Pain in the wallet: Affording back pain care

Chronic back pain often not only affects your physical health but also your financial health. Medical expenses and lost wages can impact your income and lifestyle and cause more stress and worry than dealing with your health problems. It’s easy to forget this fact when you are focused on immediate medical needs, but the sooner you give it some thought, the better prepared you will be.

Where money and back pain may meet

Financial problems may affect you a little or a lot, depending on:

  • Your financial health before developing chronic back pain

  • Your health insurance

  • Your ability to maintain your usual income

If you are financially healthy when illness intrudes in your life, you may be able to devote your energy to getting better, without many other worries. But if each paycheck is essential and there is no cushion to absorb extra costs in your budget, there are many important issues to consider.

Health insurance

A good health insurance plan will cover most of your medical expenses, leaving little for you to pay. If the insurance comes from your employer, it can be an important reason to continue working. Now is the time to learn your insurance details, the “small print” that you may never have looked at before. You may find surprises, like coverage for gym membership or weight loss programs, and discounts for non-traditional treatments like massage.

Get help understanding your insurance by calling their telephone number for customer service, and learn how to appeal a decision if they don’t pay a claim that you believe should be covered.

Keep receipts for “out of pocket” medical expenses, as some of them may be reimbursable by your health insurance or through a ‘cafeteria plan’ at work. Transportation to medical appointments may be used as part of the medical deduction on your income tax.

Applying for new health insurance

In 2010 President Obama signed legislation to overhaul the nation’s health care system and guarantee access to medical insurance for tens of millions of Americans. Since then there have been attempts to repeal this legislation in Congress. As of November 2011 the fate of the legislation is in the hands of U.S. Supreme Court.

You will find it challenging if you are not part of an employer group and need to find new health insurance. Each state has a state Insurance Commission that can help you learn about the health insurance policies that are available in your state. If you belong to a union or a professional organization, see if they offer a group plan. If you are a U.S. Veteran, remember that you have health care benefits through the Veteran’s Administration. Eligibility for enrollment in Medicare and Medicaid as a ‘disabled person’, the state and federal health insurance programs, depend on whether you can be “gainfully employed;” this is the government’s term for work leading to wages that meet specific guidelines.

Income maintenance

The best way to maintain your income is by continuing to work. If full-time work is no longer possible, you may be able to work fewer hours and still preserve your health insurance benefits. Talk with your employer about work reassignment to a job that is less physically demanding, or consider retraining for a more suitable position. With expanded access to the Internet, working from home for some companies is becoming more common.

Depending on your illness or injury, you may be eligible for worker’s compensation benefits or income from your disability insurance policy.

If you are unable to work, you may be eligible for a state or federal income maintenance program. State programs may cover workers with a temporary disability (less than a year), but federal programs require you to have a disability that prevents you from being “gainfully employed” for a year or more. Application for these programs, Social Security Disability Insurance (SS/DI) and Supplemental Security Income (SSI), is made through your local Social Security Administration office. The wait from application to acceptance for these programs can be many months. Once you are eligible, you may also be entitled to Medicare or Medicaid coverage.

Where to get help

This is a time to make good financial decisions: stay away from running up credit card debt or taking on additional high-interest loans. Develop a realistic budget, calculating your actual living expenses. See where you can cut back.

Don’t feel uncomfortable telling your health care providers that you need assistance; they can’t read your mind. They may have access to resources that you didn’t know existed, such as:

  • Financial counselors who specialize in helping people navigate health insurance and government programs

  • Pharmaceutical patient assistance programs that help patients get medication at lowered cost

  • Medical social workers who know a wide range of programs that can help

  • The United Way, which in many communities can help you find a non-profit consumer credit counseling agency

Summary

Managing your finances when you have chronic back pain is just like managing your health care: try to stay on top of the situation and actively seek out new information and new resources.

References

Patient Assistance Programs. (2008). Retrieved 11/14/2011 from www.needymeds.com

The United Way.  (2011). Retrieved 11/10/11 from United Way of America. https://apps.liveunited.org/myuw/