Medical debt is not a new concept to many of us and unfortunately, something we struggle with in this post-pandemic era. Included in this post are links to articles about how healthcare-related financial stress impacts patients and families. We also discuss what you can do to alleviate stress from medical debt so you can focus your efforts on being healthy
When it comes to health care, patients and families consistently rate financial stress as a top concern both during and after a diagnosis. Studies from The National Cancer Institute indicate that patients with significant financial burden report having a lower quality of life, which may come in the form of more symptoms (pain), poor mental health (depression), being unsatisfied with social activities and relationships, and worrying that their cancer may come back.
Let’s highlight some things you can do to help yourself or a family member reduce any current or upcoming bills:
- Purchase an adequate plan for your health situation. You can speak with your primary health care provider and assess your lifestyle to determine risk factors that may exist so that you can change your plan to expand coverage if appropriate. You can use this health insurance comparison worksheet.
- Understand your plan’s details, such as deductible, co-pay, and co-insurance amounts.
- Use in-network providers when possible and the out of pocket maximum to your benefit.
This article in Translational Behavioral Medicine details potential solutions that support reducing financial burdens as a component of quality care. One strategy is patient-centered discussions of cost at the time of making decisions about their care. This may not always be possible due to limited time during medical visits and lack of knowledge, resources or comfort of physicians to discuss cost with patients. However, it is always worth asking, especially if your provider is willing to help.
Questions to ask your provider about expected costs:
- How much is treatment and are their lower cost options that are as effective?
- What other providers or services will I be needing throughout this process and are they in-network?
- Can a portion of my bill be waived or written off.
You can also inquire about:
- Ability to pay programs, discount programs, or other financial assistance through a social worker or case manager within your health system or insurance company.
- Dollar For (https://dollarfor.org/debt-forgiveness/), a charity care program that helps patients check if they are eligible for financial assistance at their hospital, prepare and submit applications and eliminate medical bills for free.
Another strategy to alleviate financial burden is using financial navigation services. The above article reported a study of four hospitals in which financial navigators helped patients save around $30,000 per year each from free medications and premium assistance; around $12,000 through insurance optimization; and $900 on non-medical costs (transportation). The Cancer Team offers financial navigation as part of our oncology services.
As much as possible, consider the following to lower your bills prior to receiving care:
- Negotiate with providers, understand why and how necessary each recommendation is.
- Arrange independent lab work at alternate facilities or through direct-to-consumer lab testing companies.
- Look into Healthcare Blue Book, which provides fair market values of various tests and procedures.
- Consolidate follow up appointments, when possible.
- Inquire about less expensive or generic versions of treatments available.
- Obtain necessary prior authorization before procedures (imaging, surgery).
Other tips and resources:
- Wait for the Explanation of Benefits (insurance company sends this) before paying any bills and review them for accuracy.
- Keep a medical portfolio to track communication with providers, bills, test results and medical literature.
- Ask a navigator for support resources for non-medical costs such as transportation, child care, etc during medical visits or treatments.
- Ciitizen is a service that gathers all medical records for patients with certain conditions, which is helpful to make sure all of your providers can work together with the same information to guide appropriate treatment decisions.
Check out these guides on managing medical bills and tracking bills.