Treatment or House: How to Avoid This Medical Decision

Let me introduce you to Cari; a teacher, loving wife, and mother of two young children whom was recently diagnosed with crohn's disease and prescribed infusions. Cari, assumed her insurance policy covered these treatments until she received a bill for close to $20,000, and that was for ONE treatment. She would have to continue these treatments every five weeks!!!!! After not much success, Cari reached out to me in panic, and we managed to get her bill down to $411 with some of the following tips:

1. Get into your Zen: The last thing Cari needed was an ulcer. With a few deep breathes and a plan of action in place, she was ready to tackle this "billing monster."

2. Get a copy of the itemized bill and medical records: We were able to uncover some billing mistakes, but get a "clearer picture" of what was being done and if there were any options. In Cari's place, it looked like her insurance rejected part of the bill because the infusion center was not covered by her insurance.

3. Talk to the right person: Some facilities have patient advocates or social workers that can help find other options for payment. Cari was able to verify what we discovered through an advocate at the facility. In addition, the advocate pointed out some additional insurance options that Cari was qualified for, but not taking advantage, so we immediately filled out all the paperwork with the help of the facility and got her on the correct plan within 2 months.

4. Talk to your prescribing doctor: Maybe there is an alternative medication or cheaper treatment? In Cari's case, she had an adverse reaction to alternative treatments, so that was not an option. In some cases, the prescribing doctor may have free samples (usually about 2 months worth) that he/she can provide you with until a financial solution is figured out. Cari's case was a little more difficult since she was in need of a biologic which tends to be a little more complicated therapy since there are many factors involved including an infusion site.

5. Find out what financial assistance programs are out there: There are plenty of "patience assistance programs" and/or "financial need programs" that are available for all situations. Familiarize yourself with these programs and get qualified as soon as possible. Some websites that may be helpful include: NeedyMeds, together Rx Access, or a State Pharmaceutical Assistance Program.

6. Go straight to the manufacturer: Many larger manufactures have an "Access Services Manager" or someone equivalent that can help guide you through the process of qualifying for some of these access and affordability programs. Cari found Kim, an access services manager for the Remicade she needed by going to the Janssen Pharmaceuticals, Inc. website and calling the 888 number provided. For those that are not as savvy, the prescribing doctor can help provide you with the correct number by contacting the representative they deal with from that pharmaceutical company.

7. Be pleasant and prepared: Before initiating any calls, take a deep breathe and be sure you write down the following information so you can provide it in a cohesive way when the representative asks, which will make the call pleasant and quick:

Your name and contact information

The pharmaceutical prescription

The desired location if needed

Insurance information (if you have insurance)

Your income level (a copy of your W-2 can provide this information)

Some programs may require additional information, and you may not get the correct person on the phone the first time. Be patient and be persistent. If your blood starts to boil, hang up and call again when you are calm, or have a loved one call with you.

8. Take notes: Get the person's name and contact information if possible. Document the date and time of the call, and summarize what was said, including any additional instructions given to you as well as when the person may call you back. In Cari's case, we were asked to call back to get an update on what Kim was able to find out regarding her situation. In conclusion, Kim was able to locate a site that was accepting her insurance and determine that this site was accepting new patients. Kim also enrolled Cari in an additional free service to remind her of her infusion dates.

9. Breathe and get started: Now that everything is verified, Cari is able to get her infusions and NOT go into medical debt. In addition, she knows to ask for an itemized bill and a copy of her medical records after each infusion, so she can keep track of her bills and be sure there are no mistakes. If there is a discrepancy, she has her access service manager, Kim to help her work it out and avoid an ulcer.

Today, Cari is an empowered patient with no medical debt and an infusion center that is convenient to her house that is covered by her insurance.

Find Some Hidden Expenses in Your Car Insurance Such As Healthcare?

Chances are, if you own a car, you might be paying for some unnecessary "extra options." For example, if you already have health insurance, why does one need the "medical coverage" under car insurance? Have you ever asked your car insurance company what this means? So what if you get into a car accident and you are injured? Will your current health insurance wait for your car insurance to kick in because you have this "medical coverage," thus delaying claims? How long will this be delayed, and will this affect your health insurance coverage because of a "lengthy delay," costing you more out-of-pocket medical expenses because you missed the submission day? It all sounds to familiar, right? But if you do not have health insurance and you are injured in a car accident, this "medical coverage" can help pay for some of your medical bills (it did for me).

In general, this "medical portion" of your car insurance MAY cover the following, but be sure to ask your car insurance representative to explain:

Some funeral expenses

Passengers that might be hurt while you or a family member is driving

If you are an injured passenger in someone else's car

If you are struck by a car while walking or cycling

If you require dental care after an accident

If you require extended nursing services or hospitalization while rehabilitating

If you require prosthetic limbs

So if you are doing some "summer cleaning" and you are trying to uncover some cost savings because you are worried about that mysterious increasing premium under your health insurance, be sure to call your car insurance and start asking questions (and be sure to document the answers).

Start with these warm up questions: Do you really need the rental car option if you have a new car? How does that loss of income actually help you and in what situation? When does that bodily injury actually kick in, and what part of your body?

When you feel warmed up to the point that the car insurance representative is sweating, start asking about the "medical expense payments." What is the bare minimum requirement needed in your state? What does it cover? How does it compare to your current health insurance? When does it kick in?

Medical Debt No 1 Cause Of Filing for Bankruptcy

Medical debt is the leading cause of filing for bankruptcy in the United States. Medical debt can be accrued in a number of ways, but is most often due to a lack of proper health insurance or unforeseen medical conditions and emergencies that are not adequately covered by insurance policies. With the advent of the Affordable Care Act many people are hoping that this trend will not continue, but as of right now it remains a very real and pressing concern for millions of Americans, many of whom are faced with overwhelming debt and unsure where to turn.

Reasons for Medical Debt

A recent study showed that 62% of households facing major debt cited medical debt as a big part of their problem. These debts come in the form of unexpected emergency room visits, which can be expensive even if a person has health insurance and are prohibitively so if the person does not. They also come in the form of dental work, which is a separate kind of insurance not generally covered by basic health plans. Dental work can easily run into the thousands of dollars, and is the kind of work that, when needed, is absolutely needed ASAP.

Another huge factor in outstanding medical debt that gives people thoughts of filing for bankruptcy is the out-of-pocket costs of prescription medications. Prescription drugs can cost an arm and a leg, and are notoriously difficult to get covered under typical health insurance plans.

Health conditions that lead to skyrocketing debt are generally related to obesity and to the effects of age, and those suffering from such conditions and the associated debts are filing for bankruptcy at an increasing rate.

Another worrying statistic in the study is that households already saddled with medical debt are less likely to seek treatment when needed, wishing to avoid further debt burden and filing for bankruptcy.

In addition, even after filing for bankruptcy, which can clear giant chunks of unsecured debt, many people are afraid to go in for new treatment, since they likely would still not have proper insurance and would not be able to discharge new medical debt for several years after the initial discharge.

1.7 million people will be filing for bankruptcy due to medical debt this year, the study estimates. Luckily the protections offered by filing for bankruptcy are strong and able to discharge most of the debts incurred by those suffering from poor health or accidents - but the larger issue is that poor health and accidents are a reality of life, and it feels like something is inherently wrong when a system fails to account for these realities in a meaningful way.

Medical Emergencies: Leading Cause of Bankruptcies in America

There are several reasons people file for bankruptcy. What may come as shocking news is that most people are a SINGLE major health issue away from considering bankruptcy as an option. How can this be when majority of families have some form of health insurance? For one thing, it all depends on a number of circumstances. Here are a few examples of what needs to be considered:

• What type of insurance you have 

• What sort of medical issue you have 

• What is the co-pay percentage

Medical bills are actually the biggest cause of bankruptcies within the United States. In 2013 alone, almost 2 million people had filed for bankruptcy citing medical bills as their reasons. Even health insurance provides minimal help in preventing these cases.

Why?

One reason is that the average co-pay in most plans is 20%. This works out well for check-ups and minor injuries but if you happen to contract a major illness or get in a serious accident, you could possibly rack up a bill over $50,000 where you would need to cover 20% or $10,000 along with the deductible. For just about anybody, this would be a life-changing tragedy that necessitates seeing a bankruptcy lawyer.

Who are affected?

Of those who have stated medical bills as their reasons for filing bankruptcy, 78% of them had medical insurance of some sort. Most of those affected were educated middle-class families. 1 out of 5 Americans will face problems paying medical bills this year. Accidents and life-changing diagnosis can happen to anybody.

Even with proper savings and good spending habits, the burden of some medical bills is simply too much for most people to handle. This is a problem that an estimated 56 million Americans will need to face this year alone.

What can happen?

Seeing as most health care institutions employ their own means of collecting debts, overdue health bills are treated the same way as other types of debt regardless of the fact if you are now incapable of maintaining your job due to your health issue. You can expect similar means of debt collection such as multiple phone calls, court ordered actions, and other harassing techniques.

How to address the issue?

Bankruptcy is, and should always be, considered as the final option and should only be seriously considered once all other options are exhausted. Lawyers that specialized in bankruptcy are also experts when it comes to finding working solutions for debts. Your best course of action would be to seek the assistance of a bankruptcy lawyer as soon as you are facing a massive medical bill.

The common belief is that credit card debt or mortgages are the main causes for filing for bankruptcy. Most people are caught blindsided by such big bills that they find themselves at a loss for what to do. Simply having the knowledge that 3 out of every 5 bankruptcies are caused by medical bills is already a good start. Knowing is always half the battle and it always beats being caught off-guard.

How Crowdfunding Can Help Pay Medical Bills

Crowdfunding can help pay for medical bills... it really is that simple. You can crowdfund for just about anything, including medical bills. Many times people are placed in a medical crisis and aren't sure where to turn. Medical bills can accumulate in no time and medical bankruptcy is a real thing. You'd be amazed by how many people in "your own crowd" are willing to help.

In a study published in January 2014 from the Center For Disease Control (CDC), one in four families experienced financial burdens of medical care.

This "financial burden" of medical care equates to medical bills that they can't currently pay and are forced to pay monthly over time.

This study goes on to share that families with lower incomes were more likely to experience the financial burdens of medical care. Those families with incomes at or below 250% of the federal poverty level had the highest levels of any financial burden of medical care.

250% of the federal poverty level (based on guidelines for 2013) means that a family of four with an annual income of $58,875 or lower were at the highest level of the population feeling the financial burden of medical care for a loved one. That's our middle class America. Those are the families living paycheck to paycheck and not prepared for a medical crisis.

The is a baby with his eyes closed and an oxygen canula in his nose. He was born with a bad heart, a weak immune system, and problems eating which caused a condition labeled by doctors as "failure to thrive". Isaac spent the first year of his life in and out of hospitals in Las Vegas and at Stanford where he underwent multiple heart catheterizations and procedures, open heart surgeries, and had a feeding tube placed surgically to ensure he received the proper amount of nutrients. Isaac's family had great insurance, covering 80% of all medical costs. But, they still spent over $100,000 out-of-pocket the first year of his life in deductibles and medical related expenses.

Shocking... right?

I know... My name is Kathy, and I'm Isaac's mom.

I remember people asking us if they could have fundraisers for us, give us money... they would offer to do anything just to help. At that time, I could not have imagined the costs that we would incur, nor could I imagine all the things that insurance doesn't cover. You assume that you pay for insurance, you'll have a deductible... The End.

If that were only so.

Words of Advice:

Start a Crowdfunding Campaign Immediately

Don't be too humble to let other people offer to help you. You really can't imagine the costs of things in the medical world and how they add up. It is TOO hard to think about money when you're talking about the healthcare of someone you love. You want anything and everything done... you'll worry about the bills later.

From a Mom that's Been There

Don't expect the people in the middle of a medical crisis to be thinking clearly (well, I sure wasn't). If you're related to the family or just a loving friend... talk to them about the medical bills and the reality of the situation. Talk with them about what they need now and what their needs may be in the future and help them come up with a budget and plan to get everything their loved one needs. From bills, equipment, therapy sessions... even therapy dogs, all these things can be a necessity now or in the future.

How exactly will crowdfunding help pay my medical bills?

Well, they can't send a check to the hospital for you, but they can offer you a platform that will help you tell your story as well as share it with your friends and family. The right crowdfunding platform will provide support for you all along the way, from guidance writing your story, picking pictures to post, sharing on the social media channels, and even help writing press releases to get national exposure.

Crowdfunding can help you pay for your medical bills by allowing YOU to take care of your family and letting your "crowd" help YOU. Donations will be made by people you have inspired and want to help you. These people will have a platform to donate to you on their schedule and an amount that is within their means. They will be assured that the funds are going directly to YOU and not an anonymous organization.

You are not alone in your medical crisis. Crowdfunding is a viable source for helping to pay for medical bills and other medical related necessities.