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-- Programs and Services -- Contact Information What do you do when you can’t pay the bills?
By Margie Ware, Elder Services Regional SHINE Director
One of the most daunting issues confronting low and moderate income elders is how to deal with unexpected medical bills or “higher than my budget allows” healthcare costs. The natural human instinct is to panic. Following the panic, what seems easiest is to either throw the bills away or stuff them in a drawer. If it's out of sight, it's out of mind.
The problem is that today physician’s offices, hospitals, and other organizations are turning more quickly to collection agencies to support their billing procedures. From their point of view, the system of paying for healthcare has become so complex, and the army of administrators that they have to hire to deal with the paperwork becomes so overwhelming that they want to remove their offices from the issue as quickly as possible. However, the appearance of a “dunning notice” an aggressive overdue notice from a collection agency, sometimes within 60 or 90 days of the first due date, is enough to send a person into a full-blown anxiety attack.
So how can seniors plan ahead to deal with potential emergencies? First, if you do not have supplemental insurance to complement your Medicare coverage, consider purchasing the least expensive option, referred to as “core” insurance, at the next open enrollment opportunity. Core covers the 20% of physician’s services not covered by Medicare Part B. While it still leaves some gaps in one’s Medicare coverage, often those are gaps that moderate-income consumers do not have to be worried about.
If you can afford it and are a well-disciplined with only has occasional medical bills, you may want to create your own version of a “health care savings account.” Core insurance costs between $75 and $80 per month, or between $900 and $1,060 per year in premiums. Since the insurance is covering 20% of one’s doctor bills, the assumption is that the average ratepayer will have approximately $5,000 per year in medical bills. You may want to put $1,000 in a savings account on a monthly basis, automatically deducted from your Social Security or pension check. At the end of the year, if there’s something left over, you can take a friend to lunch, buy your grandchildren some new books, or take a cruise, depending on how healthy you are. This probably works on for the financially able and the well-disciplined. For many, the temptation to “borrow against” the health savings account for other “necessities” may be too tempting.
If you don’t have supplemental insurance or a health care savings account, and you receive a bill for your copay, the first thing you want to do is to sit down and write a check for whatever portion of the bill that you can handle. Physicians’ and therapists’ offices appreciate patients who make an effort to make payments on their accounts, even if the payment plan will extend over several months. Your act of good faith is the best guarantee of a good credit relationship with your provider.
Bills for the one day deductible on a hospital stay not covered by Medicare may be covered by the Uncompensated Care Pool. This is a state fund, which reimburses hospitals for costs for individuals who are low and moderate income and fall within certain guidelines. If you or a loved one is hospitalized and you anticipate that there will be a bill, speak to the Social Services office at the hospital about applying for assistance.
Until Medicare begins covering some prescription drug costs for all beneficiaries in January, many individuals will still have major problems meeting those requirements. If your income is between $10,000 and $20,000 you may qualify for a transitional assistance drug card or a patient assistance program through a pharmaceutical manufacturer.
The “gurus” for answers to questions are the SHINE counselors at your local Council on Aging and at Elder Services. We are entering an especially busy time over these next six months, so we would appreciate your calling ahead for an appointment if you need assistance. As always, we are at 800-544-5242 or 413-499-0524.