Saturday, July 19, 2014

The C-Word: Staying Solvent When You're Sick

I've read a ton of books on treating and surviving cancer, interviewed 30 people who've survived cancer using alternative methods, a wealth of healers who have assisted people using western protocols or worked with people who chose to opt out.

But no one's ever mentioned money. Or how to deal with your finances when you are sick. Or, the harder one, I think - how to deal with your finances when you come out the other end.

If you are sick, here is crucial advice. PAY ATTENTION TO YOUR FINANCES. In the new age world, we say, things grow when they have attention. It's like a houseplant, if you water it and put it in the sun, it will grow. You don't have to have the answers, you just have to see what's what. (I admit that this is not my strength). Just start.

Talk to your doctor about the cost of your care. Only 19% of people do - because they are scared they won't get such good care. But the truth is, your doctor may be able to help reduce some of the costs, especially if you don't have insurance. I spoke to a doctor recently who told me that they often work with patients - and sometimes reduce the cost up to 75% depending on what they can afford. I have friends who have negotiated with the billing departments of hospitals and managed to get their bills down 50 to 75% or more.

The other thing I recently learned is that if your doctor is doing blood tests or labs, find out where he/she is sending them. The labs charge you separately and they are also willing to help you out, especially if your doctor is already making concessions. Try calling the lab and asking if they can get you the results for less. If they can't, ask the doctor - sometimes different labs and diagnostic centers - even right across the street from each other charge totally different prices. Again, another friend found out the lab where her son's blood was being sent was very expensive. She asked someone in billing at the hospital and was told to walk across the street. The first lab was charging $1300 for the results, the place across the street - which was not as pretty, admittedly, but just as accurate - was charging $350.

One of my friends said, "You should spend whatever it takes to heal your cancer, because what good will your money do you if you are dead?"

This is true. But if you live, what will you do if you can't afford it any more?

Unlike standard chemotherapy, radiation and surgery, which are generally covered by your health insurance, alternative care requires you to pay out of pocket right from the start. (One could argue that, if your health declines having chemotherapy, you will end having greater costs in the long run. Most insurance, brutally, will only cover you up to a point. But that's another story).

On the other hand, if you are self-employed or you lose your job while you are sick, you will need to clean up the financial tangle when you get well. In the current economy, that can take some time, so be patient with yourself. For me, it was useful to remember that having a lot of money doesn't make you a better person - or more of a success - though it may feel that way.

After a lot of leg work, I found two very kind financial advisors from Forest Hills Financial Group who gave me some insights. Daniel Hochler and Isaac Cohen both had experience with family members with cancer and other illnesses so they know how difficult it is to face both things at the same time. They will actually come to your home and try and make sense of your various bank accounts, insurance policies and debts.

Of course, the first piece of advice is what everyone hears - the best way to prevent a financial collapse when you have a major illness - is to have at least a years' worth living expenses of saved. Plan ahead. Sadly, that doesn't work for many people. But, if you have a family history of cancer, you might consider starting to save now. Isaac recommends you save 15% of your gross income.

My advice is - the minute you are diagnosed - you, and a friend who isn't judgmental, go through all of your paperwork and get an overview of your finances. (I mentioned lying in bed, waving to a paper bag full of unopened bills and crumpled receipts, and Isaac did say that was not the best way to start. So organize what you can, in a way that makes sense.)

You may be pleasantly surprised to see that when you get the big picture, it's not all that bad. Perhaps you have very little debt. Or perhaps you do have a lot of debt, but you have assets that you could liquidate (or sell). Issac suggests that you look at every possible asset you have.

When I was diagnosed, I had already been out of work for several months and my savings were gone.

So here are some things you can do, even when it feels like you have no options.

1. Life Insurance - Do you have permanent (not term) life insurance? What Isaac told me is that you may be able to sell the policy. You may also be able to take out a loan against it. Check to see if your insurance has disability coverage or long-term care coverage.

2. Retirement savings and 401(k) - do you have either of these? Again, you may be able to either withdraw some or all of it, or take a loan against them.

3. Mortgage, Credit Cards and Car Loans - call them and tell them what's going on. A lot of banks will actually give you a "forbearance" which means that your loan payments are deferred for some time. While this actually doesn't do you a lot of good - it does take the pressure off. If you can afford to keep your payments up, I suggest you do it, because when the forbearance period ends, you will suddenly have a lot on your plate again. But do call your banks and credit cards and tell them you are sick or recovering and they may be able to work with you. It's when you don't call them back that they start going a bit crazy. Also, keep records of all your phone calls - get the names of who you spoke to and when - just in case they don't keep their side of the bargain. You'd be surprised, with credit cards and car loans, you may have some negotiating room to lower your interest rate or find a lower pay-off amount.

4. Get a little help from your friends. I know a number of people who've used Indiegogo or other crowd funding sources to cover some of their extra expenses. There is a crowdsourcing especially for cancer patients called Give Forward. They have good advice, but I don't know if they have the reach of a Kickstarter. I was also amazed at how many of my friends gave me giftcards to Wholefoods or Organic restaurants. What is good is to get a friend who can be an intermediary so that when people call or email or facebook to ask how they can help, your friend can ask them to help pay a bill or donate a gift card to a juicebar or a grocery store.

5. Credit Rating. Make sure you look at this thing. It seems scary, but it's worth checking regularly when you are not well, because you don't know if there are any discrepancies. If you have a friend who wants to help, ask them to sit beside you on the bed and read things aloud to you. If there are discrepancies, your friend could write a letter on your behalf to correct them.

6. Get friends to help you contact these resources for cancer patients.  The only hard thing is that when you are not well or recovering, a cordless phone or a computer screen can make you feel sicker. So see if you have a healthy friend who can help you make the calls.

7. Cut back where you can. The minute you are diagnosed, find ways to trim your budget. Personally, I cancelled my newspaper subscription and reduced my cable to the minimum. I took my car out of the parking lot and parked on the street. I don't go to Starbucks anyway so that wasn't a problem. But find ways to cut back that won't affect your emotional state (remember, you need to feel good so you will get well). Buy your household supplies in bulk - send a friend to Costco or Sam's club. Send another friend to the farmer's market for fruits and vegetables. Eat home rather than eating out - which is wiser when your immune system is compromised.

8. Don't cut back on the stuff you NEED for your health, even your emotional health. If that means juice, acupuncture, energy work and organic food, try to find the best way to get that stuff. Especially, if you are still weak.

9. Get a financial advisor. If you have a bit of money saved, think about having someone advise you on the best way to organize your assets so that you will not come back to total devastation when you are well.

BUT BE CAREFUL - there are a lot of insurance salesmen who work for companies like AIG and Mass Mutual - they will try to convince you buy life insurance or put all your money into their annuities (from which they will make money) and often you can't get the money out in less than 10 years without enormous fees. I had a "friend" called Les Edwards who convinced me to sign all my savings to his control while I was dealing with a family emergency and it was very expensive and extremely stressful to untangle.

10. Your home. Unless you have a lot of help, I wouldn't recommend selling your home while you are ill or in recovery. You need a sanctuary and a safe place to be. If you have a place that you could move to, effortlessly, and people to help you in the process, that is another way to free some cash. If you live in an expensive rental - and again, you have help - you might move to a cheaper one. But this is really a last resort if you are not well.

11. Look at your car and homeowner's and other insurance. You might be able to greatly reduce your monthly premium payments by raising the deductible (this is what you would have to pay out-of-pocket if you have an accident, before the insurance payments kick in).

12. Wills and trusts. It's a good idea, early in your treatment, to make sure you have a will and everything in it is the way you want it. My suggestion is to do this not immediately after being diagnosed - when you are still in a panic and not thinking clearly - but once the details of your treatment have been decided and you have a little rhythm. You don't want to do it late in the treatment, because, especially if you are doing a conventional treatment, it can make you weak and too tired to think. Also, remember that the computer emits an EMF that is theorized to slow healing, so don't spend too much time on it when you are weak.

I had left everything I owned to my daughters, who were at that point, minors. What Isaac explained is that if I had passed away, everything would actually have gone to their fathers who were their adult next-of-kin. He told me that lots of divorced people did not want to leave their homes and property to their exes! Instead, he suggested I create a trust for the girls. Today, I would like leave everything to Sasha who is 21 and knowing that she is a very caring older sister, I would leave her to divide the assets with her younger sisters.

Issac reminded me that in the midst of the chaos, one needs to remember the kids. Make sure that they know that there is a plan in place so they will be looked after. If they are old enough to understand, get them involved in the financial planning, but don't make minors beneficiaries, because then their adult guardians will make the decisions for them.

If you run a business, create a transfer strategy to make sure your family is protected, no matter who your successor is. Review the ownership of the business and separate your assets.

Though once you get well, that's when things get really tough. At that point, your creditors and family members are often exhausted of trying to help you hold things together.

And in this economy, it's tough to pick up the pieces.

One idea is to contact Debtors Anonymous. They can help you not do what I did, which is not look at anything and hope that it would go away.

They have regular meetings and can help you organize the way you face your creditors.

In my case, in desperation, I called 311. They directed me to an NYC program called the Financial Empowerment Center.  A bright young woman called Elena actually looked through all my paperwork and created a spreadsheet with my monthly income and my costs. She also looked through my credit rating with me and helped me correct errors.

She recommended lawyers and tax accountants who did pro-bono work. Apparently, this is a nationwide intiative that is expanding. So if you are in the U.S.,  try contacting them.

However, WATCH OUT FOR PAID CREDIT COUNSELORS! There are lots of unsavory ones who make money off you and/or steal your identity and other horrid things. Try and find a government-initiated program or get a referral from a friend.

Just remember that money is not scary (I tell myself this), it is energy and numbers. Don't give it power over you. Like your body, it needs you to pay attention to it to stay healthy.

If you can survive a major illness, you can survive a major financial setback. Lots of people come back even stronger.

If you are a friend of a person recovering from an illness, offer to help with that stuff. You have no idea how long it takes to get back to normal.

And keep breathing. You will get there.

Please add any other ideas!