Spoiler alert: If you think this is going to be about COVID, I am sorry to inform you that it is not. However, if you want a fast paced blog about the problem with rules, keep reading…

We all know about HIPAA. According to the CDC (do I need to define them for you?):

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.

Does everyone understand why we have these laws? Basically to provide privacy to someone who is sick. And you all know that I defend the right to privacy. Completely.

However…

Sometimes we create rules to protect that end up screwing the person that most needs protection.

Case in point: My Dad has long term health care insurance. In order to qualify to reap the benefits of said insurance, you need to meet certain criteria: namely, that the person needs help doing normal, everyday things. It means that the person probably needs help advocating for themselves.

As my Father does not have the ability to sit on hold for 90 minutes waiting for a customer service rep, I have been helping him out.

Here’s the rub: I am not allowed to ask questions about the policy without his consent. Which is fine. I get the law and how it’s trying to protect people. And I call my Mom and get her to put my Dad on the phone so that he can give consent, for that day and that day only, for me to help. And my Dad is ill. And I’m trying to get him help with THINGS HE PAID FOR FOR THE PAST 20 YEARS…

Can you feel my frustration about this.

So, after I lost it last week and I emailed the CEO of the insurance company, and got a senior executive to answer my call…I will share with you what I told him left me a tad frustrated…

I asked how a long term care policy could be put into effect without the policy NEEDING to have at least one authorized individual who can speak for the insured. I carefully explained, like I stated above, that by the time the insurer needs the policy they can’t actually do the leg work. I told them that it SHOULD BE REQUIRED THAT EVERY POLICY TAKEN HAS AN AUTHORIZED PERSON THAT CAN ACT FOR THE INSURED. I said that you can send out an update form on a yearly basis as to who that authorized person should be, with updated contact info. I asked how, MY MOTHER, his WIFE OF 59 YEARS IS NOT ALLOWED TO DISCUSS THESE THINGS- and how she wasn’t put on the policy 20 years ago…which my parents swear that they did…

I then pointed to the part of the policy that states that I am the one to be called if for any reason they payments lapse. I told the Sr. Exec that my parents assumed by putting me on that, making me responsible for the money and all, would allow me to have access and speak for my father.

Next, I told him how my parents filled out the necessary paper work so that my Mother and I could have access to speak to the insurance company, and how the insurance company DENIED THE PAPERWORK because the SIGNATURES DON’T MATCH. My father is ill and has trouble feeding himself sometimes. DO YOU THINK HE HAS THE SAME MOTOR SKILLS?

I understand rules/laws are meant to protect people. But sometimes the rules/laws hurt the very people that they are supposed to protect. When we set a standard, we need to make sure that people truly are protected, and it’s not just an additional 80 levels of paperwork and bureaucracy…and added levels of angst and frustration.

So, the moral of the story is: if you have long term health insurance, make sure you have someone listed as an approved person to discuss matters.

And if they do amend the law that every care policy like this MUST HAVE A DESIGNATED PARTY TO SPEAK ON ONE’S BEHALF…

You’re welcome…

46 thoughts on “HIPAA and You

  1. Amen to that! Your opening paragraph made me chuckle. What an incredibly frustrating situation! That makes no sense at all. I didn’t have that problem with my mom’s long-term care insurance. Was the exec actually able to do anything or were they just there to absorb your very valid venting? Argh. How frustrating!!

    Liked by 1 person

    1. Well, before he called me he listened to all the recordings of my calls about the policy. And he heard my fathers voice on the phone giving me ability to speak for him. And you could tell the guy was speechless to hear my very I’ll father giving me access, because it was abundantly clear that my father can not speak for himself. Then he looked at the rejected paperwork and agreed that it was ridiculous and vowed to get some sort of change to how they handle the administration of long term care policies. And he helped and is getting the paperwork in for approval. FYI…they say it takes 14 days for approval of the consent forms….I explained to him that that’s ridiculous because sometimes the patient might not last 14 days

      Liked by 2 people

  2. I am so sorry you are having to deal with that bureaucratic nightmare. Unsolicited advice incoming…feel free to ignore. Have you investigated a medical power of attorney or healthcare proxy for your parents. My MIL, bless her, had the foresight to set POA (medical and financial) up in advance of her final illness. I am not sure how my husband and I would have managed her care without it. I am not the particulars in your state, but in ours my MIL could customize the authority to her comfort level.

    Many **hugs** to you.

    Liked by 1 person

    1. Yes I have. Here’s where it gets sticky fir me. My mom is a control freak…which is super fun to deal with. But she’s also so afraid of being feeble…I have to carefully balance so she doesn’t get depressed about being “old” and needing help

      Liked by 1 person

      1. More **hugs** to you. That just adds another level of complication to an already heartbreaking task. My MIL has been gone now for three years and I appreciate her forethought more and more as many of my friends are facing the issues you are experiencing now.

        Liked by 1 person

  3. I know your pain. I went through this with my mom. It was even tougher because my dad was her POA but he couldn’t handle it. So we had to get back with the lawyers so he could legally decline. I spent months on the phone with her LTC company trying to understand why it was taking so long to complete the elimination period. There are so many rules!! Once she finally qualified, we were paid three times before she died. Not HIPAA related, but I can’t even call my dad’s credit card company with questions without him giving verbal approval. And how do they even know it’s him??? These rules make it very tough for a child to help their elderly parents. Grrrr.

    Liked by 1 person

    1. I know! And I understand that there are kids who take advantage of their parents. I understand the need for rules. However, there should be some sort of failsafe built into the system

      Liked by 1 person

  4. Yes, a nightmare to deal with and I’m sorry it’s falling on you. There’s always one kid who seems to get the brunt of the hassles rather by age, location, ability…but this is exactly the situation where a proactive person is needed and I would be thankful to have you working your butt off for me!

    Liked by 2 people

      1. Love your attitude, of course. IDK how I got so lucky with Mom’s LTC insurer but I had no trouble talking to them on her behalf. IDK if it’s because I had her POA but I don’t think so because I don’t recall them asking me for it. I may have also passed myself off as her which of course you can’t do for your dad. Even her stockbroker was amazed at how easily all her investments were transferred to me as her executor even before her recent death. Another thing I can think of, as I have relayed to some of my friends, is that the “rules” change over time, between different states and even between different companies, like stockbrokers and insurance.

        Liked by 1 person

  5. I suppose that for these reasons I should be grateful that mom went so quickly. She had already given me, and later my sister, access to her medical stuff and put us on her bank accounts. I am listed as her beneficiary so I can apply for any benefits she had once I get the death certificate. I think you did a marvelous job advocating for your dad. Big hugs to you! It is not easy or fun.

    Liked by 1 person

    1. The only silver lining is that my husband is now aware of what could happen eventually with his mom, so he’s starting to get things in place to help him in that eventuality

      Liked by 1 person

  6. LOL, I’m sorry. Not laughing at you but for you. I love HIPPA (LOL) and I love insurance. I got a funny one that will hopefully make you smile. We got 3 EOB’s for a surgical procedure that never happened. The “provider” did not provide any info to BCBS. So they cannot tell me anything. BCBS told the “provider” information pertinent to actual procedures so they submitted new claims against that date of service. I’m convinced this is an Ethiopian scam at the highest level, BCBS is arguing with ME and that I need to pay the “provider” because it is outta network ($10K). They refuse to believe they’re being scammed. Hippa doesn’t save us from the insurance company providing scammers with our medical info. LOL OMG

    Liked by 1 person

  7. Can you get POA for your dad and mom? Or at least your dad? I find the same issues with my husband. He’s working all the time on the phone and he wants me to handle stuff. Much of it can’t be done without his authorization every single time.

    Liked by 1 person

    1. I’m dealing with I refer to as reverse parenting. My mom is really a control freak, and feels feeble having someone take over stuff for her. I’m trying to deal with her very bruised ego because she is faced with a very steep learning curve on a variety of things. I have to watch how I broach things

      Liked by 1 person

  8. I am so angry for you, and there are so many things to say about it all, but you have expressed the frustrations so well. To begin with, HIPPA is a joke. It protects the companies against law suits. It seems we have no privacy; the CCP probably knows more of our private health matters than we do. Absolutely, by the time you need this insurance you have paid on for so long, you are in no position to handle the stress of dealing with the system. Particularly since your hearing and eyesight are failing. As to signatures? Have you ever had to sign one of those digital machines with your finger or a pen? Totally unreadable. Or signed a contract with an electronic signature where you choose your font? How can that company dare say the signatures don’t match? It is a crazy world, and corporations matter, people don’t. I don’t know how it can happen, but I wish you the best in dealing with unreasonable scenarios in the future while you are doing your best in your family in coming to grips with your father’s illness. 😟🙏

    Liked by 1 person

    1. Thank you! You have no idea how I just reached the end of my tether last week. The tipping point was after waiting 90 minutes on hold, I was told they couldn’t answer my question, which was to define a term (not even policy specific) and they said I had to call a different customer service number….can you imagine?!?

      Liked by 1 person

      1. 90 minute hold to not answer a general question? That is the new definition of insanity in my book. To add insult to injury, there is absolutely no one in that company that really sees what has happened or cares. You are just one push of a button and move on to the next person.

        Liked by 1 person

  9. My (almost certainly) future DIL’s family has had a nightmare time dealing with medical stuff for her sister that has severe CP. She is non-mobile and non-verbal, basically has zero form of communication. They knew there would be issues when she turned 18 and did as much legwork as possible before then so they were ready (all the legal docs to have full medical power of attorney and conservatorship), yet still had to deal with the stupidity of someone requiring a signature from her on some insurance form. No matter her actual condition or the mountains of paperwork set up to ensure this kind of thing wouldn’t ever be an issue, they kept saying that the parents could not be the ones to sign for her. Even going to far as to lightly suggest they could put a pen in her hand and guide her (which I would think would constitute forgery, but what do I know). It is absolutely asinine. Yes, there should be privacy, but there also needs to be paths to give consent to share with those of your choice or certain explicit exceptions.

    Liked by 1 person

  10. Would the insurance company accept a medical power of attorney? POAs are what my aunt and I rely on to take care of my mother, who has severe dementia. I also have a financial POA. Once the insurance companies etc have a copy in their files, I have had no trouble.

    Liked by 1 person

  11. We had something similar with hubbys mom in the end he and his sister took out a power of attorney, so now they can take charge and sort out everything concerning their mom.

    Liked by 1 person

  12. I’m so sorry LA, working through issues in the healthcare industry is never easy, and mostly an incredible time suck with very little accomplished. I too dealt with this when my parents were very sick, it was horrible, and I’m sorry you have to maneuver through this inescapable maze. Sending love, C

    Liked by 1 person

  13. It is a nightmare, even though my father had the foresight to put POAs in place for both himself and my mother. He also had the whole family around the table for a discussion with the lawyer present so what was drawn up was clear, understood and accepted by all. The problem (in the UK anyway) is that once registered, the POA lies dormant until activated “because of demonstrable need” and then it takes up to 6 months to be available for use. I’m sure I don’t have to tell you how many calls and letters need to be made and sent in the course of 6 months. I continue to have the same problem with my mother now. She doesn’t “need” the POA but she has never handled financial and organisational decision making, and is too old to learn how in her 80s. We struggle on.

    What I’ve learned is to face what you yourself need to do to make it easier for your child when the time comes. Plan it now, talk about it now, and remove as much of the difficulty for her as you can. My son-in-law has told me he wants me and his parents all living in the immediate neighbourhood before we get too old and set in our ways to be moved. He’s wise, because he’s learning from his mother’s struggles with her mother. You can’t control your mother’s behaviour, but you can do something about how your actions will effect your daughter down the line.

    All the best LA, it’s a tough old road to travel.

    Liked by 1 person

    1. Thank you! There’s just so many things obstacles and there has to be a better way to track things. We try to protect people and then we can’t because of bureaucracy….😆,

      Liked by 1 person

  14. I’ve never been in this situation but you bring up some valid points. How do you help someone who is sick when the protections in place end up having the opposite effect?! I’m glad to hear you took it further and brought this to their attention. I can only imagine how frustrating all of this must be!

    Liked by 1 person

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