“I Have Enough Money for Today, But What About Tomorrow?”

Review your income, expenses and health insurance coverage to get an accurate picture of your financial situation to determine whether your healthcare costs will be covered.

Do I have enough to pay the bills? Will I have enough money in three months? Do I have to pay all the bills right away? Can I hold some for later, or reduce what I owe? Do I have the adequate health insurance?

Even if you are able to cover all your current monthly and annual expenses, take a hard look at where your sources of — employment, Social Security, disability insurance, income from assets — and how it may change over time. Then ask yourself: What specifically are my monthly family expenses?

If your illness has caused a sharp drop in your income, then this guide may help you develop strategies that are both practical and achievable.

CURRENT INCOME SOURCES

First, list all your sources of current income. These may include:

  • Income from employment
  • Social Security
  • Supplemental Security Income
  • Social Security Disability Income
  • Short- or long-term disability payments from employer plans
  • Individual disability policy
  • Investment or retirement income
  • Veteran’s benefits
  • General assistance from government sources

EXPENSESReview all your bills, particularly those you pay monthly: mortgage or rent, fuel, phone, car payments, utilities, credit cards, etc.

Consider your quarterly and annual bills, including property taxes and insurance premiums. These are easier to overlook, and could be an unpleasant surprise if not planned for.

GETTING YOUR HEALTH INSURANCE COVERAGE IN ORDER

Since healthcare costs will be a component of your expenses, it is important to assess the quality of your coverage. Review your health insurance policy or employee benefits booklet.

Here are some common items in health insurance policies that will affect your costs:

  • Lifetime maximums: (the maximum amount your insurance company will pay for your healthcare over your lifetime) and how much is left.
  • Deductibles: There may be a single deductible per year, or there may be deductibles for some or all covered procedures or expenses.
  • Required co-pay amounts.
  • Coverage for prescriptions and their reimbursement
  • Annual out-of-pocket maximum (after which insurance pays 100% of allowable charges).
  • Coverage differences between inpatient (hospitalization) and outpatient (home or clinic care).

Check the limits or outpatient and same-day procedures. Sometimes, lab tests and x-rays are covered only if performed in a hospital or affiliated clinic. Also find out the coverage for emergency room treatment, and if there a separate deductible?

An important rule to remember is always ask questions if something is unclear. Be persistent. If you don’t like the answer, ask again or ask to speak to a supervisor.

Other points to consider:

  • If your plan requires that all care be coordinated through a primary care physician, make sure all appropriate referrals are sent to any consulting doctors.
  • If a pre-authorization number is required for visits or procedures, record it in a safe place for future reference, in the event of billing problems.
  • If you are having trouble paying co-pays and deductibles for hospital bills, contact the business office supervisor and try to negotiate a smaller monthly payment schedule. For doctor bills, contact the physician’s office manager.
  • If problems occur, review and follow the appeal or grievance process included in your plan.
  • If there are still unresolved issues, contact your state insurance commissioner for possible assistance and guidance.

Health insurance policies and employee benefits booklets can be confusing. If you have any questions about the meaning of your coverage, call the claims department directly.

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