One touchy subject of caregiving can be the financial aspects required by the patient. Some patient’s may be able to care for their own financial needs, bills and insurance debacles, but others may require varying levels of assistance. Most people prefer to keep their financial situation private. No one loves discussing their money issues, bills, liabilities, or lack thereof. This transition for some can be very uncomfortable and stressful. If you are able, consider having an attorney or financial planner help during this process. This trained assistance may reduce the family tension that may arise when different people want to do things their own way. Ensuring that the patient’s wants, and desires is the most important part of this process. Above all else, include your loved one and your patient in each decision and meeting made to discuss anything financially related.
Begin by making a list of financial assets and liabilities, all bank accounts, any Social Security information, certificates of deposit, stocks and bonds, real estate deeds, insurance plans and policies along with any annuities, retirement or pension funds, credit cards and other debts, mortgages and loans, and any other income related item. Keep detailed records on when money is coming in and from where, and when it is going out. You may need to establish a new bill system with the patient so you both can become aware and get used to the new routines. This might mean you will be added to banking accounts as a secondary so that you can help handle any issues that may arise.
There are many financial situations that may arise over the duration of helping your patient through their tough times. These tips and suggestions were compiled from other caregivers, doctors, nursing staff and hospital billing department agencies to help caregivers find and keep their footing. Here are tips in each category of the financial side of caregiving.
Insurance coverage
- Ask the insurance company to assign a case manager to the patient. This may give you a single point-of-contact for questions about coverage and out-of-plan benefits.
- Make sure you and the patient understand what treatments need to be pre-approved by the insurance company and get the necessary approvals.
- Keep detailed records when either you or the patient speaks with the insurance company. Write down: who you spoke to, what was said, and when you were in contact.
- Understand your co-pays and deductibles and keep track of them.
- If the insurance declines to pay for something, ask again. Often it takes several tries.
- Check out the state’s Health Insurance Assistance program.
- Find out if wigs are covered under the insurance plan. (Sometimes insurance companies will cover part or all the cost of a wig if a healthcare provider writes a prescription for a “hair prosthesis.”)
Hospital bills
- Check to be sure that medical bills are accurate. Billing errors happen. Call the hospital billing department if you have questions or concerns about charges.
- Arrange for a meeting with someone from the hospital’s billing department or talk to a hospital social worker about payment plans, reduced rates, “charity care,” or “indigent care” programs.
Prescription coverage
Out-of-pocket prescriptions costs can add up quickly, especially if the patient is taking an oral chemotherapy drug. Ask the oncology provider or the hospital’s patient services representative if the company that makes the patient’s chemotherapy has a “patient assistance plan” to help pay for it. You can also find out about prescription assistance plans by contacting your insurance agency or local health department for assistance.
Home healthcare
- Home healthcare services can cost a lot and are often not covered by insurance.
- Talk to a hospital discharge planner about home care options and expenses.
- Get help from a hospital social worker to figure out what services are needed and get help contacting a home healthcare agency.
- Check to see what the patient’s insurance covers, and what’s needed to qualify for coverage. For example, you may need a doctor’s prescription for home care.
- Check to see if there are state and federal medical assistance programs that can help.
- Compare different home healthcare agencies. Look at what each agency provides and the cost of their services.
- Look into borrowing home care equipment that’s not covered by insurance like a wheelchair, walker, or hospital bed.
Family financial planning
- Figure out your monthly expenses. Include rent or mortgage, phone and utility bills, transportation, insurance premiums, food, clothing, child-care and elder-care costs, medical expenses, any monthly loan payments, taxes, tuition, legal and accounting fees, and anything else.
- Prioritize your bills.
- Ask utility companies, such as gas, electric, and phone, about available assistance programs.
- Meet with a financial advisor to help plan for your family’s finances.
- Let your creditors know about your financial situation, if you are having trouble paying your bills.
- Look at possible Social Security and Pension benefits including compassionate allowances from the Social Security Administration. You might need to become the power-of-attorney to talk to others about the patient’s financial and health matters.
- Make sure you and other family members have healthcare coverage, and long-term care insurance.
Remember, giving up or letting go of one’s control of their own financial self is complicated and can cause undue stress for some patients. If your patient is struggling with worry and fear about having help with their finances, consider meeting with a financial planner so that the patient can have another voice on their side, working towards their goals and ultimately helping them to fully heal from their cancer treatment or illness.
Citations:
AARP
American Cancer Society
National Institutes of Health and Human Services