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How to adult? insurance, bills, phone calls, and getting no one to actually help

needlenose2

New Member
New here. Anyone have any ideas about how to handle wading through all the phone calls and conflicting information in regards to a medical bill? I don't like being a burden on family and friends but I can't seem to manage that sort of situation. Been crying yet again over it all, and as far as I can tell this should have been a simple, and straight forward issue that could be resolved in minutes. But nope. And any phone call to insurance is filled with back ground noise that makes it even harder to hear. And everyone acts like I should understand billing codes, which of course I don't.
 
Afraid I don't have a solution to offer seeing as how I am not good at such things myself. Welcome to the forum though.
 
I don't like being a burden on family and friends but I can't seem to manage that sort of situation.
Maybe asking for help from someone like a family member or friend wouldn’t be as burdensome to them as you are imagining.

Are there any email contacts or online options for dealing with this?

Otherwise, I’d say:

- Take good notes
- Get names of who you spoke to
- Manage your stress before the call so that you are at least not starting the call exasperated
- Be bold and persistent
 
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Write down a list of questions for need- to- know facts when you call the insurance.
Knowledge is power when dealing with billing departments on medical bills.

I don't know what type of insurance you have or the details, but I can tell you the problems I encounter with a dual-complete Medicare/Medicaid advantage plan.
This usually applies to all primary insurances with a secondary that pays the balance.

I still get bills for co-pays or amounts I do not owe and have to explain to the billing agent why and what to do.
Example: Primary insurance such as Medicare or whatever type you have, pays first.
If you have a secondary, in my case Medicaid, it pays the 20% balance.
Without a secondary there is usually a co-pay you owe.

The QMB law of 2013 makes it illegal for medical providers to charge you anything
above what the primary insurance pays if you have Medicaid.
QMB is Qualified Medicaid Recipient.
It is even illegal for you to pay them the extra or a co-pay if the provider accepts
both primary and secondary insurances.

For anyone with Medicare and Medicaid this is essential to know.
Again, I don't know what type of insurance you have, but for people with Medicare and a secondary insurance, whether it's Medicaid or another type plan, it is good to know. Being asked for amounts I don't owe happens quite often.

And welcome here! @needlenose2 🦎🙂
 
Your concerns are quite valid. You are not alone.

At times just trying to understand the terms of Medicare make my head spin.

This also reminds me of once contacting a creditor, as I couldn't interpret certain amounts listed which totally confused me in terms of what I actually owed. Made worse with having to deal with someone (anyone) on the phone. Not my best avenue of communication. It took time for me to understand that the numbers I was concerned with were not important to what was actually owed. :rolleyes:
 
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Write down a list of questions for need- to- know facts when you call the insurance.
Knowledge is power when dealing with billing departments on medical bills.

I don't know what type of insurance you have or the details, but I can tell you the problems I encounter with a dual-complete Medicare/Medicaid advantage plan.
This usually applies to all primary insurances with a secondary that pays the balance.

I still get bills for co-pays or amounts I do not owe and have to explain to the billing agent why and what to do.
Example: Primary insurance such as Medicare or whatever type you have, pays first.
If you have a secondary, in my case Medicaid, it pays the 20% balance.
Without a secondary there is usually a co-pay you owe.

The QMB law of 2013 makes it illegal for medical providers to charge you anything
above what the primary insurance pays if you have Medicaid.
QMB is Qualified Medicaid Recipient.
It is even illegal for you to pay them the extra or a co-pay if the provider accepts
both primary and secondary insurances.

For anyone with Medicare and Medicaid this is essential to know.
Again, I don't know what type of insurance you have, but for people with Medicare and a secondary insurance, whether it's Medicaid or another type plan, it is good to know. Being asked for amounts I don't owe happens quite often.

And welcome here! @needlenose2 🦎🙂
ACA insurance. Doubt it's any less complicated. I am sure I am not the only person who has problems like this, but obviously being autistic is likely making it even more difficult. Maybe I need to just learn when it really is ok to ask for help and then make that person a pie. Unfortunately I have to admit that I am as susceptible as anyone to the effects of ableism. No idea when it's really ok to ask for help and when I am just not trying hard enough.
 
I agree with @Rodafina that asking someone for help doesn't have to be the awful thing we imagine. Especially since in your case it seems to be a specific, limited problem: Handling medical bills. It's not like you need to do that every single day, right? Maybe once or twice a month in a bulk? You could ask a friend or family member to assist you on those times. An alternative could be to ask someone to sit with you on a Zoom (etc.) call and guide you through the sorting process and writing down tasks, so that afterwards, you have a clear idea of what to do.

If you don't want to ask family or friends, there might be volunteer programs who offer to help with things like that. Or even a local autism group, where one of the members might find organizing things very pleasant, and could help you with that specific thing?

The last one just occurred to me because I love making lists and organizing stuff. Just with my own things, I struggle, but someone else's things are much easier. If it's a fellow ND person, you might also feel less embarrassment, because they understand the struggles. Maybe they have another thing they struggle with and where you can help. Our individual spiky profiles can also mean that we can help each other very well.
 
True friends won’t mind your asking for help. If your family really cares about you, they’ll be willing to help, too. I usually reach out to my family and friends when I have questions. I also have a life coach - one might be helpful for you if you can afford it.
 
No medical bills live in Canada paid through our provincial taxes. Similar to how many countries pay for their defence,
 
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True friends won’t mind your asking for help. If your family really cares about you, they’ll be willing to help, too. I usually reach out to my family and friends when I have questions. I also have a life coach - one might be helpful for you if you can afford it.
How do you find a good life coach? That is something that sounds more useful than therapy.
 
I agree with @Rodafina that asking someone for help doesn't have to be the awful thing we imagine. Especially since in your case it seems to be a specific, limited problem: Handling medical bills. It's not like you need to do that every single day, right? Maybe once or twice a month in a bulk? You could ask a friend or family member to assist you on those times. An alternative could be to ask someone to sit with you on a Zoom (etc.) call and guide you through the sorting process and writing down tasks, so that afterwards, you have a clear idea of what to do.

If you don't want to ask family or friends, there might be volunteer programs who offer to help with things like that. Or even a local autism group, where one of the members might find organizing things very pleasant, and could help you with that specific thing?

The last one just occurred to me because I love making lists and organizing stuff. Just with my own things, I struggle, but someone else's things are much easier. If it's a fellow ND person, you might also feel less embarrassment, because they understand the struggles. Maybe they have another thing they struggle with and where you can help. Our individual spiky profiles can also mean that we can help each other very well.
We don't have much available here but I found a mental health organization that helps some in figuring out how to cope with some of this sorta thing. I plan on stopping by and seeing what advice they can offer.
 
Thanks everyone for the ideas and advice. I'm going to let friends and family help but I am also going to try and find out what other options might be for next time. And make the friend a pie. Feeling a bit calmer.
 
How do you find a good life coach? That is something that sounds more useful than therapy.
There are several ways. AANE and other certainly may be a good resource (I had a personal advocate and support person from there for a while when they were offering services in my city). Googling life coaches in your area and/or getting recommendations and referrals from other people and organizations may be helpful. You’ll want someone with good credentials and coaching experience, and who can help specifically with the kinds of things you need help with. So once you have some names, you’ll want to have consultations with them to see if you think they’d be a good fit for you. Tell them your exact situations and what kinds of things you’ll want their help with. Ask them lots of questions and bring up any concerns you may have.
 
See if there is a members' phone number on the back of your insurance card. If there is, those people are generally your advocate. We just had an issue with our health insurance denying medical claims for our son. We called the number on the back of the card and got an agent who said they would talk to the insurance and to the doctors and make sure the doctors gave the insurance all the right documentation.
 

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