By Beth Witten, MSW, ACSW, LSCSW

A chronic illness can be a strain on you, the patient, and your family, not only emotionally and physically, but also financially. Help is available. There are several organizations willing to help you and your family cope with the financial obligations that come with treating a chronic illness.

The American Kidney Fund (AKF) provides limited help for drugs and provides help to pay for health insurance premiums if you apply and qualify. AKF also provides financial help for expenses that insurance will not cover, such as transportation, medications, special diet, kidney donor expenses and other treatment essentials. Some National Kidney Foundation (www.kidney.org) affiliates also offer limited financial help to meet day-to-day needs.

The HealthWell Foundation (www.healthwellfoundation.org) pays premiums or drug costs if you meet financial guidelines and have certain diagnoses, such as anemia of chronic kidney disease/kidney failure, secondary hyperparathyroidism, take immunosuppressants for an organ transplant or have any of the other conditions listed on its Web site. You may get help from pharmaceutical assistance programs. You can find a list of these at www.rxassist.org, www.needymeds.org or www.pparx.org. Some states have state operated kidney programs and some of these help with drugs.

Medicare Part D can help you afford your drugs even more -- especially if you have limited income and assets. If you have Medicare, you can join a Part D plan. If you qualify for “extra help” (also called low income subsidy), you may only need to pay a small co-pay, depending on your income and assets. Social Security accepts applications for extra help if you do not qualify automatically. If you have Medicaid, Medicare Savings Programs (called QMB, SLMB or QI), or SSI without Medicaid, you will get extra help without applying.

With Part D, the trick is choosing a plan that covers your drugs. If you can afford it, choose a plan that offers some coverage (at least generic drugs) during the coverage gap (also called the “doughnut hole” ). Part D will not allow standard plans to cover some drugs. Some states’ Medicaid agencies will pay for these drugs if you have Medicaid and Medicare Part D. You can have Part D and other drug coverage. If your drug coverage is through an employer, check with your employer to be sure that joining a Part D plan will not change your health plan coverage.

Log onto www.kidneydrugcoverage.org for more information about Part D, especially the Medicare and Part D 2007 Update which is in a Q&A format and the Compare Drug Plans Packet that are both linked from the home page.

For general information about financial resources to help pay for treatment, refer to Employment: A Kidney Patient’s Guide to Working and Paying for Treatment at www.lifeoptions.org/catalog/pdfs/booklets/employment.pdf and Taking Control: Money Matters for People with Chronic Kidney Disease at www.kidney.org/transplantation/transAction/resourcesFinancial.cfm. If you are considering or have a transplant, check out www.transplantliving.org/beforethetransplant/finance/finance.aspxfor information on financing before, during and after a transplant.

Finally, talk to your social worker who will know the national resources as well as those in your state and local community.

Beth Witten, MSW, ACSW, LSCSW, a renal social worker since 1978, has worked with the Medical Education Institute team since 1993 as a contributing writer, researcher, technical consultant, and community outreach expert.