Cash Before Care: Don't Get Blindsided

By Sid Kirchheimer

How to protect yourself from unexpected—and expensive— upfront medical costs:

• Know your coverage. Understanding the specifics of what is and isn’t covered can help you avoid pre-admission sticker shock. When Shirley Giarde’s husband was diagnosed with congestive heart failure and needed to have a defibrillator and pacemaker implanted, she discovered that her health policy considers the devices as durable medical equipment, which isn’t covered. Giarde, 55, of Walla Walla, Wash., owes $102,000 for his treatment and has refinanced her car to help pay for it.

• Challenge the decision. If faced with unexpected expenses, call your insurer and say you need relief, advises Nancy Davenport-Ennis, CEO of the Patient Advocate Foundation (PAF). Medicare patients should contact their state health insurance assistance programs. Go to www.shiptalk.org

• Apply for “charity care.” Check with your state health department to see if you qualify. Some hospitals may give you the runaround and say they don’t have a charity care application, Davenport-Ennis says. But federal law requires that hospitals receiving federal funding—and most do—must devote a certain percentage of services to charity cases.

• Get an advocate. Last year, the PAF www.patientadvocate.org or 1-800-532-5274) took on the cases of 45,000 patients from all 50 states and gave telephone guidance to nearly 7 million others—at no charge. “If an older person is acutely ill and needs hospitalization, we can go to court and try to receive an injunction to facilitate immediate admission. Then we fight with the insurer and hospital about payment,” says Davenport-Ennis.

• Seek other money. Specialists at the National Cancer Information Center are available 365 days a year to help cancer patients with treatment-related financial problems. The center maintains a database of community and national resources that have funds available for medical care or to help patients with utility bills, food or rent. Call 1-800-227-2345.

• Avoid medical credit. Big-name lenders such as Chase, Citigroup and GE Money are pushing lines of credit and credit cards specifically to pay medical costs. Some hospitals and doctors get incentives for promoting the deals to patients, but these offers can come with penalties, high interest rates and other fees, according to Consumer Reports.

• Get insurance. If you want to buy individual insurance, and don’t have a preexisting condition, go to www.healthinsuranceinfo.net for information on your options and state insurance rules.

DISCLAIMER: The information and opinions expressed on this blog are not an endorsement or recommendation for any medical treatment, product or course of action by One For The Aging. For medical, legal or other advice, please consult appropriate professionals of your choice.




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