HOW
TO AVOID A MEDICAL FINANCIAL DISASTER
The
inability to pay mounting medical bills was the main cause for filing
nearly half of all personal bankruptcies in 2004, according to a
study recently released on February 11, 2005 by Harvard UniversityÕs
medical and law schools. So what can you do to avoid a financial
disaster due to medical expenses?
DonÕt
assume youÕre not vulnerable. Just because you have health insurance
doesnÕt mean youÕre not at financial risk. In a surprise finding,
the study learned that 76 percent of the households that filed for
bankruptcy because they couldnÕt pay their medical bills had health
insurance when their illnesses began.
In
fact, the study said the majority of the filers were middle-income
homeowners. The problem for many was that they lost their employer-provided
medical coverage when they lost their job due to the illness. With
no paycheck, and mounting medical bills, they frequently turned
to credit cards to try to keep themselves afloat, and eventually
they could never recover financially.
Try
to maintain coverage. Even if you lose your job, try to maintain
medical coverage. One option is COBRA, a federal program that requires
most employers to allow workers covered under group plans to continue
that coverage for up to 18 months after loss of employment.
The
downside is that the worker must pay the entire premium, plus administrative
costs, which can be very difficult if youÕve lost your job. The
upside is that it can keep major medical bills from piling up and
it requires your next employerÕs insurance company to cover you
regardless of pre-existing conditions—something an individual
policy probably wonÕt do.
Build
an emergency fund. One way to help pay the COBRA premium or high
co-pays and deductibles under current employer coverage is to have
an emergency cash reserve in place before a catastrophe strikes.
Build the reserve (to cover three to six months bare-bones living
expenses) through judicious budgeting and diverting any extra income.
DonÕt skip coverage.
Nearly a third of Americans under the age of 65 went without health
insurance for a part or all of the two-year period from 2002–2003,
according to Families USA (September 2004). Two-thirds of
them went six months or longer without coverage. Some households
truly canÕt afford their own coverage if itÕs not offered through
work, but others who can afford the coverage skip it just to Òsave
money.Ó DonÕt go without.
Know
your planÕs coverage. If your plan lists approved doctors and hospitals,
study it so there are no surprises later. Using providers not on
the approved list, for example, can significantly increase out-of-pocket
expenses.
Know
which services are and are not covered by you policy, and what the
lifetime limits are of the coverage. Talk to your human resources
department if necessary.
The
Harvard study found that unreimbursed medical bills often piled
up even for people with coverage due to high co-pays and deductibles,
and unreimbursed expenses such as prescription drugs and physical
therapy. The average out-of-pocket medical costs for those filing
for bankruptcy ran $11,854, according to the Harvard study. This
is where an emergency fund can make the difference between solvency
and bankruptcy.
DonÕt
be rejected. If the insurance company declines to pay for a particular
expense, appeal the decline, and be persistent.
DonÕt
automatically choose the Òcheapest plan.Ó It may leave serious gaps
in coverage and actually be more expensive in the long run. For
example, a plan with smaller co-pays and lower deductible or specific
coverage—even though the premiums are higher—may make
sense if you anticipate certain medical needs, such as starting
a family.
Use
flexible spending accounts. Employer-sponsored FSAs allow you to
contribute pre-tax dollars from your paycheck into an account to
later pay for co-pays, deductibles, and qualified medical expenses
not covered by insurance. The downside is that any money in the
FSA that you donÕt use during the year is forfeited, so you need
to conservatively estimate your anticipated expenses.
Coordinate
coverage. Spouses often carry separate coverage at work. It may
be less expensive to carry both under one plan, or at least be sure
the plans donÕt duplicate coverage. Otherwise, youÕre wasting dollars
you could stash in that emergency fund.
Improve
your health. While you canÕt always prevent a financially devastating
illness, you can reduce your chances of a serious medical problem
by staying healthy and minimizing risky behavior.
This article
was produced by the Consumer Affairs Dept. of The Financial Planning
Association and provided to you courtesy of Terry P. Welsh, CFP,
Ketchikan, Alaska. If you have any questions or concerns regarding
this, or any other financial topic, please call me at 1-907-225-0619,
or click on the "CONTACT US" button to arrange for a free initial
consultation.
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