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Health insurance for elderly parents

If you are anxious about health care for your aging parents, you can reduce your stress by educating yourself about your parents' health and insurance needs. The key is knowing exactly what information you need and where to look for it.

Collect essential health data

Third-party notice

Do your parents sometimes neglect to open their mail or pay bills on time? Find out whether your parents' medical or long-term care policies feature a "third-party notice" option. This allows them to name you (or another relative, friend or professional such as an attorney or accountant) as the person the insurer would contact if your parents' coverage is about to end because the premium has not been paid.

Encourage your parents to select a third party to receive notice if their policies are about to lapse due to nonpayment of premiums. Sometimes people with cognitive impairments such as Alzheimer's forget to pay their insurance bills and lose their coverage when they most need it.

While your parents are still healthy, become active in their health care. Know where to find their complete medical histories and document their prescriptions and over-the-counter medications. Include the dosage amounts and frequency. This information is crucial in a health emergency, but is also essential to correctly complete medical claim forms.

At the very least, ask your parents for the names, addresses and phone numbers for all of their health care providers. Organize this information in one easily accessible place. If your parent is mentally or physically incapable of giving you this information, you can obtain most of it from insurance or Medicare bills.

Identify health insurance coverage

In addition to knowing who is medically treating your parents, you need to know what companies insure them and where the health insurance documentation is kept. Are they covered only by Medicare? Do they have retiree health benefits from a former employer? Do they have private health insurance to supplement Medicare? Ask your parents where they keep important papers, including health insurance cards and bills. If they're unable to assist you, contact their doctors for insurance information.

Understanding Medicare benefits is essential to ensuring your parents are getting proper services and payments. For more information about the services that are available to enrollees of Medicare, visit www.Medicare.gov.

Aging resources
AARP's official Web site
The Administration on Aging
ABLEDATA — the federal database of assistive devices and rehabilitation equipment
National Alliance for Caregiving

Read your parents' health insurance and/or Medicare handbooks. If your parents don't have the information, try to obtain copies. The latest Medicare handbooks are available online.

If your parents can't help you, call the insurers' customer-service departments, explain your situation and ask them to send you replacements. Save this telephone number. You may need it later to obtain more information or help with your parents' medical claim forms.

If your parents have long-term care (LTC) coverage, make sure you know exactly what types of services and facilities the policies cover. This information is especially important should they be incapable of making a decision about a long-term care facility and the choice falls to you.

Consider durable power of attorney

Because of privacy and financial-abuse concerns, insurers often will not give you information about your parents' policies unless they have your parents' permission. If your parents are unable to consent, you'll need to present the insurers with a legal document naming you as your parents' agent, "attorney-in-fact" or legal guardian.

A durable power of attorney is a document that allows your parents to give you (or another trusted relative, friend or professional) the authority to make financial and legal decisions and transactions on their behalf. A durable power of attorney differs from a "general" power of attorney because it remains effective even if your parents become mentally incompetent. In many states, a durable power of attorney for health care will allow a designated person to make medical treatment decisions.

The time to talk with your parents about giving you durable power of attorney is before a sudden illness or injury would necessitate lengthy and expensive court proceedings to name you as their legal guardian.

You also can ask them to give you durable power of attorney for health care, also known as a "health care proxy." This proxy becomes effective only when they're not competent to make their own health care decisions. A health care proxy's powers include:

  • The right to refuse or consent to medical treatment.
  • The right to access medical records.
  • The right to withdraw life-sustaining treatment.

Before your parents have reached the age where they might be in a situation where they cannot provide consent for medical procedures or life-sustaining treatment, they can assign a health care agent to make decisions for them. This can be any person they elect who is over the age of 18. When it comes to health care decisions, health care providers often look to family members for guidance. However, in New York State for instance, only a health care agent appointed by your parents has legal authority to make treatment decisions if they are unable to make them for themselves. A health care agent allows your parents to control their medical treatment by:

  • Allowing their health care agent to make health care decisions on their behalf.
  • Choosing one person to make health care decisions because they think that person would make the best decisions for them and has their best interests in mind.
  • Choosing one person in order to avoid conflict or confusion among the family or significant others on what to do about their care.

Health care agents are bound by the instructions your parents write in their health care proxy that discusses what their wishes are, as well as their moral and religious beliefs.

Understand Medicare vs. Medicaid

Medicare is the national health insurance program for Americans age 65 and older, paid for by the federal government. Medicaid is an assistance program for certain individuals and families with low incomes. It is paid for by federal, state and local tax funds. Medicaid is the largst source of funding for health-related services for America's poorest people.

While Medicare doesn't pay for long-term care, Medicaid pays the nursing home bills for older people who have depleted their financial resources. (Neither pays for in-home care.) Because each state administers its own Medicaid program, eligibility requirements vary. Medicaid also has strict "spend down" rules that govern how and when a senior's assets can be disposed of before eligibility begins.

It makes sense to educate yourself about health insurance for seniors. When your parents turn to you for help, you'll be ready.

Checklist for helping your parents with health insurance

  • Collect, or know where to find, your parents' medical histories.
  • Document their prescriptions and over-the-counter medicines.
  • Obtain the names, addresses and phone numbers of their health care providers.
  • Know where they keep their health insurance documentation.
  • Ask your parents if you may read and refer to their health insurance and/or long-term care benefits handbooks.
  • Talk to your parents about granting you durable power of attorney.
  • Understand the difference between Medicare and Medicaid.

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