...but it beats the alternative!
Today, however, I had an experience that makes me want to qualify that saying by adding the word "usually."
Carol's aunt (her mother's twin sister) is almost 83. She has days when she's pretty lucid, and then she has other days when things are very confused. Her name is Doris.
Doris still lives with her husband, who is in better physical and mental condition than she is. He is not, however, without a few peculiarities of his own. One of those is that when he gets their mail in and sorts it, anything of no interest to him (or that he doesn't really understand) is tossed.
They live in a small apartment about an 80-minute drive from Victoria. Fortunately they have a housekeeper (Ninfa) who comes in on weekdays and helps with household cleaning, chores and so on. To the extent she can, Ninfa also helps them with decisions on some matters.
Today she was trying to submit a refill request on one of Doris' prescriptions, and was informed that the insurance coverage had terminated. Doris has retiree medical coverage for prescription drugs and a Medicare supplement, all provided by her former employer of many, many years -- Sears.
Ninfa, unsure of how to proceed, called Doris' sister, Carol's mom. Carol called me.
Why me? Well, I'm a Human Resources manager, familiar with benefits and health insurance coverages and all that, and maybe I could find out what happened to her insurance?
Armed with Doris' social security number, birth date, address and phone number, I began calling at about 11:15 this morning. This quest occupied me the entire rest of the work day!
What did I learn? Well, back in September Sears announced some major upcoming changes in their retiree insurance programs. In October, enrollment kits were sent to all retirees. The enrollment period was November 1 through December 16, 2005.
Did Doris and husband get the notice and enrollment kit? Probably. Did husband not understand them and toss them? Probably. The kit explained that if no election was made coverage would lapse on December 31!
Thank goodness they tried to refill a prescription this week and not two months from now! Why? Because I was able to speak to a very nice, very empathetic lady from Sears (Kimberly) who understood the problems sometimes associated with aging and assured me that it was not too late for Doris to re-establish coverage effective January 1.
Kimberly put me in touch with Vicki, a rep from the new insurance administrators, who was willing to explain to me the various options available to Doris under the new plans, but for privacy and security reasons could not send any information to my address or discuss anything about Doris' previous levels of coverage.
All I wanted to do was get her enrolled in a plan similar to what she had been used to. But it's not that easy.
Bottom line? A new enrollment package with all the options explained and priced is being sent overnight to Doris' home. I have notified husband to please accept it and keep it until the housekeeper can get there, pick it up, and send it to me. Once I get it I'll try to determine what Doris had, and enroll her in something comparable.
One concern I have is: I don't know her financial situation. Is cost (the premiums) a major concern, or is level of coverage more important? Does she spend a lot (over $2250 per year) on prescriptions? If so, she'd be better off with the "high" level coverage with a higher premium, if not, the cheaper coverage will save her money. Who knows? Neither Doris nor husband. Certainly not I.
Today Doris was pretty confused. I'm not sure she knew who I was, and she sure couldn't answer any questions about details of her former insurance. Husband knew me, and knew I was trying to help, but he is clueless about details like that. Why? Well, because he has his own retiree health coverage from a different former employer. He has never concerned himself with her insurance.
The deterioration of the body as we age somehow seems much less cruel than to see someone's mind just wander away over a period of a year or so. I can only hope that if I get to an age where that begins to affect me, perhaps the alternative to getting older will be the better option. I don't know, and it sounds blasphemous to write that, but...
6 comments:
Working with senior citizens all week, I see a lot of this kind of stuff, and it is so sad. I don't know if every state has programs such as ours, but for every elderly person who can manage their affairs, there are three or four who cannot.
My husbands grandmother is becoming more and more like that. And its getting harder to do things because she wants them ran by her but then she doesnt understand them.
We are at the stage of choosing medicare drug coverage plans and it is like shooting craps in Vegas. Why is it so hard to understand??!!
I notice that, in the course of reading your posts, you're quite often doing for others, be it standing in line for a gift or something to the effect of this post.
You're a good, good person. Not that I'm surprised.
I have thought your same thoughts about the deterioration of the mind. Growing old is scary. Good luck to us.
I think they should outlaw junk mail! Then we know everything they put in the box is important. Someday we'll probably have benefits counsellors just like we have tax accountants. It's hard enough to figure out which cell phone/company/plan and I'm not anywhere near dementia...I think...
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