Money talks: financing a catastrophic illness

THE movie John Q, starring Denzel Washington, dramatized it and we all may know somebody who has experienced it: a catastrophic illness without adequate insurance.

In the movie, a factory-working father learns that only a heart transplant--estimated to cost $250,000--will save his 10-year-old son's life. But his insurance policy only covers $20,000 of the cost and the hospital refuses to operate without at least a $75,000 down payment. The father ends up holding hospital emergency room patients and a heart surgeon hostage with a gun, demanding that his son's name go to the top of the transplant list.

The good news is that there are better ways to make sure you get the medical coverage you need.

First, carefully review your health insurance policy. If it doesn't provide coverage for your specific needs, find supplemental coverage to kick in when your primary policy is exhausted, says Roosevelt Haywood III, chairman of the National African-American Insurance Association, and president and CEO of an insurance company in Gary, Ind.

People who are underinsured with minimal insurance coverage should investigate other options, such as the reduced cost of care they can receive at a university hospital, says Dr. Gary R. Hill, assistant professor of medicine at Nova Southeastern University in Ft. Lauderdale, Fla.

The biggest drawback of being underinsured is not being refused care, but getting care and then having to pay the bill. "It can become as much of a burden as the disease process itself that was alleviated by treatment," Dr. Hill says.

Victoria Griffin made sure she had the salary and benefits she required before taking a new job as a malpractice claims adjuster for Fireman's Fund Interstate Insurance Co. in Chicago. She was offered a benefits package with medical, dental and vision benefits, and a 401K plan. Griffin, who was pregnant when she interviewed for the position, knew it was the company for her because after six weeks on the job, she would receive tax-free maternity-leave pay for eight weeks.

Like Griffin, you should make sure the limits of your policy cover your potential medical expenses. You also should find out how soon disability payments kick in, what percentage of your salary is covered if you're disabled for an extended period, how long you must be on the job to be eligible for health benefits, and if long-term managed care is included. Also consider flexibility in choosing a physician, the percentage of medical bills covered, the co-pay, prescription costs and deductibles, and whether preventative services such as a colonoscopy are covered.

5 Best ways to Save MONEY

1 FIRST, CAREFULLY review your health insurance policy thoroughly before you have an emergency.

2 MAKE SURE YOUR health plan covers your potential medical needs, including prescription drug coverage, well-care visits for yourself and your family, rehabilitative therapy and, most importantly, 24-hour emergency care.

3 MAKE SURE YOU choose a plan that promptly pays your bills.

4 INVESTIGATE supplemental coverage. People who are underinsured with minimal insurance coverage should take a look at other options.

5 IF FOR SOME REASON your claim is denied, ask for an explanation. If the problem isn't resolved, file a grievance with your health plan. A grievance committee could reverse the denial.

COPYRIGHT 2003 Johnson Publishing Co.
COPYRIGHT 2003 Gale Group