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Karina's Cancer Blog - Page 5


Surviving the Financial Costs of a Rare Cancer



I thought I'd write a post to share tips.

Everyone knows this disease is expensive. Here are tips we've used to deal with insurance companies and try to avoid going bankrupt over this cancer.

1.Case Manager. Get an insurance case manager. They're free and they'll help expedite insurance appeals, getting approval etc. if you need one. If you've been overbilled, you can also call 1 person every time and not have to start over with "I have this rare cancer.."

2.Insurance Appeals If you've been denied for a medication or procedure, you call them. Insurance companies usually give in on an appeal (I've heard 75%) - you just have to do it. They don't want you to die. They don't want to be sued either.

3. Ask to Pay in Installments  Almost every hospital will agree to let you pay off your bill in installments. We pay some off over 6 months - and other over one year (we have a high deductible plan). Sometimes you need to ask to have all the bills combined into one installment plan (e.g. if the doctors, radiologists, etc. are on different payment / billings systems). If you have a very high fee from a doctor who is out of network, call their office and ask if they're willing to accept a lower fee. Many are. 

4.Fundraisers  When a big event is coming up, think about a fundraiser and think about opening a charity account. People can donate into your account - it just makes it easier for them to do it. We set ours up at Bank of America. Because we give talks (learning issues, dyslexia), sometimes we waive our fee and donate speakers fees or products fees to our daughter's health fund. The advantage is it goes to the health bills and it is not taxed as income (it adds up).

5. Medical Tax Deduction - Used to be if medical bills add up to 7.5% of your income, this year it's 10% of your income (boo) - you can take this as a tax deduction. Do it! The costs really add up. Look at all that are allowable. This is the IRS page for 2009:
We add up mileage driving to doctors appointments (this may be airfare), up to $100 per night when away for medical treatment. Driving to the pharmacy, etc. Every year the reimbursement rate per mile for medical changes, so you have to look up how much you can deduct. Save all the costs and itemize in case you're ever audited. I keep track of everything with a very iPhone App - iExpense it and FYI Mileage. I keep track of both business expenses and medical expenses. I love these apps - it allows you to take a picture of the receipt and have the report emailed to you - so you don't have to keep everything in a shoebox.

6. Self-Employed    We are self-employed which can be another killer for medical costs - but we tried to help by buying our insurance through a broker who combines small groups like ours to get reasonable insurance rates through companies like Blue Cross. That's really helped. Another big tip I discovered only a few months ago was MERP and switching to a C corporation. We had been an S corporation, but switching to a C corporation helps out a lot. Because we have only 2 full time employees (my husband and I), we created a MERP (Medical Expense Reimbursement Plan) that covered full time employees. As a result, now medical and dental expenses not covered by insurance (like copays, deductibles, over-the-counter symptom medications etc) can be picked up by our business. The advantage to us is that the money we spend on medical is not part of our income tax. Not everything is deductible, so read the tax info carefully and consult with a CPA if necessary. We borrowed a Nolo book from the library - Home Business Tax Deductions - it's great.

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