Medical Costs

I need a wheelchair. How can I get help to pay for it?

Medicare, Medicaid and private insurance plans may pay for assisting devices (such as wheelchairs, walkers, braces and splints) if they are a medical necessity. Ask your doctor to write a prescription for you for these items. Other possible sources of help in paying for equipment include your employer's charitable giving program, state vocational rehabilitation offices, the Department of Veterans Affairs, religious groups and civic organizations, such as the Kiwanis, Rotary and Shriners. Call your local chapter of the Arthritis Foundation to find out what may be available in your area.

What else can I do to cut down on medical costs?

Here are a few ideas:

• Find a doctor in whom you have confidence and stay with that doctor. Constantly changing doctors wastes time and money. 
   
• Ask your doctor for suggestions on ways you can save money on doctor visits, lab tests 
  and medications.
   
• When a doctor orders a test, ask why it is necessary. Keep records of previous tests to avoid costly repetition.
    
• If you are in doubt about a procedure, get a second opinion. The second opinion may cost extra, but it also may result in avoiding the procedure altogether. 

Housing

I want to stay in my home, but it needs to be modified because of my arthritis. 
How can I keep costs down?

If you can't do the work yourself, get bids from three contractors, compare prices and check their references. Do not pay for the work until it is completed. Call your local chapter of the Arthritis Foundation for contractor recommendations or for the names of volunteer groups that may do the work for free.

In general, the costs of changes made to your home for medical necessity may be deductible from your income when calculating your income taxes. Get a doctor's letter to document medical necessity and check with your tax advisor. 

Try these ideas for relatively inexpensive modifications to your home:

• Replace your doorknobs with levers, which do not require grasping and turning.
• Install rollout shelving in your cabinets.
• Lower closet racks.
• Raise electrical outlets and lower light switches to a height that is easier for you.
• Replace knob-type faucets in showers and sinks with levers. 
• Install raised toilet seats.
• Add ramp access to a low deck or sunken den.
• Install grab bars in hallways and bathrooms.
• Widen doorways.
• Add heavy-duty, nonslip flooring.

What if I live in an apartment?

Ask your property manager if there is a unit in your apartment complex that is handicapped-accessible, or if the apartment owner will modify your apartment for your disability. (Your state may require that a certain number of units in an apartment complex be accessible to people with disabilities.) If you decide to move, look for an apartment that has a sidewalk or elevator entrance instead of stairs, lever door handles instead of knobs, wider doorways, bathrooms with grab bars, and appliances and light switches that are easily reached. Your local housing authority or independent living center can guide you to apartment complexes that have these modifications.

I'm having trouble paying my rent. What can I do?

Call your local housing authority or human services agency and ask about subsidies to help low-income individuals pay for an apartment or house. With these programs, sometimes called "Section 8" programs, you pay a percentage of the rent based on your income, and the government pays the rest. Another idea is to find a roommate to share expenses.

Savings on Taxes

When filing your income taxes, keep the following options in mind:

• Earned Income Tax Credit. This credit reduces taxes for many low-income workers, and it may even give you a refund. You can claim this credit on Form 1040.
   
• Medical deduction. If you file an itemized tax return, you can deduct medical expenses that exceed 7.5 percent of your adjusted gross income. Save all bills and receipts for medications, parking fees to visit the doctor, gas and so on. Ask the doctor to write prescriptions for items that you need. For example, medications, splints, wheelchairs, medical appliances, special clothing or mattresses can all be tax deductible-if prescribed. If your car is adapted for medical reasons or if you've bought a walker, scooter or wheelchair, those expenses also may be deductible. Likewise, if you modify your house because of medical necessity, the cost may be deductible. You may want to consider consolidating these deductible expenses into a single tax year (calendar year), if possible, to maximize the benefit of this deduction.

Ideas for Cutting Everyday Expenses

Clipping coupons, shopping at garage sales and thrift stores, trading baby-sitting with friends and cutting out costly expenses such as premium cable channels, smoking or buying lottery tickets are tried-and-true ways of trimming everyday expenses.

In general, experts recommend that you compare prices at three places before buying anything-from prescription drugs to car insurance. Before you buy, ask yourself whether you need the item or just want it. You may be surprised at how many things fall into the "want" category.

What other ways can a person with arthritis save money?

If you are disabled because of your arthritis-and especially if you have a limited income-you may be able to take advantage of special programs that can save you money. Here are a few suggestions:

• Your city's bus system may provide free or discounted transportation for seniors or people with disabilities.
• Your local Red Cross may provide transportation to medical appointments. Visit their Web site at www.redcross.org, or call them at 202-639-3520.
• Your telephone company and gas and electric company may have special programs for seniors or people with disabilities. 
• Meals On Wheels delivers meals to homebound people of all ages. Look in the business section of the telephone book for the number of your local Meals On Wheels program or visit www.mealsonwheelsassn.org.
• Call your grocery store, pharmacy and department store to find out about home deliveries. Many department stores provide free "personal shoppers" who will gather items for you when you don't feel like shopping. You meet with the shopper, and then select the items you want to buy.
• If you are on Medicaid or Medicare, you may qualify for limited, at-home assistance with bathing, shopping and preparing meals.
• If you have long-term care insurance, check to see if the policy provides a benefit for home care.
• IBM has a program that provides discounted computers to people with disabilities. The Web address of the IBM Accessibility Center is www.ibm.com/able/.
• The National Patient Travel Helpline helps patients find discounted airfares or connect with an association of private pilots who fly people to and from medical appointments when they have no other way to get there. Call 800-296-1217 to learn more. Or visit their Web site at www.patienttravel.org. 
• WorldSHARE offers individuals packages of food at a substantial discount in exchange for a few hours of volunteer time. Call 619-544-2980 or visit their Web site at www.worldshare.org for information about a program in your area. WorldSHARE also has a discounted prescription drug service. Call 800-542-1110.
• The Time Dollar Institute is a volunteer "time bank" in which people exchange their 
  services. No money is involved. Instead, people bank time. For every hour of service they provide to others, they are entitled to withdraw an hour of someone else's time. For example, someone with arthritis might make phone calls for a few hours in exchange for a few hours of yard work that would be completed by another volunteer. Contact the Time Dollar Institute at 202-686-5200, or visit their Web site at www.timedollar.org, to learn if there is a program in your area.
• Your local Agency on Aging provides information about programs for seniors. Consult the yellow pages under "Senior Citizens Services" for nonprofit and for-profit organizations that can help. 
• Nonprofit independent living centers across the country provide a wide range of services to people with disabilities. Call your state's vocational rehabilitation office for an independent living center near you. You can find the telephone number in the government section of the telephone book. Or visit the Web site of the Independent Living Research Utilization, a program of The Institute for Rehabilitation and Research, at www.ilru.org for a directory of independent living centers in your state.
• The United Way is another source of information about programs in your community 
  for seniors, disabled persons and others. Visit their Web site at www.unitedway.org, or call 800-411-8929.
• The Arthritis Foundation can also point you to special programs in your area. Call 
  800-283-7800 or locate a chapter near you.

Cutting Costs on Prescription Drugs

©2001. National Endowment for Financial Education. All rights reserved.

Note: Certain content areas in this material are current as of the publishing, but legislative and regulatory changes as well as new developments may date this material over time. This content is meant to provide general financial information; it is not meant to be a substitute for or to supersede specific professional or legal advice.