Phone cords tangled in a ball with health insurance cards splayed on the ground.

My Father, Khader: Figuring Out His Health Insurance Plan

Last updated: January 2020

For the past 3 months, there has been one thing consistently on my to-do list - figure out my father’s health insurance plan. Mostly, figure out how to get him a daily home health aide covered by insurance.

Medicare is making me beg

My father, Khader, having Parkinson’s disease that is in stage 4, can no longer be by himself while my mother is at work. His being alone has resulted in a few falls (one which led to a busted lip and six stitches) and more than one episode of chest pain because he forgot to take his heart medication. Coupled with orders from his primary care physician and his neurologist, one would assume that it should be pretty simple to get insurance to cover someone monitoring him for a few hours a day. But no, Medicare is wonderful and evil and is quite literally making me beg for it (which I assure you, I am not above doing).

Qualifying for AARP Medicare

Because he turned 65, Khader now qualifies for AARP Medicare. He does not, however, have Medicaid - which is given to those with qualifying income (the poorer the better). If his income was about $5,000 less, getting him the care he needs would be much simpler. I know it sounds ridiculous to complain about making too much money, but unless you’re Warren Buffet, no one on retirement makes enough to afford the health care costs of a chronic illness.

Medicare has two different types of coverage: 1) Part A & B plus supplemental for drug coverage, or 2) Medicare Advantage. (At any point in this rant, if I have incorrect information, please contact me and break it down for me because all of this information is self-learned.) For the sake of what Khader needs covered, Medicare Advantage is his best bet.

So many phone calls with health insurance companies

August and some of September was lost in a haze of phone calls with well-intentioned insurance representatives and unhelpful Medicare counselors. 10,000 hours later and I realized he is not going to get a home health aide through Medicare. Now, here is where it gets confusing. I am not too sure who is the boss because every time I call United Healthcare (Khader’s insurance company contracted by Medicare) to figure out how to get what I need for him, they say it’s up to The Wellmed Group. The Wellmed Group does not take phone calls from anyone but the PCP’s office or United Healthcare, but when they call to tell The Wellmed Group “HEY THIS GUY NEEDS HELP” The Wellmed Group says “Meh, we don’t really believe you.”

This journey has been hellish

So now, the next part of this hellish journey is to find an insurance company I can work with. But I’m not going in like I did last time. This time, I know some things. Under Medicare Advantage is something called, Medicare SNP - Medicare Special Needs Plan. Basically, Medicare SNP is a type of plan for someone with a chronic illness, like Parkinson’s Disease which my friend, we definitely have. The next task on my to-do list? Find an insurance company that has a good Medicare SNP. It is going to take sitting on my butt and calling about 40 different insurance companies, but I am determined and dedicated. I don’t think I can see him fall again and bust his lip. It might take some time and he’ll have to hold tight, but I will get my father the care he needs.

Or I won’t. And none of it will change anything.

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