Finances 101: A Toolkit for YAs with Cancer (Medical Bills, Part One)

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Last month, we announced the launch of our new program, in partnership with Triage Cancer: a toolkit to help you, our young adult survivor community, make the best informed financial decisions you can so that you don’t find yourself drowning in bills and consequences for years after treatment.  We’ve previously addressed some of your most frequently asked questions about health insurance in a two part post (which you can find here and here), and now we’re tackling your questions about medical bills, with answers from the experts at Triage Cancer.

1. Often times I get multiple things in the mail for each doctor’s appointment and I don’t know how to deal with all of the paperwork and how to figure out what I am actually supposed to pay!

The amount of paperwork generated for each office visit may seem overwhelming. Here is a quick breakdown of the various things you may receive from your insurance company and your health care providers and what you need to do with each of them:

From your insurance company:

  • A letter letting you know that they have received a claim from your provider
  • A letter letting you know that they are processing your claim
  • An Explanation of Benefits (EOB), which details each claim and how much the provider charged for the particular service (e.g., x-ray), what the health insurance company is going to pay, and what you may owe the provider (often called the “patient responsibility.” You can generally identify an EOB because it will say “THIS IS NOT A BILL”

From your provider:

  • The bill with an amount that you are supposed to pay

You may not receive all of these things, but you should always get at least an EOB and a bill from your provider.  The tricky part is that sometimes, the bill from your provider comes before the EOB.   So, consider waiting to receive your EOB before paying your bill, to ensure that the bill is correct.  Once you have both documents, review them for accuracy.  Don’t be afraid to ask your provider to clarify codes or description of services, to make sure that you actually received all of the services for which you are being charged.

There are sometimes mistakes or discrepancies that, if corrected, could significantly reduce the amount you owe.  Also, sometimes you will hit your deductible or out-of-pocket maximum with that bill, and that would ultimately reduce the amount that you owe.  If you are concerned that you are going to miss the due date on the bill, while waiting for your EOB, you could contact your provider and let them know what is going on.  Most providers will be very understanding and will not penalize you for missing their due date.

If you have a large number of providers and bills, you may want to consider enlisting the help of a professional bill reviewer or medical claims organization.  One example of a company that might help is MedClaims Liaison. Also, the Alliance of Claims Assistance Professionals may be able to provide you with a reference to a claims assistance professional in your area.

Keeping track of all of this paperwork may seem overwhelming.  There are a few pre-made organizers that may be helpful.  For example, Cancer101 has a planner you can order.  But  any system that works for you is just fine.  Some people use a three-ring notebook or an accordion file folder, and some people scan everything and carry around electronic records on an iPad or computer.  Our suggestion is to find a system that works for you, and to stick with it.

In addition to medical bills and EOBs, keep track of pre-authorization documents, other communications with your insurers and providers, non-reimbursed or outstanding medical costs, meals, lodging, and travel expenses (including gas and parking) related to medical care, and long-distance phone calls related to medical care.  Some of these expenses can be paid for using a Flexible Spending Account (more information on FSAs can be found here) or be deductible on your federal taxes.

2. I am in school right now and only working part time.  I have health insurance, but my portion of the medical bills is still very high.  Is there anything I can do?

Generally, you should contact the provider’s billing department to go over any potential options before the bill is past due. Many hospitals and providers will work with you to reduce the amount of your bill or offer you a payment plan, to make the payments more manageable. Some providers will discount your bill if you can pay a portion in full.  Sometimes these options are based on financial need, so be prepared to provide tax returns and other financial information.

You may also want to review your health insurance policy to make sure that you have adequate coverage.  If you are under 26, is moving to your parent’s health insurance policy an option for you? If you have individual coverage, consider looking into your state’s Health Insurance Marketplace to see if there is a policy that would cover more of your health care costs and/or reduce your out-of-pocket costs.  Visit http://healthcare.gov for more information.

We hope you found this Q&A helpful! As we mentioned above, we’ll be doing a whole series of these posts on a variety of topics relevant to YAs and your financial recovery, so keep an eye out for more info heading your way.

Have feedback or comments? Feel free to email us at toolkit@thesamfund.org.

© Triage Cancer 2014. Please note that this information is designed to provide general information on the topics presented. It is provided with the understanding that the experts are not engaged in rendering any legal or professional services by its publication. The information provided should not be used as a substitute for professional services.

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