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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Overview

When choosing a hospital, either for emergencies or for an elective procedure (one in which you have a choice about timing), choose the hospital that is best for your medical needs and best for you. In general the key is the quality of care -- not fancy lobbies or art on the walls. .

It is also advisable to pre-plan before entering a hospital. Focus on things to do before you enter the hospital, as well as entering a hospital through the front door on a voluntary basis or through the emergency room.

While in the hospital:

  • Participate actively in your care to make sure you maximize your stay, minimize medical errors and risk of infection, and save money.
  • Have a family member or friend with you as much of the time as possible to act as a patient advocate, to make sure you get the tests, treatments and drugs that are scheduled, and that people who touch you follow anti-infection guidelines.
  • Learn what each of the medical people who visit you do - and, if your insurance has a network, whether they are in your network. For instance, there may be a hospitalist - a doctor who works in hospital and coordinates care. 

Before being discharged, be sure to get a discharge plan.

Review your hospital bill even if you have insurance. Studies show that most hospital bills have errors - usually in the hospital's favor. If you have insurance, you may be responsible for "balance billing" - charges for out of network services. If you are, steps to take include reviewing the bill and negotiating. If you don't have insurance, there are tips for negotiating the bill. 

NOTE:

  • A hospital and the health care providers in it cannot discriminate against anyone because of their health condition.
  • You can bring your own drugs. If you take an expensve medication, it may be worth bringing it with you to the hospital. The drug must be in its original container with the original label.

For information about these subjects, see:

How To Maximize Your Stay In A Hospital Safely

It's easy to think that you are at the mercy of a hospital bureaucracy to give you what you need when you need it and to take all precautions to avoid medical error and infection. It's also easy to think that there is no need to keep track of the services you are provided in a hospital either because they are included in the basic charge or will be billed correctly by a computer It is also to think the bill is irrelevant because you are insured.

In fact, it is up to you to be sure you get what you need in a hospital, to do what you can to avoid medical error and getting unnecessary (potentially deadly) infections. It is also important to keep track of services provided because a large number of hospital bills are wrong - and you pay a large share even if you are insured.

Until you are feeling up to the task of taking care yourself, it is advisable to have a family member or friend with you to act as your advocate as much of the time as possible. You or your advocate must make your needs known and see that they are met.

The steps you and/or your patient advocate should take are described in the documents in How to Maximize Your Stay In A Hospital. In general, you and/or your advocate should:

  • Be informed about your health condition and treatments to be sure you are getting the treatment  you are supposed to be getting, when you are supposed to be getting it.
  • Learn who the various professionals are who treat you, and what each of their functions are. For example, a doctor known as a Hospitalist may be in charge of coordinating your medical care while in the hospital.
  • Be alert to what's going on.
  • Know your rights.
  • Be assertive. You can be assertive without being obnoxious.
  • Keep in mind that you do not have to be in pain.
  • Do what you can to help avoid unnecessary infection.
  • Keep track of treatments and services provided to you as they are provided.

If you have health insurance, do not rely on the hospital to check that all medical care providers are covered by your coverage. If your insurance only covers in-network doctors, it's up to you to be sure all medical personnel contract with your insurer. Otherwise, you may be stuck with the bill for that person's services. This is known as "Balance Billing." (There are steps you can take if you get billed under "Balance Billing.")

If you executed a Living Will or a Health Care Power of Attorney, ask a nurse to check to be sure they and the name of your health care proxy are noted in your chart. If you have executed a Do Not Resucscitate order (DNR), it should be prominently noted throughout your chart so everyone who is involved with you will see it. (It also helps to hang a DNR sign above your bed - even if it is handwritten).

NOTE:

  • You can keep family and friends to date easily through such alternatives as free web sites designed for that purpose or simple phone trees. (For more information, see How To Keep Family And Friends Up-To-Date)
  • Your right to receive visitors you designate has been extended in hospitals which receive money from Medicaid or Medicare to include a domestic partner - including a same-sex domestic partner, as well as spouses, family members and friends.

How To Review and Negotiate Your Hospital Bill

A large percentage of hospital bills contain errors. The overcharges average a lot of money.

It is advisable to check your hospital bill, even if you are insured. Studies indicate that the percentage of hospital bills with errors is well above 50%.  If you are covered by insurance or Medicare, you may be responsible for a deductible or a percentage of the bill.  Even if you are not required to make a payment, overcharges can use up your lifetime limit, especially if you have multiple hospitalizations.

You should not pay for the cost of fixing medical errors which occurred in the hospital. Likewise, you should not pay for preventable conditions either. Medicare no longer does. Neither should you. For example, Stage 3 or 4 bed sores (pressure ulcers) acquired after admission to a hospital.

To learn how to review a hospital bill, click here.

If you need help reviewing your bill, there are professional services available. Some bill review services only charge a percentage of the money they save you.

If you do not have insurance, or if your insurance doesn't cover a procedure or treatment, you can negotiate your bill. Hospitals and doctors are generally willing to negotiate.  At the least, try to have the bill lowered to the lowest amount paid by private insurance companies, Medicaid and Medicaid. 

To learn how to negotiate a hospital bill, click here.

NOTE: If you dispute a hospital bill, inform the billing department of the dispute. Explain that you are trying to sort out the bill and ask them to place the bill on hold. Otherwise, the clock starts ticking when they send you the bill. If the bill isn't paid within the time specified by the hospital (such as 60 or 90 days), the bill is likely sent to collection -- and that can hurt your credit score.

What To Do After Discharge From A Hospital

Take recovery seriously. Too many people end up back in the hospital because of pushing themselves beyond what is safe or for not paying attention when problems start.

Follow your doctor's discharge instructions.

Eat nourishing foods (they are not any more expensive than unhealthy foods).  

Be active.

  • Exercise if it is permitted. 
  • If there has been no discussion about rehabilitation ("rehab"), ask your doctor about rehabilitation. If you have health insurance, it is likely covered.

If problems start, report them to your doctor right away. A small infection that can easily be treated can become a major problem if untreated.

Ask for help if you need it. Family and friends are the first line of help. If more help is needed, speak with your doctor or his or her staff about getting additional help. (If you have insurance, help is likely covered.)  To learn about home health care, click here

Last, but not least, if you haven't reviewed your hospital bill, once you are feeling better but are still convalescing is a good time to do it - even if you are covered by health insurance. To learn more, click here. If you do not have insurance, or are under insured, a hospital bill can be negotiated. To learn more, click here.

Protections Against Discrimination

Doctors and Other Health Care Workers: The federal Americans With Disabilities Act (ADA) prohibits doctors and other health care workers from discriminating against a person because of a health condition.

This means that doctors and other health care providers cannot do the following:

  • Refuse to treat you
  • Treat you differently than other patients.
  • Provide a different or separate service or benefit than provided to other patients.
  • Use eligibility criteria that screen out or tend to screen out people with disabilities (unless the criteria are necessary).

A health care provider is not required to treat a person who is seeking or requires treatment or services outside the provider's area of expertise.

A doctor or other health care provider may lose his or her license to practice for refusing to treat people with a particular health condition.

In addition, doctors and other health care providers must provide reasonable accommodations if needed for people with disabilities.

If a health care provider discriminates against you because of your health condition:

  • You may go to court to enforce the law. You don't need to file an administrative claim first for this type of discrimination (unlike other sections such as employment discrimination). However, you can't receive an award for money damages.
  • The U.S. Attorney General and the Department of Justice are empowered to bring a civil suit. (You may also have a right to sue under the Federal Rehabilitation Act, state or local laws). To learn how to enforce the ADA, click here

Hospitals

The federal ADA also prohibits hospitals from discriminating against people because of a health condit ion.

If you are discriminated under this section of the ADA, you can sue, but cannot receive monetary damages. You can also request the U.S. Attorney General to investigate an alleged ADA violation. To learn more, click here.