Health Insurance for Elder Person

[NotAnAtty]

I have a question on how to describe a problem with health insurance. I need to know the proper terminology to describe the legal issues with my mother's current health insurance.

My mother became an incapacitated adult ward nearly a year following the death of my father. Mom is going to be 80 years old this year. The attorneys that took the appointment as guardians/conservators of my mother "warehoused" her in a group home and forced her to see a doctor making house calls for their own convenience and that doctor does not participate with mom's Federal BCBS and Medicare insurance available to her, which has caused mom to pay exhorbitant retail prices for medical visits and treatments that should have cost her almost nothing if an approved insurance participating doctor/service provider had been used instead. Attorneys admitted that they had not submitted anything to insurance for reimbursement during a hearing with the local Commissioner of Accounts.

Now I've read about the rampant abuse of health insurance fraud for unnecessary services perpetrated on elderly in group homes, assisted living places, and nursing homes. So my question is this, what exactly would be the legal terminology for what what is being to my mom since they are forcing her to not use her available insurance as they expense out her cash assets rather than conserve them? Is it financial exploitation? Or Fraud? Or both?

Any other relevant comments about what is legally wrong with what I've described above is greatly appreciated. Thanks in advance.

[goddessoflubboc]

Re: Health Insurance for Elder Person

I would strongly urge you to get an attorney to have you appointed her guardian if possible.

If these lawyers use these drs for all of the people they are guardians of then yes they are running a typical scam where they then get a kick back off what she pays the dr. This is highly illegal. She is being defrauded out of her money by the very people charged with her fiscal responsibility.

If it is just one specialist she must see who is out of the network that is one thing. If this is her routine care you have a serious problem.

[Disagreeable]

Re: Health Insurance for Elder Person

Agree with Goddess.

[NotAnAtty]

Agree with Goddess.

I can't afford an attorney. I went to the local legal aid office and they said my elderly mother had to walk in herself or call in. That is impossible. The guardians/conservators keep mom "warehoused" in a group home and they and the person who owns the group restrict my visitation and won't let me have any private

[NotAnAtty]

Agree with Goddess.

I can't afford an attorney. I went to the local legal aid office here in Northern Virginia and they said my elderly mother had to walk in herself or call in. That is impossible. The guardians/conservators keep mom "warehoused" in a group home and they and the person who owns the group restrict my visitation and won't let me have any private time with mom. Nor does mom get to use their phone with any privacy. If I discuss any legal matter with mom and the staff reports it to the owner or the lawyers then my visitation is taken away in retaliation and mom is isolated from family contact. How do I get help under these circumstances? Are there any places to get a pro bono lawyer that represents victims of abuse and financial exploitation? I am so frustrated at continually having the door slammed in my face because I literally have no money. it breaks my heart and soul that my mom is being abused and exploited and suffering in these circumstances.

[Disagreeable]

Re: Health Insurance for Elder Person

Your problem is that even if mom is suffering financial abuse, she is receiving proper care otherwise. Your primary basis for complaint, seems to be there will not be anything left for you to inherit. You should have stepped in earlier and filed to become guardian.

[NotAnAtty]

Re: Health Insurance for Elder Person

Ummm ... stepped in with what attorney when I can't afford to pay one and legal aid won't help as I have described above.

Mistakenly you have assumed that the facility my mother is warehoused in is providing proper care. They are not and are not even providing her with a kidney friendly diet as her nephrologist has specified for her.

In no sentence have I ever said or used the term "inheritance" regarding my mother. I love my mother and am trying to help her get out from her situation of abuse and financial exploitation.

Please only reply if you can provide some helpful insights or information that I can use to help my mom rather than make assumptions and throw insults or shoulda-coulda-woulda remarks. I am seeking answers to go forward and help my mom and get her justice and restitution. What is happening to her is not right and she is suffering.

If you were in my shoes, what would you do to help mom?

Thanks in advance for any replies that are actually useful.

[goddessoflubboc]

Re: Health Insurance for Elder Person

If they are not caring for her properly the states all have an agency just as they do for children. I suggest you contact them, they will investigate at no charge.

You might also contact the local DA if you believe she is being scammed out of money she may need to live on (bc when it runs out the state gets the tab!).