Page 60

Mended Little HeartGuide

Introduction Contents SECTION Read the Explanation of Benefits information you received from your insurance company to make sure that your coverage is correct and that valid procedures are not being denied. Sometimes, procedures and treatments get coded wrong and they are either denied or end up costing you much more than they should. If you have ANY questions, ask your insurance company. These real-life scenarios have saved families thousands of dollars. Knowing your insurance deductible (the limit on your out-of-pocket costs) will help you feel less stressed when bills start coming in because you will know that you can only owe up to that amount — even if it is a high amount. Your insurance company can assign you a case manager to help you manage your coverage. Often, you will get bills from different practices (cardiology, radiology, anesthesiology, etc.) within one hospital, which can be very confusing. Get help with this right away so that you understand all of the charges. If possible, make sure everyone treating your child is an in-network provider. If your child needs to be seen by an out-of-network provider, ask your insurance company what you need to do. Talk to the hospital staff and your insurance company to be sure you understand your financial responsibilities. Prescriptions Another medical expense is the cost of prescriptions for your child. Make sure you know which medications are covered and what your costs are. Some medications are very expensive, and you need to know this up front. Most pharmaceutical companies offer assistance to people who can’t afford medications, so ask your pharmacist or go online to see if help is available to you. Other Medical Costs Formula costs, monitor costs and other products your child may need are not covered by insurance. Ask your About My Child’s Heart Table of hospital social worker to recommend resources that can help you reduce or cover these costs. Some formula companies, for example, may have programs to help you pay for special formulas for your child. Your state’s Department of Health may also have information about options to help cover these costs. You may qualify for the Women, Infant and Children (WIC) program that will help cover infant formula cost. For more information, go to www.fns.usda.gov/wic/women-infants-and-children-wic. Waivers Waiver programs may be available to you, even if you are above the income level required to receive Social Security benefits. Some programs are provided for medically fragile children, regardless of income level. Contact your Department of Social Services or Department of Health and Human Services to find out which waivers are available for your family. Expenses at Home While you are at the hospital with your child, it feels like your whole world has changed. It’s hard to think about life as usual continuing outside the hospital walls, but it does. Unfortunately, your mortgage company, credit card companies and utility providers do not stop billing during this difficult time. Here are a few things that may help: • Make a list of bills that need to be paid and when they are due. If possible, set up automatic bill pay. • If you traveled unexpectedly for your child’s surgery, you probably did not arrange to have your mail checked. Ask a neighbor, friend or someone from your church to check your mail for you and to forward anything you may need during your family’s hospital stay. Go To 60


Mended Little HeartGuide
To see the actual publication please follow the link above