Wednesday, September 17, 2014

Medical Expenses: My Tips for Paying Them Off

Medical bills... Those two words can make me break into a cold sweat. Prior to having Jaycee, I thought that as long as you had health insurance, you were fine. I found out that having insurance helps, but there are still deductibles, co-pays, and some things that simply aren't covered by insurance. Medications, doctor and specialists co-pays, emergency room co-pays, hotel stays related to hospital admissions, transports, it all adds up. In 8 years, I know for sure we have spent over $50,000 in medical expenses. At some point, I quit counting because it was just too depressing. So, believe me when I say that I know about medical expenses. So, here are things, I have learned over the years.

-First and foremost, know what is covered in your insurance plan! We found out early on that our insurance only pays for emergency room visits if the child was admitted to the hospital. Therefore, we try not to use the emergency room unless it truly can't wait until tomorrow. Emergency room care is expensive if you are stuck with the entire bill. Also, it's also important to find out who is in network with your insurance, since this will be significantly cheaper than out of network providers. You can usually find this information out all online now, so it makes it easier.

-Check if there is a discount. Sometimes hospitals will offer 10-20% off the bill if you pay within 30 days or less. Usually, this applies to larger balances like $500 or more. Almost always this discount offer will be marked on your bill or sometimes my bill will say "call for discount." Make the call if it says it because every dollar off counts.

-Often times, hospitals or larger home health or therapy services will provide financial assistance on what you owe. Sometimes, the hospital with advertise this information and sometimes they don't, so you have to ask.The times we have applied for financial assistance from a hospital, it has required lots of paperwork. They want to know your income, your expenses, a copy of your income tax return, how much money you have on hand, your assests, etc. It really is an overwhelming process that I think probably weeds out most people. But, by going through the long application process, it has helped us get 10-68% off of our bill.

I have learned that if your situation needs explaining, then add a letter to the financial assistance application explaining what needs to be explained in order to make your case for why you need help. If our income has changed significantly from our income tax, then I explain it. For instance, when my husband gets laid off from his job, I explain that. I list my daughter's medical conditions, and her monthly expenses in total for her medical care. If I have loyally used a hospital for years, then I tell them that too. Basically, in my letter I try to give any information that would explain why we need help and how Jaycee's medical conditions have affected our lives (i.e. missed work due to illness). I don't say anything that isn't true. I don't fudge the numbers. I simply present our case. Sometimes, we barely get anything knocked off our bill but sometimes it has really paid off!

-Ask for a payment plan when all else fails. If you can't get a discount or anything else, most hospitals or big offices are open to letting you make payments interest free. The larger the balance, the longer places will drag out the payments. Usually, they will offer something like a payoff by 2 months. I say I can't do it, and we bargain back and forth. Basically, the first offer they give you usually isn't the only one available. I usually try to ask for longer than I need just in case something comes up since it is interest free. Like, if I feel like I could pay off something in 6 months but they will go 8 months, then I will do the 8 months. You can never give them that information though. If they know you could pay it off in 6 months, then they are not going to stretch it out for your convenience. Again, if there's a income change or situational change that explains why I need to make payments, then I do that. If I'm on a payment plan, I make the payments on time every time. Sometimes, I pay them off early and sometimes I need the full time to pay it off. I have been told that they can take your account to a collections agency if you ever miss a payment, but I do not have first hand experience with this.

-The hardest people to deal with for us have been helicopter transport companies. They have NOT gone beyond two years of payments no matter how expensive the bill is and we are talking about thousands of dollars! The first time we got a $12,000 bill for Jaycee's first helicopter transport we were depressed, astounded, and perplexed. Really? It costs that much! And, we weren't the ones who ordered the helicopter transport yet we were stuck with this bill we were totally unprepared for. We have had two transport bills. They did give a small discount towards the end just to get our account closed. The second bill was taken care of by applying for state assistance, more on that in a minute. But the helicopter companies we have dealt with are not overly helpful or friendly.

Just fyi: There are medical helicopter insurance policies you can purchase for these situations. However, these would not benefit our situation with Jaycee. So, our best plan on helicopter transports is to avoid them, which we have done by transporting her ourselves using her monitor and home oxygen.

-Apply for state assistance. Our state has medical coverage for children based upon income guidelines. Normally, we don't qualify for anything. But, I have learned that we do qualify for something called a spend down program when our medical expenses are really high in a given month. So, the last time she got a helicopter transport, I applied for medical assistance the moment I got home from the hospital in preparation for the large bill. The only way to know if you are eligible is to apply. The first time I applied for help, I had mixed feelings about it but ultimately you have to do whatever you need to do to help your family.

-When your child is in the hospital, find hotels with a hospital discount. Some hospitals will tell you about hotels that work with their families, but they don't always know all of them. I have learned to call all the hotels around the hospital to see what their rates are. There may be a $15-30 difference between them. Of course, the hotels within walking distance or those offering breakfast are other factors to consider. Or, find out if there is a Ronald McDonald House near you. The times we have been offered to use the RM House has been when a long stay is anticipated for Jaycee. Usually, the social worker has referred us to the House and a room is offered if it's available. We have only used the Ronald McDonald House once when Jaycee was born. We paid a very small amount to stay there. We had a chore to do each day like empty the dishwasher or take out the trash. It was a nice place to stay but the one we were in wasn't private. You had to share a bathroom and you could only eat in the kitchen area. It was accommodating for families and really nice, but sometimes when you are stressed and upset, you just want a private hotel room to let your feelings go and dive into some cake!

-Let people know if you are seriously in a bind. People are usually helpful if they know there is a need. If people offer help, let them help. We've had everything from gift cards, cash, snacks, and free meals given to us during or after a hospital admission. Churches, individuals, friends, and family members are all people who have given to us, almost always without us asking. Sometimes, just telling someone that you're paying $120 a night for a hotel room will spring people into action.

-Consider using a 90 day prescription medication mail service. For me, I saved some significant money by ordering Jaycee's inhalers and other oral medications at a 90 day mail order prescription service. The biggest savings have been on the inhalers. However, when I've had a problem with the company sending the medication, it's been nearly impossible to correct it because I can't walk in some where and explain it. Instead, I have gotten the run around on the phone. So, while I have saved money with this 90 day service, I can't say I'm completely satisfied with the service.

-Time purchasing of medical equipment with deductibles and co-pays. As soon as our co-pays are met, I order Jaycee's bi-pap, oxygen saturation monitor probes, and nasal cannula supplies. Before the end of the year, I will make another order before all of my co-pays start over again. Certain supplies can only be ordered so many times a year or every so many months with our insurance, so I try to keep track of it.

All in all, the only way to make medical bills go away completely is to pay them off. There is no magical poof button that makes them disappear. But making small changes and investigating some options may help you save some money.

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