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<p class="MsoNormal">Gotham,<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<ol style="margin-top:0in" start="1" type="1">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l1 level1 lfo1">THANK YOU – the responses & advice I received was helpful & heartwarming.<o:p></o:p></li></ol>
<p class="MsoNormal"><o:p> </o:p></p>
<ol style="margin-top:0in" start="2" type="1">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l1 level1 lfo1">Here’s what I have learned in the past 24 hours.<o:p></o:p></li></ol>
<p class="MsoListParagraph"><o:p> </o:p></p>
<ol style="margin-top:0in" start="1" type="A">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level1 lfo2">When you’re taking care of elderly or ill family members, you should have the following information handy:<o:p></o:p></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Their FULL LEGAL NAME<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Current address<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Date of Birth<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Social Security #<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Email address & password<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Bank account numbers, login username, passwords, secret questions and answers<o:p></o:p></li></ol>
</ol>
<p class="MsoListParagraph" style="margin-left:1.0in"><o:p> </o:p></p>
<ol style="margin-top:0in" start="2" type="A">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level1 lfo2">Medicare, Medicaid, Private Health Insurance, Dental & Vision insurance
<o:p></o:p></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">policy numbers,
<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">contact phone numbers,
<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">policy coverage dates,
<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">policy benefits,
<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">policy limits
<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">Where coverage OVERLAPS, where you have JOINT coverage and where 1 plan ends and another begins<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level2 lfo2">(yes, this is a LOT of confusing information)<o:p></o:p></li></ol>
</ol>
<p class="MsoListParagraph" style="margin-left:1.0in"><o:p> </o:p></p>
<ol style="margin-top:0in" start="3" type="A">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l2 level1 lfo2">EVERYONE speaks in jargon and code. WRITE DOWN the jargon they use and ask what it means.<o:p></o:p></li></ol>
<div style="mso-element:para-border-div;border:none;border-bottom:double windowtext 2.25pt;padding:0in 0in 1.0pt 0in">
<p class="MsoNormal" style="border:none;padding:0in"><o:p> </o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">As for my father-in-law, here’s a quick synopsis.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">He’s 65+ and has <o:p></o:p></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoListParagraph" style="margin-left:0in;mso-list:l0 level1 lfo3">Medicare PART A (Hospital care)<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l0 level1 lfo3">Medicare PART B (Medical care)<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l0 level1 lfo3">Medicare Part D (Prescription coverage)<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l0 level1 lfo3">He also has MEDICAID (which is for people with limited income)<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l0 level1 lfo3">MEDICAID MANAGED Long Term Care (MLTC) with HealthFirst<o:p></o:p></li><li class="MsoListParagraph" style="margin-left:0in;mso-list:l0 level1 lfo3">(that’s 5 different plans before we touch vision & dental…)<o:p></o:p></li></ul>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">His MEDICARE benefits ran out because he has been in hospital+rehab for more than 100 days<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">The VERY SCARY Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNFABN) form is simply Medicare telling the facility they won’t pay for him anymore and the facility needs to apply to his secondary insurance. That means
Medicaid and healthFirst.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Now, we’re waiting for HealthFirst to tell the nursing home what benefits and for how long they will cover him.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">The summary is the result of 4 hours on the phone with 5 different instutituons.<o:p></o:p></p>
<div style="mso-element:para-border-div;border:none;border-bottom:double windowtext 2.25pt;padding:0in 0in 1.0pt 0in">
<p class="MsoNormal" style="border:none;padding:0in"><o:p> </o:p></p>
<p class="MsoNormal" style="border:none;padding:0in">Important Phone Numbers:<o:p></o:p></p>
<p class="MsoNormal" style="border:none;padding:0in"><o:p> </o:p></p>
<p class="MsoNormal" style="border:none;padding:0in"><b>MEDICARE – Federal 800-633-4227<o:p></o:p></b></p>
<p class="MsoNormal" style="border:none;padding:0in"><b>MEDICAID – New York State</b> -
<b>800-541-2831<o:p></o:p></b></p>
<p class="MsoNormal" style="border:none;padding:0in">Medicare LONG TERM CARE OMBUDSMAN 800-342-9871<o:p></o:p></p>
<p class="MsoNormal" style="border:none;padding:0in"><b>HEALTHFIRST - 866-463-6743<o:p></o:p></b></p>
<p class="MsoNormal" style="border:none;padding:0in"><o:p> </o:p></p>
<p class="MsoNormal" style="border:none;padding:0in">I hope this helps someone.<o:p></o:p></p>
<p class="MsoNormal" style="border:none;padding:0in"><o:p> </o:p></p>
</div>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">EDITORIAL:<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">The ENTIRE MEDICARE PARTS A, B, D (oh wait, Medicare PART C eliminates the need for Parts A. B. D) + Medicaid + MLTC system is designed to confuse, frustrate and annoy people.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">There’s no reason why the elderly, the infirm and those without copious free time should have to call 4-6 organizations and THEN stitch together the answer.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">A sane country would replace this bureaucratic maze with a simpler system. But because we are Americans and we don’t want to see our neighbors benefit, we have built this enormously complex bureaucracy from hell.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial",sans-serif;color:#1F497D">--Raj </span><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#1F497D"><br>
<br>
</span><span style="font-size:11.5pt;font-family:"Arial",sans-serif;color:#1F497D">Rajesh Goel, CISSP </span><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#1F497D"><br>
</span><span style="font-size:11.5pt;font-family:"Arial",sans-serif;color:#1F497D">cell 917-685-7731</span><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#1F497D"><br>
<a href="mailto:raj@brainlink.com"><span style="font-size:11.5pt;color:blue">raj@brainlink.com</span></a></span><span style="font-size:11.5pt;font-family:"Arial",sans-serif;color:#1F497D"> </span><span style="font-family:"Arial",sans-serif;color:black"><o:p></o:p></span></p>
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