying are exorbitant.

Cut the Walmart visits to once a month or so. He can get reimbursement from the VA for mileage. After each visit, he should fill out the mileage reimbursement request (in our VA it's on a stand, like a banking stand for completing deposit or withdrawal forms) and generally in the office rather than the medical areas.
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Thanks for your answer!
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When someone needs higher-level of care than family can provide, or the caregiver/family cannot handle the physical, mental, financial strains, it's prudent to place the elder in a facility.
When the elder unreasonably insists on staying home...especially if that is also ruining the care-family's financial stability too....then that elder is likely not being responsible nor prudent, but more likely, has some level of dementia. Some can be downright abusive.
Dementia can make someone seem unreasonable...at that point, whoever is the POA must be decisive and directive, whether the elder likes it or not [you are now the parent figure]...and place the elder in a facility, to save your own hides and healths.
Welfare administers one or more programs that can help, like:
==There's a Federal program which pays the Medicare Monthly premium that's normally deducted from the Social Security check;
At State level, there are food stamps; Medicaid [in CA, MediCal].
Programs might vary per State.
Usually, Medicare and Medicaid can be combined to cover facility care, as long as the patient has spent-down their assets to the State mandated limits.
States will "look-back" at where the person's assets got spent, for a 5-year period prior to applying for assistance.
Elders might loudly/emotionally dislike the idea of existing the rest of their days in a facility. OTH, families have a responsibility to themselves, too.
States do _not_ want a care-family to become yet more welfare recipients due to caring for their elder!
Sometimes, you must bring that situation to Welfare's attention....that if you continue to spend your resources, you will become welfare recipients, too; but if able to set up accounts properly, you have a better shot at not needing to be welfare recipients yourself. Sometimes that gets lost in the process, and they need reminded.
Ask the Social Worker directly, what asset limits are for your State, that your elder must spend-down to, in order to get help.
Your local Area Agency on Aging [some areas, those have other names], can often help with finding the care help and supports you need.
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Thanks all!

I am trying to talk to him about applying for medicaid again, but so far he refuses. He did agree to get a recliner instead of a medical bed. We also had a talk about why he won't eat the meals from the senior center - meat is too tough to chew, pasta is undercooked, and food is "way too salty."

He also says my cooking should be "used to poison dogs, or torture terrorists." At least he still has a sense of humor...

He owns no property, so a reverse mortgage won't work.

The advice on writing collections is appreciated, I'll try that while I continue to work on getting his bills down.

I also found out that his taxi rides to Walmart in town are costing $68 round trip, and to his VA clinic are $177. So basically, everytime I can't do it, or arrange someone to take him, - there goes the budget for the week.
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Forgot to say that you need to object in writing preferably certified mail.
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