I hope this is in the right area as it overlaps several sections of interest, not just POA but also Medicare for which there is no specific section, and what to do when someone moves due to Dementia and where all the important mail and information should go, like taxes, medicare, healthcare, legal, or any other mail someone needs to be responsible for!
I need some clarifications and responsibilities for DPOA and medical POA with considerations of Medicare and healthcare coverages as seen by the healthcare provider and what may be needed for changes in address upon the diagnosis of mental incompetence where the loved one cannot make decisions and receiving mail would complicate billing or possibly risk loss of payments and cancelations.
After my mom was diagnosed with dementia, and by 3 Dr's it was time for her to move and be cared for. We have a trust and I am the DPOAto manage assets and finances. We also had a medical POA form that listed me as primary contact with 2 sisters listed as contacts, this would allow access to medical info for all if needed. One sister changed that medical POA where she's the only one listed and for about a year and a half it wasn't recognized by the HMO Kaiser, it now is and they cannot speak to me about my mom's health, HIPAA.
With a recent sale of the primary residence, all bills are paid, everything was good. I had been getting all letters for my mom about her coverage at my home address since she cannot receive mail and know what to do with it, it has to be received by a responsible party to make the financial decisions and with everything working with mail coming to my home I wasn't changing anything. As far as I know, Kaiser has no right to any of my mom's financial information and her trust has no bearing on her Medicare coverage, so why would Kaisier even be concerned where the bill goes so long as bills are paid?
It seems the sister who had my mom sign a form making her the only medical POA and likely my mom had no idea what she was signing at the time has inquired with Kaiser who no says they can't send me anything and changed the mailing address to my mom's care home at my sisters request and then she did not get the mail then she had it changed to her home, I do not get any of the mail now. Kaiser says something about Medicare and I'm not allowed to know about her coverage? Wait I'm her DPOA and Trustee for her trust and responsible for her bills and coverage as her DPOA???
It seems something is really wrong and I'm unsure what to do or where to start. I know my mom would want me shut out of her healthcare info. While I'm fine with my sister now having to be my mom's healthcare advocate I don't always agree with her decisions and thought processes. I don't want my sister to make any changes in coverage but it sounds like I can't stop it if she wants to.
What to do?
This should say " I know my mom would NOT want me shut out of her healthcare info"
Secondly, managing as a medical POA and as a DPOA in general or in financial is entirely two different things. If you are managing all bills then you must be CORRECTLY put on accounts as POA and you must do all bills signing your Mom's name "by daughter as POA" (your name). Your Mom can be given a small spending account if she is able to handle that.
You have to register yourself with all entities from Medicare to Bank Accounts to Bills. It is a year's worth of trial and error and hard work (was for me anyway) with mailings arranged coming to POA, and with sending your papers everywhere. Do know that SS doesn't recognize a POA. You would have to be rep payee if you are to do it at all, a whole OTHER process. Also IRS doesn't nor does Medicare but they will deal with you with the permission of your Mom.
This is all very very difficult and there is a steep steep learning curve. Please start with a good attorney who can guide you in this, or a Licensed Fiduciary who will help you get all set up for a fee/usually hourly. The attorney, who works with Court Fiduciaries can introduce you to one as they work with them all the time in instances of an elder with no progeny. Your Mom's estate pays for this help.
I wish you the best of luck. This is very difficult. I would never want to do it again, though I did learn a lot.
The fact that your sister is on for the insurance as POA is VERY COMPLICATED and must be changed with your POA all going with you to Kaiser to get yourself set up as POA> I had to do this with United Health. The more cooks in this stew the more awful it will taste. That's for certain.
I despise the drama and fighting but it looks like I'll need an attorney to help, and then ensure that I'm the contact for all of her financial needs other than medical decisions and get my mom to probably sign a new POA for health care so I can speak to her care team when needed.
Alvadear, do you know if my sister can make medical financial decisions as her medical POA or if any decisions have financial requirements does she have to ask for permission?
Thanks
This is why the DPOA and MPOA needs to be the same person. Medical POA only comes into the picture to protect Moms wishes. As DPOA, you need to pay the bill for Healthcare coverage and know if Mom has the money to pay for any changes. How was the Medical POA written originally? Were the 3 of you equal or the other 2 secondary meaning the seconary only makes decisions when the one daughter cannot perform her duties. You sister cannot change how a Medical POA is written, only ur Mom can and she is incompetent to do so.
Due to incapacity someone can assume the successor role if it is so written. How on earth can someone with dementia manage their own affairs? The incapacity must be proven, which it was and reviewed by the attorney who created the trust and another attorney who guided me after my mom was ruled as incapacitated. Her bank required proof and the trust so that I could legally manage her assets and be named as the successor trustee and stated this was very normal and they do it somewhat frequently and even have a division that specifically handles these.
Be careful when you make statements without knowing the law and legally binding language in a trust.
As it seems that you are already getting legal advice, it is certainly best to ask the lawyer, not us.
It might help you to get answers if you could rewrite your blurb, with specific questions you want answers to. There are people on the site with expertise in some of it. If you end up with a lawyer, having things clearer would save you time and money anyway.
Yours, Margaret LLB FCCA
My suggestion would be to stop proceeding on this thread, and start a new one with a clearer set out of what is going on and the questions you want answered. And of course without this mistake. Add a last post to this one that explains what you are doing.