How do I pay the bills?
Dealing with the cost of medical treatment for your child can be overwhelming. The information below can help get you started.
There are several sources of funding available to cover the cost of medical care for your child.
Am I Alone?
No! There are many families and organizations who will be glad to talk with you and help you with information and support.
Private and group health insurance will usually pay at least part of the cost of treatment of craniofacial conditions. The following are important considerations when dealing with health insurance companies.
- Does your child have a specific diagnosis?
- Does your health insurance plan address your child's needs?
- Are there limitations on services?
- Are there waiting periods for pre-existing conditions?
- If you are involved with a managed care (HMO or PPO) organization, will they cover your child's doctors if they are not in the group?
Always request a copy of your health insurance policy, not the benefits summary brochure. The brochure is not specific enough.
Remember, the insurance company works for you. You pay them to provide a service. When dealing with the insurance company, be sure to:
- Get an 800 number; if they don't have one, ask them to call you back
- Everytime you call, write down the date, the name, position and telephone number of the person you spoke with, as well as what you discussed.
- Ask to be assigned a case manager from the insurance company. This person will act as your advocate through the insurance maze, as well as become more familiar with your child's condition, in an effort to speak on his or her behalf to the company decision-makers.
These programs are a good source of information. The following website is an excellent one that will take you to all of the programs available in your individual state: www.insurekidsnow.gov. They are required by the government to have "800" numbers. When dealing with public programs, be sure to:
- Get a written list of benefits, restrictions, and eligibility criteria
- Find someone within the program to help you through the process. Make him or her aware of your child's needs
- Get involved on the advisory board for the program; you will be able to more directly affect the program
- Get your legislator involved
Private and Non-profit Agencies
There are numerous private and non-profit agencies which may be able to help out. Many organizations deal only with a specific disability or illness. Some organizations in your community could be:
Shriner's Hospitals, Lions Clubs, Police Benevolent Associations, Civitan Clubs, Kiwanis Clubs, Sertoma Clubs, Churches, Rotary Clubs, and Junior League Organizations.
If they cannot help you, always ask if they can refer you to another organization who might be able to help.
Shriners Hospitals for Children-Cincinnati
All care at Shriners Hospitals for Children-Cincinnati is provided in a family-centered environment, regardless of a family’s ability to pay. One telephone call is all it takes to schedule an appointment: 866-206-2096. Families do not have be associated with a Shriner or Shrine organization to obtain care, nor is there an application process. Parents can call the toll-free number and answer a few medical history questions and schedule an appointment. A photo may be requested prior to scheduling to show the physician.
The UnitedHealthcare Children’s Foundation (UHCCF) is a 501(c)(3) charitable organization that provides medical grants to help children gain access to health-related services not covered, or not fully covered, by their parents’ commercial health insurance plan. www.uhccf.org
- Find out if your local hospital or health care center has a private endowment fund
- Itemize out-of-pocket medical expenses on your tax return
- Ask your employer to set up a health care reimbursement account
- Negotiate reduced payment with the hospital or doctors
- Identify disability related organizations in your community
- When applying for assistance, be sure to emphasize that your child's health needs affect the entire family
Finally, be proactive. Become an advocate for your child. Speak out; it is the only way in which health care reform will occur.
Am I Alone?
No! There are many families and organizations who will be glad to talk with you and help you with information and support. Don't forget books, videos, and even websites. Listed below are a few resources to get you started.
FACES: The National Craniofacial Association
P. O. Box 11082
Chattanooga, TN 37401
We provide financial support for non-medical expenses to patients traveling to a craniofacial center for treatment. Eligibility is based on financial and medical need. Resources include newsletters, information about craniofacial conditions, and networking opportunities.
National Health Law Program
1444 I Street NW, Suite 1105
Washington, DC 20005
Provides extensive information on health care law affecting families whose children have special healthcare needs.
This website, www.cleftadvocate.com, under the direction of Deb Oliver, focuses on a number of financial issues of cleft repair and treatment. She includes a number of example letters to assist parents in appealing insurance decisions, as well as to assist with state Medicaid issues. Most of the information on this website is very applicable to other craniofacial disorders and can provide excellent assistance to parents making their way through the insurance maze.
American Speech-Language-Hearing Association
2200 Research Blvd
Rockville, MD 20850
Click HERE for a checklist developed by this organization outlining how to approach an employer to request that health plan coverage for speech and hearing services be added or improved.
Hill Burton Act
This legislative act provides funds for indigent care at hospitals where federal monies were used for construction. The hospital admissions office has information on the availability of these funds and the guidelines for eligibility.
National Association of Insurance Commissioners
444 N. Capital Street NW Suite 701
Washington, D.C. 20001
Provides information on the Insurance Commissioner in your state. The state insurance commissioner is the governing body that regulates the insurance companies doing business in your state. This office can assist you in determining if your insurance company is following all the rules and regulations as set forth in your policy.
Patient Advocate Foundation
421 Butler Farm Road
Hampton, VA 23666
Patient Advocate Foundation is a national, non-profit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment, and preservation of their financial stability. Patient Advocate Foundation serves as an active liaison between patients and their insurer, employer and/or creditors to resolve insurance, job retention, and/or debt crisis matters relative to their diagnosis through case managers and attorneys.