The National Craniofacial Association
P. O. Box 11082	* Chattanooga, TN 37401
800-	332-2373

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.

• Health Insurance
• Public Programs
• Private and non-profit agencies
• Other alternatives

Health Insurance
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.

Public Programs
There are a variety of federal and/or state funded programs that may be able to help your child receive the care he/she needs. A few are:

• Medicaid
• State Children's Health Insurance Program
• Maternal Health & Child Health Block Grants

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:  http://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.

Other Alternatives
There are several other things you can do to help pay for and/or reduce medical bills:

• 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
(800)332-2373
email: faces@faces-cranio.org
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
(202) 289-7661
Website: http://www.healthlaw.org
Provides extensive information on health care law affecting
families whose children have special healthcare needs.

Example of letter to write when your insurance company denies your claim.

Example of letter to write when you disagree with the amount the insurance company pays on your claim.

Example of letter to write to your state insurance commissioner to lodge a complaint against your insurance company.

Cleft Advocate
This website, 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
800-638-8255
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.

New England Serve
101 Tremont Street, Suite 812
Boston, MA 02108
(617) 574-9493
email: info@neserve.org
www.neserve.org/neserve/ptb.html
Visit the website or call to receive Paying the Bills: Tips for Families on Financing Health Care for Children with Special Needs. Excellent resource!

Hill Burton Act
http://www.hrsa.gov/gethealthcare/affordable/hillburton/compliance.html
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
(202) 471-3990
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
(800)532-5274
email: help@patientadvocate.org
website: www.patientadvocate.org
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.

Last modified on: Tuesday, February 08, 2011 04:38 PM

© Copyright 2006. FACES: The National Craniofacial Association. All rights reserved.