Obtaining Future Medical and Cost Needs for Client -- How You Can Help

Fast, easy access to quality medical care is something we all would like to have every time we need it. But at times, this access can leave those of us most in need with unmanageable medical debt. One out of seven older Americans has reported that paying medical bills was either "very difficult" or used up all their savings. (Cathy Schoen, et al., Medicaid Beneficiaries: A Population at Risk, Commonwealth Fund (1998.)

Advocates representing elder clients with large medical bills should know that they have a range of powerful strategies at their disposal, including:

• Informal advocacy and negotiation
• Finding outside sources of funds to pay the medical debt.
• Debt prioritization strategies.
• Bankruptcy
• Potential affirmative claims under federal and state fair debt collection practices acts, state consumer protection acts, and other state laws.
• Raising consumer-related defenses if the client is sued over a medical debt.

Of course, these are just a few of the strategies for effectively assisting clients with excessive debt. In many situations the attorney's responsibilities don't end when a case has been settled. For a client with long-term disabilities an attorney is obliged to advise the client about the impact of the settlement on Medicaid eligibility, an essential resource for many clients with ongoing medical care needs and insufficient financial resources. Assistance can come through the use of a special needs trust for obtaining or keeping Medicaid coverage for medical costs.

Clients with disabilities – whether by illness, traumatic injury or otherwise – may have suffered severe financial and personal losses. They may have lost the ability to work for a living or perform daily living tasks without assistance. They may suffer significant depression, chronic pain and ill health. And your assistance in helping them obtain, protect and preserve all available financial resources for their future security is invaluable.

Some other tips:

• Clients who have large medical bills should look at their overall financial picture.
• Sometimes clients simply cannot afford to pay medical bills in addition to all their other bills. In that case, it is critical to make sure that clients do not simply forego payment of high priority bills, such as mortgages and car loans, in order to pay medical bills.
• The priority of a medical debt depends on a client's individual circumstances. A client may need to take non-financial factors into account, such as ability to obtain future care from a provider to which the client owes a debt.

Handling medical debt can be an exceedingly difficult issue. However appropriate strategies and proper planning can alleviate a great deal of the stress. Having as much knowledge before the case even begins helps reduce costs—both human and financial—now and in the future.