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Tips for Hard Times

When the Health Care Crisis Gets Personal

As 2009 winds down, Michigan continues to struggle with a brutal economy. A national financial meltdown is a very personal struggle for many here in the state with the worst unemployment rate in 25 years.

The University of Michigan Comprehensive Cancer Center has seen a rise in the number of patients who are newly unemployed and overwhelmed by medical bills. Our team of oncology social workers and our new financial counselor, Linda Zywicki, put together some tips for coping.

If You Need a Safety Net, Use It

The sole purpose of public assistance is to help Americans in crisis. If you need help paying your medical bills, you may qualify for assistance, including Medicaid. For some, it can be difficult to admit they need financial help. "What greater justification does someone need to have besides acquiring a health-care crisis like cancer?" said social worker Chris Henrickson. "It's not your fault. It doesn't represent a failure on your part. You pay for these programs with your taxes, so that theyre available when you need them."

Don't Wait to Ask for Help

Resources may be available to help you pay your medical bills, but taking advantage of them can be tricky. Zywicki and Cancer Center social workers can help you navigate the daunting bureaucracy of public assistance, but it's key that you start the process early. Deadlines are non-negotiable. Also, many other forms of assistance -- such as the University of Michigan Charity Care Program -- require that you apply for Medicaid first.

Appoint a Financial Guru

Coping with cancer and its treatment is tough, so if you arent up to handling the financial aspects of your care, seek out a trusted family member or friend to help you. You will need to provide permission to allow this person to act on your behalf.

Get Organized

Keep records of your medical bills and all correspondence with insurance companies. If you speak with someone by phone, write down the name of the representative you talk to and take notes.

Read Your Mail

It can be easy to let mail pile up if you're not able to pay bills or you're too tired to deal with them. But if Medicaid requests further documentation and you miss the deadline for responding, your case may be closed and you may wind up owing more.

Go in Person

If your Medicaid caseworker isn't responding to you, go in person or send someone on your behalf. Some caseworkers are better at responding by e-mail; ask if that's an option.

If you Don't Understand a Bill or Letter . . .

. . . from your insurance company, bring it with you to your appointment. Talk with Zywicki on Level B-1 of the Cancer Center or ask to talk to your social worker. They can help you figure out your next step.

Be Nice

Never lose your cool with caseworkers or insurance representatives. "No matter how frustrated and angry you get, be nice, be patient and be understanding," said Dawnielle Morano, a Cancer Center social worker. "Remember, caseworkers are overwhelmed, too. But they can be key members of your health-care team if you work to develop healthy relationships with them."

Set Up a No-Interest Payment Plan

If you can't pay your medical bills in full, Zywicki can help you set up a payment plan. If you are disputing a bill with an insurance company, do the same thing. When the insurance company pays, you will be refunded what youve paidand in the meantime, you will avoid having your bill forwarded to a collection agency. "People always say, 'If I pay, I'll never get my money back,'" Zywicki said. "That's not true. My job is to help you to get it back in a timely manner. I'm your connection."

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Additional Resources:

• Ten tips for coping with the financial impact of cancer
  
  
• Cancer Center Financial Services
  
  
• How to budget
  
  
• Patient Advocate Foundation