Tag Archive for: financial help

Understanding Clinical Trials and Associated Cost and Mitigating Financial Stress

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Remember the law that passed 2 years ago that prevented medical debt of under $500 from hitting your credit report? That was good news for many people. That, however, doesn’t stop debt from actually happening while potentially compromising your financial future. Let’s take a look at medical debt in the United States and how it is distributed, and what can you do to mitigate the effects of medical debt.  

Clinical Trials: There are several ways to find a clinical trial. You can find them yourself or you can work with your health care team to identify a clinical trial that might be a good fit for you. Some of the resources available to help you find a clinical trial are: 

 It’s very important to talk with your healthcare provider as well as your insurance company to find out what they will pay and what labs, scans or other medical procedures will not be covered under the clinical trial. The Patient and Affordable Care Act requires most private insurance companies to cover the routine costs of your health care when you participate in a clinical trial. The routine costs include office visits, blood tests, and imaging scans that you would receive if you were getting the standard of care. Remember, your insurance company cannot drop your coverage or refuse to let you take part in the clinical trial.  Also, you need to be aware of other associated costs such as: Any research costs that are specific to the trial are not required to be paid for by your insurance company. Check with the trial administrator to see if they will cover these costs. If you are participating in a clinical trial that is out of network, your insurance company is not required to pay for the associated cost if they would not normally cover out-of- network providers. Some insurance carriers will pay at a lower rate, resulting in you having to pay more out-of-pocket. 

For other insurance providers such as government programs includingMedicare, military, and VA plans, different rules may apply. To review coverage go to: cancer.gov/about-cancer/treatment/clinical-trials/paying/federal-programs. 

If you are covered under Medicaid, Medicaid will cover your routine associated costs with the clinical trial. You cannot be denied coverage based on where the clinical trial is conducted or whether the provider is in or out of network. For more information go to: www.medicaid.gov  

  • Location of the trial, which may require additional costs for travel, parking, ground/air, lodging, food, etc. 
  • What is the time commitment and how will it impact your ability to work or care for your family if you need to take time off for an extended period of time, will you still be able to meet your financial obligations? 

What happens if your insurance company says no? 

 First, don’t give up. A large percentage of coverage requests and claims are paid on appeal.  

Again, you will need to file an appeal if your insurance company won’t pay treatment costs. You can contact the drug manufacturer or advocacy groups for assistance. Also, have your healthcare provider reach out to them as well. Your doctor can also file a letter with the appeal telling the insurance company about the benefits of the trial. They can include information about other insurances who have paid for the trial. 

If you need assistance with filing the appeal of your claim, go to: 

I have heard many times patients say, “I don’t want to take money from people who need it more than I do” when they are in situations where they really need it. Non-profit grants used to assist patients with the cost of co-pays, deductibles, insurance premiums, coinsurance, travel and many other needs already have been vetted for the patients they want to serve. If you qualify, then don’t hesitate to seek them out.  

Don’t forget to seek financial assistance from local organizations as well. A number that people seem to forget they can call 211 to inquire about local assistance programs. 

You all probably have heard or even know someone who has resorted to Go Fund Me to raise money to pay for medical bills. Go Fund me has become a standard resource for raising money to pay for medical needs. It’s unfortunate that the need is so great.   

As with many things, the people who are most harmed by the high costs of medical care are those who are already disparaged. Mainly people of color.  

Asking about your treatment options as well as the associated costs before participating in a trial, or getting treatment is key in advocating for yourself. And seeking out help understanding your insurance coverage as well as other available resources is the key to better and sustainable treatment as well as reducing financial stress.   

Sources:  

https://triagecancer.org

https://healthtree.org

https://www.medicaid.gov

https://www.patientadvocate.org 

Estate Planning: Secure Your Future, Protect Your Legacy

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Estate Planning is probably the least understood area of financial planning. It is also possibly one of the most important components of a solid financial plan. Many people think it is only for the rich, or it can be done later when you’re older. Neither of these are true or wise! There are many benefits to estate planning that are beneficial to you when you are alive.

Your estate is everything you own, minus everything you owe. Everyone has an estate! 

Estate Planning

Estate planning is a well thought out action plan you can use to determine what happens to your assets, such as house, car, savings, businesses, and other valuables as well as your obligations, (debt) while you are alive and after you die.

It is very common for even people with a lot of financial resources to not have any plan in place when they become sick or die. You’ve heard of celebrities like Prince or James Brown that have plenty of money but failed to plan. 

Therefore it is important for everyone to make sure that all of your resources are working, and that there are no gaps or weaknesses that will surface at the moment we need to be concentrating on other things such as your health and recovery. 

A Will 

This is one of your first lines of defense in estate planning. This is a legal document that outlines how assets are distributed, who takes care of children and pets, and other wishes you may have after you die. 

An Executor

An executor is a trusted person you appoint to manage your affairs after death. You should make sure this person is competent and able to manage these affairs as they can become quite complicated. Appearing in court, getting inventory evaluations, debt information collection, valuable papers, are only some of the responsibilities that are required of the executor, 

A Power of Attorney

Not only is it important to “get your affairs in order” in the event of death, but there are many estate planning tools to help you manage your finances while living. For example: A Medical Power or a General Power of Attorney.

A durable power of attorney can help you protect property in the event an individual becomes unable to handle financial matters. It also allows that person to authorize someone else to act on his or her behalf to do things like pay everyday expenses, collect benefits, watch over investments and file taxes. The power of attorney must be drawn up by an attorney. This is important. They will keep a copy on file. I would also suggest that the person you name is someone who has your best interests in mind as they will have access to your money. This person needs to be reliable, trustworthy and responsible. Taking the time to identify this person is imperative. 

A Living Trust

A living trust (also known as a revocable trust) is a separate legal entity that protects property and investments. It’s called a living trust because it’s meant to function while a person is alive. The Trust is controlled by the person who creates it, and they can change the terms, transfer money, transfer property in and out of the trust or end the trust altogether. That individual can also name a co-trustee, such as a financial institution or a loved one to manage the assets in case he or she is unable to do so. Do not wait until you are in a crisis to set up a living trust. 

Keep mind, there are many types of Trusts. Working with an Estate Attorney as well as a Financial Planner can help determine which one is right for you. 

An Advanced Medical Directive

An advanced medical directive lets others know what medical treatment is desired, and it establishes who will make medical decisions for the individual in the event they are unable to make decisions for themselves. Depending on what’s allowed by the state in which the person lives, this document may also include a living will, a durable power of attorney or healthcare, and a do-not-resuscitate order.

Planning Ahead

Planning ahead for these things will allow everyone to know in advance what you want. It will allow expenses to be paid without interruption and can give you peace of mind as to how you want to be medically cared for in the event you cannot make those decisions for yourself.

It is possible to make sure you have your assets titled in a way that can help you manage your assets both before and after your death. If you have a lot of assets and different kinds of assets, a financial plan can be your first line of defense in pulling everything together. You should make sure the person you appoint as executor or successor executor as well as appointing a guardian for minor children are aware of your requests and have access to your documents. 

Some estates are simple and others may be more complex, especially when you have blended families. I suggest talking to an estate attorney to give you direction. Planning now can save you thousands of dollars later. 

You can prepare your funeral request in a will. As well as many other considerations.

Imagine the peace of mind you and your family will have when you have prepared in advance. 

I know it isn’t an easy topic to dwell on, but making sure you have everything in order can save a lot of headache for you later and your family at your death. The financial and emotional cost of waiting is too high! 

Sources:

American Bar Association, Real Property, Trust and Estate Law Section: https://www.americanbar.org/groups/real_property_trust_estate/ 

Trust and Will: What is Estate Planning? Estate Planning Basics Patrick Hicks, Head of Legal, Trust & Will: https://trustandwill.com/learn/what-is-estate-planning 

Financial Fitness Workouts

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From PEN-Powered Activity Guide VIII: Supporting Your Support System

It seems every day we’re being bombarded with ways to stay fit. there is always a new fitness program or a new types of fitness equipment that’s supposed to give us the best bodies we can have. But with those who are dealing with a chronic illness, fitness takes on a different meaning. Not only do we need to feel our best physically, we also must be prepared in every aspect of our lives with your sight always set on your best possible treatment and your continuum of care.

I thought this would be a great time to review four of the most impactful areas you can review, reallocate, and make the changes that are most appropriate for your specific circumstance.

A good way to look at it is, in the fall we make sure we perform maintenance checkups or in our furnaces. We prepare our gardens and lawns for the upcoming spring, we check the exterior for homes for energy efficiency and we do checkups on our cars to prepare them for the winter season.

Unfortunately, few of us take the time to review the foundations of our financial lives that in fact dictate our ability to remain on treatment plans and meet all of our financial obligation. It is my hope, that everyone takes the opportunity to review at least these four areas that I’m covering in this article before the end of the year.

Medicare

First, the big one for a lot of us, Medicare. As you know the Medicare season is almost upon us. And there are changes as there are every year. If you are already a Medicare enrollee, this open enrollment period gives you the opportunity to make changes if needed. And if you have been enrolled for 12 months or less and you have a Medicare Advantage plan you even have the opportunity to replace it with a Supplemental plan perhaps with guarantee issue If you qualify. Here may be a wait period but you may not be able to get in at a later date and the coverage may be better for you.

Also, if you have an HMO plan you may be able to switch to a PPO for more plan flexibility. Review your Prescription formulary if there have been changes to your treatment. The worst thing you can do is to not review your Medicare options as there are changes every year and more plans may be available to you and the cost may be better as well. Don’t assume that the cheaper the premium the better off you are. Review your total cost. That includes the premium, co-pays, deductibles, coinsurance, and the cost of your meds as well.

Life Insurance

Secondly, review your life insurance plan. Many people aren’t aware of the benefits that insurance offers. Such as, accelerated benefit riders in the event you need access to some cash or the options of taking a loan from your policy.

Additionally, if you are still employed, on your next enrollment period with your employer see if you can add or increase your life insurance amounts. Even if you plan to retire or terminate your employment next year or at a later date the cost to take life insurance with your employer may be the only place you qualify without medical underwriting and it’s much cheaper. Also, see if your employer offer a supplemental life insurance that you can enroll in that may be portable at your termination from employment.

Review your credit to make sure there isn’t anything on it that’s incorrect. If you anticipate making a big purchase this will really affect your interest rate.

Monthly Statements

Third, as a financial advisor, I found a lot of clients would not look at their monthly statements to see how their retirement accounts such as 401k’s and investment accounts were doing. You are doing yourself a huge favor if you keep up with these no matter if the market is up or down. Speak to your financial advisor to make sure you’re taking advantage of growth, income producing, and tax efficient opportunities.

Financial Assistance

And finally, don’t assume you won’t qualify for financial assistance. The cost of treatment is expensive and probably always be. Talk to your doctor or social worker to help you uncover sources that can help you pay for co-pay, deductibles, coinsurance and other needs.

Do this before you find yourself in a financial crisis. Be proactive with understanding your illness and the anticipated change in treatments that may be available for you.

Instead of waiting for spring cleaning, take the time to do a financial review now. Go into the new year in the best possible position you can. And then, like getting a check-up on your car, do the same for your financial future every year. After all, you are worth more than a car!!