First, get to know your financial counseling team

Many heart transplant families assume they have to go through the

administrative and financial confusion alone.

They don’t know that their transplant team might have a social worker or

financial counselor who can work with the family.

These counselors are qualified professionals who have worked with others

in your situation. If they don’t know the right answers, they know the right

questions to ask and where to go to find the answers.

Know Your Health Insurance Deductible Cost

A health insurance deductible is a payment that you have to make, out of

pocket, before the health insurance company will pay their portion. Most

private, employer-based health plans have some kind of deductible and a

monthly premium. (A premium is a monthly fee to keep the health

insurance coverage.)

What often happens is that families can manage the monthly premium.

But when a serious health issue arises, they may not realize they’ve

signed up for a health plan with a $5,000 deductible.

That creates sticker shock. But the deductible has to be paid before the

health plan will cover any heart transplant care.

Know Your Health Insurance Deductible Cost (cont)

There are several ways to cover a high health insurance deductible:

Save for it: Consider opening a health savings account so that the

deductible is not a surprise.

Fundraise: Sometimes, it takes a village. A fundraiser with your friends,

family, church or work could help meet this cost.

Grants and financial assistance programs: Talk to your hospital’s financial

counselor. She may know of grants or financial assistance programs

specifically for heart transplants costs.

Don’t Panic about Hospital Bills

Hospitals automatically send out bills. It’s common for these bills to make a

scary request – “Pay within 30 days.” Don’t panic. If making the payment is a

challenge, talk with your transplant team’s financial counselor. He can talk to

the billing office and ask the following questions…

Don’t Panic about Hospital Bills (cont)

- Is there a payment plan available?

- Can payments be deferred until a later date?

- Are there financial assistance programs that could cover the costs?

Different States Have Different Rules

Our heart transplant program draws patients from several surrounding

states: Wyoming, Colorado, Kansas, Missouri, Iowa, and North and South

Dakota.

Whether it’s disability benefits, Medicaid or private health insurance, every

state runs its various health insurance and financial assistance programs

differently.

Some will not cover procedures out of state. Or, if you go out of state,

benefits don’t kick in until later. Your home state also might have different

requirements than your hospital state. Don’t fret; find out, and go from there.

Different States Have Different Rules (cont)

Here’s how you can navigate the frontiers of having a transplant in one

state while living in another.

- Have your transplant team’s social worker or financial counselor dig

into the backend of how the various state programs work.

- Try to get a direct contact. If you’re calling your state’s social security

office, you don’t want to keep getting put on hold and going through

that same phone tree.

- Ask someone. If someone else in your state has had a procedure in

the state where your child is having a heart transplant, ask that person

what advice they’d give. What surprised them? And what do they wish

they’d known beforehand.

Factor In Travel Expenses

Speaking of traveling across state borders—or even just a few hours from

home—plan on paying out-of-pocket for the following:

Lodging: If you’re not able to drive back and forth to the hospital

Food: Most hospitals only provide food for the admitted patient, not visiting

family members

Gas and transportation: Staying at the hospital with your child may help

with gas and transportation expenses, but what about when you make trips

home to visit your other kids? Or when they come to visit the hospital?

Factor In Travel Expenses (cont)

To handle those non-medical expenses, rework your family’s budget and add

these costs in.

Also, ask your hospital if there are low-cost housing options for patient

families. At Children’s Omaha we have The Rainbow House, which offers

low-cost lodging to our heart families. If your hospital does have a housing

option, make sure you know the details involved, such as:

How far away do you have to live to qualify for housing?

How many people can stay with you?

Are there facilities for laundry and cooking?

You’re Not Alone

Again, your hospital’s social work or financial counseling team are a good

first stop to make sure that financial concerns are covered, so you can focus

on your child.

Don’t be shy. Find out early who can help you. You’re dealing with enough

as it is; let someone else dig for the answers to your questions. You’ll know

you’re not alone through the process.