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In general, financial issues cannot be addressed adequately in one chapter of a medical consumer's book. Nonetheless, a few issues are discussed in this section to inform you, rather than advise you, about problems you may encounter.

Major points
Heres an encapsulation of some fairly prominent issues:
• Air travel for cancer patients and their families can be free. Organizations that can help with travel costs are described in Appendix A.
• It may be worthwhile to refinance your home mortgage for a lower interest rate.
If the current market rate for mortgages is significantly lower than yours, refinancing may reduce monthly payments, increase equity more rapidly, and ultimately reduce debt.
• Contact the Social Security Administration to see if you, your spouse, or your children are eligible for Supplemental Security Income. They can be reached by phone at (800) 772-1213 or on the web at http://www.ssa.gov. (551 differs from ssm, Social Security Disability Income.)
• Fundraising in your community or your place of employment can be a very effective way to address debts related to medical care. The Organ Transplant Fund, for example, provides sound help with raising funds for organ transplantation. See Appendix A for a list of other organizations that can help with financial issues.
• Estate planning always should be considered, even for seemingly small estates.
Some options, such as a supportive care trust or purchase of a whole-life insurance policy, may preserve some assets for yourself, your spouse, or your children-but may interfere seriously with your eligibility for Medicare. Estate planning is especially important if your spouse or a child has serious health problems of his own, requiring long-term financial support.
• A debt consolidation or home equity loan may be a useful device for reducing debt.

Bankruptcy
The two leading reasons for declaring bankruptcy are excessive medical expenses and credit card debt.

Declaring bankruptcy has changed from a last-ditch, unethical, and humiliating way to escape obligation to an honorable, if humble, effort to restructure or reschedule debt payment. Of the three forms of bankruptcy that individuals (as opposed to businesses and farmers) may use, only one, Chapter 7 bankruptcy, discharges the debtor of all debt. The others, Chapters 11 and 13, provide for a repayment plan in an hierarchical and agreed-upon way, eliminating or postponing foreclosure on your home or repossession of your car. Once you have declared bankruptcy, your creditors are forbidden by law from harassing or suing you.

Declaring bankruptcy still should be close to your last resort for solving financial problems and should always be done under the guidance of a professional financial advisor or bankruptcy attorney

Disability income
Several means are available to replace your income while you are disabled.

Social Security Disability Income (SSDI)
The Social Security Administration may grant disability benefits under the Social Security Disability Income (SSm) plan to replace lost income for an adult or to provide assistance with caring for a child with lung cancer.
To smooth the process of applying for Social Security Disability Income, take all medical records with you and let your doctors know you're applying, because they will need to give evidence.
If ssm is denied-and frequently it is denied on the first application-ask for Publication No. 05-10041, 'The Appeals Process." Sometimes just a request to have your case reviewed by the SSAs physicians will speed an approval.

In some cases, it's possible to return to work and continue to collect ssm benefits. This is possible because of special incentives the SSA provides to rehabilitate the disabled. The formula used to compute disability benefits while working is complex, but in general, you may attempt a trial work period of nine months, not necessarily consecutively, during which benefits are unchanged. If the trial does not succeed, benefits may continue. Ask the SSA for the publication called "Working While Disabled ... How We Can Help" (Pub. No. 05-10095).