How to Shop on a Budget

Even when times are tough, your health and your waistline don’t have to suffer. Here are some tips to stretch your dollar.

1. Create a weekly menu.

Planning your meals ahead of time will keep you from making too many trips to the grocery store and eliminate the guesswork about what’s for dinner.

2. Make your list and stick to it!

With your weekly menu in hand, create a grocery list for essentials — and don’t stray from it!

3. Buy fruits and vegetables in season.

Many fruits and veggies are sold year-round but some may cost less when they’re in season.

4. Buy frozen or canned fruits and vegetables.

Buying fresh sometimes costs more, and it may not last as long. But your food will be tastier and healthier without the sodium and sugar that may be in canned or frozen products. Be sure to check the label and choose reduced/ sodium-free and no added sugar products.

5. Eat in.

Dining out can really make a dent in your wallet. You’ll control your cost, portion size and nutrition.

6. Buy in bulk.

You may save money by buying in bulk (if you need large quantities) or by stocking up on sale items.

7. Save for later.

If you have leftovers, freeze them so you’ll have another meal for later.

Power Finance Q&A

View the Power Finance Q&A to read answers by Shannon Nash to other’s financial questions.

Question 1

Name: Shannon
City, State: Aurora, CO

Hi Shannon,
My name is Shannon as well. Nice to meet you. My situation is really complicated, my life is a reality, not a fairytale. I had a job as a Customer Service Representative, I was a role model, team leader, until my dreams were shattered. I had a stroke and now I am homeless. I’m fighting for full custody for my kids, but since I had a stroke, it’s been very difficult. Here are my questions:

    1. Is there any compensation in the form of money, government benefits, and/or housing grants for disabilities for a stroke?
    2. Do I need a will or a trust since I had an illness or brain injury?
    3. How much money do I need to reserve to plan for a major illness of myself, family, kids, friends?
    4. Are there any differences in insurance coverage for stroke rehabilitation such as speech therapy and occupational therapy if they are not covered by Medicaid?

Response

Hi Shannon. Nice to meet another Shannon. Yes, you have a pretty complicated situation. I will try and answer as much as I can and hopefully get you some helpful options.

1. Is there any compensation in the form of money, government benefits, and/or housing grants for disabilities for a stroke?

Yes, there are Social Security Disability benefits available for stroke victims. Generally you will be eligible for this if you worked long enough and paid Social Security Taxes. You may also be eligible for Social Security Income (SSI). SSI is payable to disabled adults who have limited income and resources.

For more information about applying for these benefits visit the Social Security Administration’s website at http://www.ssa.gov/d&s1.htm.

2. Do I need a will or a trust since I had an illness or brain injury?

A Will is a legal document that allows you to decide how your assets get distributed after you die (such as the family Bible, car, etc. ). You can also determine who will get custody of your children.

A Trust is a document that puts all of your assets in a vehicle for the benefit of your beneficiaries. Thus, a Trust establishes how your assets will be distributed immediately upon your death (without going through the state probate process). But, a Trust does not cover who will be the personal guardian of your children – that is done in a Will.

Thus, if you have children or assets that you care about (meaning they are valuable to you but not necessarily that they are worth a lot of money), you should at least set-up a Will because without one, these decisions will be left to the discretion of your state.

Generally, people set-up a Trust when there are assets that they wish to protect. In this case, it doesn’t sound like there are many assets that you are concerned about, but assuming that there are you could set up a trust known as a special needs trust – meant to cover those with a disability. There are many rules around setting up these types of trusts, including a Medicaid rule that would actually still consider any assets you put in this trust as part of your “assets” for purposes of qualifying for Medicaid for 5 years from the date that you transfer them to the trust (called the 5-year look back rule). Thus, to set something like this up you should work with an expert (financial expert and trust attorney).

3. How much money do I need to reserve to plan for a major illness of myself, family, kids, friends?

In this economy, experts are recommending at least 6 to 9 months as an emergency fund. But this amount could be much more depending on things like your lifestyle, family responsibilities, severity of the major illness etc. What is important here is that you get in the habit of setting aside funds (no matter how small) every month. This habit will get you will on your way to saving an emergency fund.

4. Are there any differences in insurance coverage for stroke rehabilitation such as speech therapy and occupational therapy if they are not covered by Medicaid?

A Medigap policy is health insurance sold by private insurance companies to fill in the gaps that Medicare doesn’t cover. Also, there are supplemental policies that cover critical illnesses, including stokes. Many of these policies can be used to help with living expenses while you are unable to work. They also can be used to cover costs related to rehabilitation and nursing home costs. For more information see https://www.medicare.gov/.

But your ability to actually get such a policy is in flux given the current state of the new healthcare legislation. Prior to 2010, it would’ve been very difficult to get this type of insurance given your pre-existing condition. However, the new healthcare law in 2010 (Health Care and Education Reconciliation Act of 2010) will likely change some of these rules over the next couple of years. However, although these pending changes may allow you to be covered under such policies, the associated costs with getting this coverage may be prohibitive. We will have to wait and see.

Question 2

Name: Debbie
City, State: Glendale, AZ
My mother had a debilitating stroke last year. She refuses to sign a Power of Attorney. I am on her checking account. If she sells me her house, will that protect it from liquidation in case a nursing home is needed? She is currently on Medicare with supplemental Blue Cross Health Insurance.

Response

Your concern about your mother’s house is one shared by many who are concerned about losing the family’s greatest asset to cover a loved ones medical expenses.

Unfortunately, without the Power of Attorney, you will have to go to court to force your mother to in essence allow you to make this decision. In most states this would be a competency hearing and yes, you would basically be declaring that your mother is incompetent to make this decision due to her current state. If awarded you would be give conservatorship (guardianship in some states) over your mothers assets – you could decide what to do with them. I suggest that you tread lightly here. In addition to the family drama this may cause for you, the expense (hiring an attorney) and time involved may take a toll on you.

In addition, even if you are successful in getting the power of attorney, if your mother is looking to Medicaid to cover her long-term care, the value of the house may still be looked at. That’s because there is a 5-year look-back rule under Medicaid that may include the value of the house in her total assets for purposes of calculating her Medicaid eligibility.

It may be too late for your situation but for others reading this, one way to avoid this scenario is to look into a qualified Long Term Care policy before your loved one suffers a stroke (or other major illness).

Question 3

Name: Margaret
City, State: New Orleans, LA

I am the caretaker for my fiancé who suffered a moderate stroke in August, 2009. He had been and still is under severe credit card debt and is constantly worrying about how he will pay off these bills along with mounting medical bills since the stroke. He’s considered bankruptcy but has been advised to only do that as a very last resort. He is not working for now and on long term disability and awaiting a decision on social security disability. He has a home but is not the full owner as his mother still has half ownership of the house. Are there any suggestions or ideas that you can pass along to us to relieve this debt and worry?

Response

Bankruptcy is definitely a last resort option for him. It’s generally used to help avoid foreclosures, garnishments, etc. and can stay on your credit report for up to 10 years. It will not get rid of taxes, student loans, child support, or alimony and is not a good way to try and clean up your credit report (i.e., getting rid of too many credit cards). This will have the most negative impact on his credit and life and it’s not clear that he has reached this point.

You fiancé should consider working with a credit counselor. Credit counseling is a repayment plan whereby the counselors help negotiate new terms with your creditors. You will create a debt management plan based on your individual needs and your creditors. The counselor then work out the details with your creditors. This will take you out of the communication loop, and alleviate those collection agency calls. In short, credit counseling will help you restructure your existing debts and hopefully allow you to sleep better at night.

This is different than some of the Debt Consolidation companies where you take all of your debts and try and consolidate them into one debt (or in some cases one payment to the debt consolidation agency). In essence, you are taking out a new loan. Many of these debt consolidations (sometime operated by non-profit organizations) can result in you paying higher interest rates for this single loan, paying on debts that had in effect been closed and even paying multiple fees. Also, unlike with credit cards, which are unsecured loans (i.e., you miss a payment and it’s a ding on your credit report but you don’t lose any property), many of these loans are secured, meaning that if you miss your consolidated loan payment, you risk actually losing everything, including your house. In short, make sure you understand what you are getting in to if you go the debt consolidation route.

For more on credit counseling, make sure your work with a professional someone who belongs to National Foundation For Credit Counseling (www.nfcc.org). Also, check to make sure that they are accredited by the Council on Accreditation (www.coanet.org). Finally, he can start the dialogue himself with his credit card companies by going to www.helpwithmycredit.org. This is a site that is sponsored by the credit card companies and provides information and phone numbers to reach debt management counselors with you specific credit card company.

What Healthcare Reform Means for Stroke Patients

The American Heart Association/American Stroke Association believes the new health care reform law, the Patient Protection and Affordable Care Act, makes significant progress toward the Association’s core principles for meaningful health reform.

The Association has worked hard to make sure that the final law will make coverage more accessible, affordable, adequate and understandable for patients with heart disease and stroke. We will continue to work on these reforms in the months to come to ensure that implementation of health reform is successful and to build on these reforms in the years ahead. The law contains the following provisions that will benefit stroke patients and their families and those at-risk for stroke.

AHA Principles for Healthcare Reform

Health care will be more widely available

  • Stroke patients and others with pre-existing medical conditions will no longer be denied insurance coverage due to their health needs, beginning this year for children and in 2014 for adults.
  • Those who currently have health insurance coverage and like their plan will be able to keep it.
  • Those who are uninsured or who currently must rely on the expensive individual and small group markets will be able to buy the private health plan of their choice through a marketplace called an insurance exchange. The health insurance exchanges will provide consumers with the benefit of competitive, group insurance rates, beginning in 2014.
  • Doctors and their patients will decide what care is the right treatment – not insurance companies or the government.
  • In exchange for guaranteed, affordable coverage regardless of health status, individuals will be responsible for obtaining health insurance coverage – just like they are required to buy car insurance for their automobiles – beginning in 2014.

Health care will be more affordable

  • People, including stroke patients, will no longer be charged higher premiums because of their medical condition, gender, or occupation, beginning in 2014.
  • Lifetime and annual caps on essential medical benefits will be prohibited (beginning this year, lifetime caps will be prohibited; for annual caps, tight restrictions will begin this year, followed by a complete ban on their use in 2014).
  • There will be limits on out-of-pocket costs so that families are protected from bankruptcy, beginning in 2014.
  • Charging older people significantly higher premiums because of their age will be limited, beginning in 2014.
  • Tax credits based on financial need will be available to individuals and families with low and moderate-incomes who purchase coverage through an insurance exchange to help make insurance premiums affordable, beginning in 2014.
  • The smallest employers will receive tax breaks to help them provide affordable coverage to their employees beginning in 2010.

Health care coverage will be adequate

  • Consumers buying coverage through an exchange will be assured that essential health care services will be covered, including hospital care, ambulatory care, prescription drugs, preventive services, emergency care, and rehabilitative and habilitative services.
  • Preventive care will be fully covered by Medicare and new private health insurance plans with no cost sharing (beginning after September 23, 2010 for new private plans and on January 1, 2011 for Medicare).
  • The Medicare prescription drug “doughnut hole” will be narrowed immediately and completely closed by 2020.
  • Consumers will be given easily understandable information about their health insurance benefits and costs.
  • The law includes incentives to improve the quality of care delivered to stroke patients, including a greater emphasis on primary, preventive and coordinated care.

Financial Information for Stroke Caretakers

Caretakers often times do the “heavy lifting” when helping a loved one recover from a major illness such as a stroke. What would you do if you found yourself suddenly responsible for taking care of someone who had recently had a stroke?

Understanding the disease, taking care of the loved ones’ day-to-day needs and planning for their care in the future can be a little less overwhelming when you tackle each issue head on. Questions like the following will need to be dealt with fairly immediately:

Where are all of the important legal and financial papers?
How much money is in the stroke survivor’s bank account(s)?
What bills need to be paid and in what order?
Will the patient need in-home care? And if so, how much and for how long?
Has the employer of the stoke victim been contacted? Is there a plan for time off, benefits and/or workman’s compensation?
Does his/her health insurance coverage have a “cap?” At what point are you responsible?

Once the reality of the situation sinks in, the caretaker will need to address the following:

  • Consider paying for help – Some strokes are mild and won’t require help outside of the survivor’s family, but many times long-term rehabilitation is needed. If your loved one is returning home, outside help may alleviate some of your concerns.
  • Finding money – In addition to money from your loved one’s job and disability benefits, look into other sources such as the following to help pay bills: retirement plans, veteran’s benefits, life insurance, long-term care insurance, reverse mortgage, and personal property.
  • Paying bills – Make sure your loved one continues to pay his/her bills on time. Call creditors, utility companies and others to make them aware of the situation. Payment plans can often be created.
  • Spending plan – With limited income, and expenses likely increasing after a stroke, it’s important to develop a budget or a spending plan for your loved one. This will help to ensure that you know how much money your loved one has to live on every month.
  • Support groups for caretakers – Your local hospital will more than likely be able to refer you to a support group for people like you. The Internet is also another great resource for online support. Being a caretaker comes with its own emotional issues in addition to the financial realities. Receiving and giving support should be a top priority to help you deal with these responsibilities.
  • Online help – Harness the power of the Internet to find out more about the disease and how it affects the patient, you and other family members.

Stroke and Family Finances

A stroke, like any other major medical emergency, can have an enormous impact on family finances. Careful planning both before and after a stroke can help alleviate some of the pain inflicted on family finances.

According to a recent AARP study, 47 percent of respondents who suffered a serious illness stated that this event wreaked the most havoc on family finances. Moreover, 75 percent said they felt “overwhelmed” about their finances after a serious illness/disability. And the impact on family finances for women is even more devastating: 46 percent of women (compared to 17 percent of men) said that the death of a spouse had a very significant impact on their finances.

Whether the person having the stroke is the breadwinner, matriarch or dependent in the family, many financial issues face those charged with being the caretakers. You and your caregivers will be thrust into a world filled with new roles and responsibilities that will ultimately affect the lifestyle of the family.

Issues and questions like the following will arise:

  • What will your new budget/spending plan look like?
  • How are bills going to be paid?
  • What benefits are you eligible for?
  • Will you still get paid and/or when will your employer stop paying you?
  • Do you need to tap into retirement benefits/insurance policies?
  • Will living arrangements change? Do you need to live with a relative/friend? Will relatives move in with you?

For more information, see the Stroke Caretakers and What you can do to protect yourself and your family pages. Have a question/comment about stroke affecting your family finances? Ask the expert.

What You Can Do to Protect Yourself and Your Family

Planning for a major personal illness is critical for you and your loved ones. The following is a checklist of the areas you should focus on in setting up your plan.

Legal and Financial Documents

Being able to tell your caregivers where to locate your important financial documents and legal papers is crucial before you suffer a major illness. You should develop a document list that you give to the caregiver or to your advisor — attorney, accountant, financial planner, etc. Examples of important documents to include on the list:

  • Passwords and logins for all accounts, including online
  • Birth certificate, marriage certificate, social security card
  • Insurance paperwork and name/number of agent
  • Will, trust, power of attorney, healthcare proxy
  • Checking and savings account information
  • Credit card accounts and passcodes
  • Retirement accounts and other investments and assets
  • Tax returns
  • Mortgage paperwork, property deed and leases

Insurance

Make sure you understand your insurance coverage and your insurance options. The key is to buy the right type of insurance at the right time. Stay in close contact with your insurance agent so that he or she has a good understanding of your wants and needs as your family grows and changes over the years. Types of insurance to consider include:

  • Health insurance, comprehensive and supplemental
  • Disability insurance
  • Life insurance
  • Long-term care insurance

Estate Plan

One of the most important things anyone can do is to provide a clear directive for their family and loved ones in case of illness or death. Your estate plan states your wishes clearly and concisely. Estate plans can be simple or complex and are best made when the owner is healthy. Items you may wish to include in your estate plan include:

  • Will
  • Durable power of attorney
  • Healthcare proxy or living will
  • Trusts

Webinar: The Affordable Care Act and You

On October 15, the American Heart Association and the NAACP partnered together on a webinar about how the health care law, known as the Affordable Care Act or Obamacare, may benefit African-Americans.

The webinar featured presentations by Dr. Keith Churchwell and Dr. Rose Blackburne and a Q&A session” at the end.

Download the webinar (39 MB)

* Please note that this is a recording. Prompts to submit questions were only available for the live webinar. If you would like further information about the Affordable Care Act, please visit www.heartsforhealthcare.org.