Before qualifying for Medicare, Deborah Rosenwinkel, who lives in Wheaton, Ill., and has rheumatoid arthritis, used the manufacturer’s discount card for Enbrel, a biologic that she injects at home once a week. time. The $12,000 card covers her deductibles and copays, while her individual policy collects a balance of up to $80,000 a year.
But when Rosenwinkel turned 65 last February and enrolled in Medicare, she was no longer eligible for the card. Even if the Medicare Part D plan covers Enbrel, the annual copays can be up to $7,000.
Ms. Rosenwinkel’s rheumatologist advised her to switch. Because the new drug is given every month in the doctor’s office, it is part of the Medicare Part B plan, which includes outpatient services. Medicare and her private Medigap plan cover the entire cost. “I haven’t received any bills yet,” she said. “I’m so grateful.”
Prices for wheelchairs, patient lifts, and other durable medical equipment can also be high. Medicare pays 80 percent if doctors and providers are enrolled in the plan. Disease-specific or local aging organizations can recommend nonprofit groups that offer free or discounted equipment.
Schwartz’s wheelchair is worth $30,000, with a $6,000 copay. But Medicare did not include a standing frame, which improves muscle and bone strength by allowing users to stand with support. To help pay for $15,000 worth of gear, he raised over $10,000 in a GoFundMe campaign.
Another source of financial help: tax breaks. Taxpayers can deduct medical expenses exceeds 7.5 percent of adjusted gross income. Among eligible expenses: drug costs, home improvements such as support bars, assisted living expenses, and medical equipment. To take advantage of the deduction, people with large medical bills should consider tapping into sources of taxable income, such as individual retirement accounts, Dr.
While dealing with his own physical and financial challenges, Mr. Schwartz helps raise money for others with multiple sclerosis. Over 10 years, first for the Myelin Repair Foundation and then for MS Society, he has performed six tandem sky jumps. He hopes to jump back in June.
“People say I’m awesome, and it’s great when people tell you how awesome you are,” he said.
https://www.nytimes.com/2022/01/14/business/chronic-illness-financial-planning.html Financial planning for people with chronic illnesses