But April showers bring more than just May flowers. Spring is big allergy season for people across the country.

And, as the New York Times’ Patient Money column illustrates, there are some serious costs for what is often an annual ordeal.

Take these stats from the column:

• Two million missed school days each year
• $2.3 million in medical bills for children under 12

These numbers don’t include any expenses the parents have with treating their own allergies or missed income from taking days off for their or their children’s allergies.

So what can you do to save money?

The experts advise taking two courses of action:

1. Spend money on treatments that work.
2. Don’t spend on unproven, over-the-counter gimmicks.

So how do you know what works? Start with a doctor, potentially even an allergist. Before you go, check with your insurance to see if your visit’s covered. If it’s covered, it may be worth your time, and even if you have to pay out of pocket, the information they provide may be valuable.

An allergist can perform special tests to help you identify the items that make your nose twitch the most. Then, you can take simple steps to avoid these.

Second, your allergist may recommend a series of allergy shots to help you cope. The first year, these may cost $1,000 and then another $350 the second year, says the Times.

However, some experts say that this cost could save you in the long run. A few years of allergy shots may save you from missed work and annual treatment of allergy symptoms, including buying costly medications.

These same experts also recommend that buyers beware when it comes to over-the-counter products promising relief. These include: “air filters, humidifiers, dehumidifiers, ozone machines, mattress and pillow cases, special breathing masks and more.”

Continues the NYT:

“Many of these products are expensive and some are ineffective. Ozone, for instance, can be a pollutant and actually worsen allergies.”

These lower-cost treatments may seem attractive, but if there’s no return then you may want to reconsider even a small investment.

In many cases, allergies aren’t just seasonal, they’re certain. Instead of treating the symptoms, and shelling out for short-term care medical bills, you may want to speak with a specialist and get long-term, real help. Remember, preventive care is often less expensive treating the symptoms later.

The identity theft cases most frequently written about are those involving stolen credit card numbers, false charges and online phishing scams. But health care has become such a commodity, that many people are stealing or fabricating new identities to avoid medical debt.

According to NPR, here’s how it works: When arriving for care, people are providing false information, including their name, social security number and insurance info. In some cases, the patients are even providing fake or borrowed ID cards.

The patients then go on to receive treatment, and the medical bills are sent to elsewhere. One hospital in Missouri has seen four cases in the last 45 days, and is working on training their staff to spot potential fakes.

But the consequences of a false ID extends beyond bill payment, and could include some seriously harmful side effects.

If a doctor brings up another’s billing information they will also bring up another’s medical history. A patient’s medical history, including blood type, medications, and past conditions and treatments may all be incorrect. If a stolen identity is used again, from a record’s standpoint it may be as if the last doctor’s visit never happened.

In a worst case scenario, a patient could be given a dose of the wrong blood type, a medication they are allergic to, a medication that doesn’t mix with their current prescriptions or a previous ailment may be ignored completely. When dealing with medicine and health care, mistakes may end up in long-term harm or even death.

NPR says hospitals are working to crack down on such instances of medical identity theft, but experts say that consumers can do their part, too. Ask for printed copies of your treatments and records so you can ensure your history is correct.

The Daily News Online reports that St. John Medical Center is thinking of taking legal action against Cowlitz County for not paying the medical bills of county prisoners.

Cowlitz County, located just south of Seattle and Tacoma, is accused of releasing inmates just before or just after a visit to the hospital. Law states that the county is responsible for the medical treatment, including bill payment, of prisoners while under county care.

St. John’s routinely provides unpaid medical care to inmates, but is now trying to collect more than $100,000 in medical debt from instances where they claim the  county is responsible. From the report:

The hospital cited state law, which states inmate medical costs must be paid by the cities and counties responsible for operating the jail, unless the inmate is eligible for state Medicaid. The hospital attorneys also pointed to a New Jersey court ruling which says a jail cannot “avoid its duty to provide health care to a prisoner by prematurely terminating his prison term.”

The hospital then outlines instances where they say an inmate was released just so he or she could receive medical care, and then picked up again shortly after being released from the hospital. St. John’s cites medical bills of $81,500, $20,000 and $58,000.

The county contends that taxpayers shouldn’t pay such bills for inmates who are only in jail for short periods of time. The cost of an inmate’s visit to a hospital can get very high, because an officer needs to be stationed with the inmate for the duration of the stay.

The Daily News says there have been about 10 disputed inmate medical bills in the last year, none of the disagreements have gotten this heated.

Both sides claim the high cost of the medical care is a reason the other should pitch in, but complex laws about which part of the government – city, county or state – has true custody of a prisoner further complicated the matter.

A St. John’s spokesperson said his group provided more than $30 million in unpaid care for inmates in 2008 and 2009, and those costs are often passed on to all of the hospital’s patients.

So could your medical bills be higher because of such costs? There’s no way to tell for sure

But in many places, getting to a doctor is easier said than done. Many parts of the country are woefully under-served by doctors and other medical professionals. In some places patients may wait months to get an appointment. In others, the nearest doctor may be several hours drive away.

In Michigan, a state where the need for doctors who see Medicare patients and the under-insured is high, officials are taking important steps to increase medical care access for residents.

The Detroit Free Press has the details on the situation in a state where almost half of all licensed doctors plan to retire in the next decade.

The consequences of inadequate health care are well known to residents like Earl Williams., a 53-year-old who lost his health insurance when he lost his job. From the report:

“Earl Williams paid a dear price for trying to save money by stretching one month of prescription drugs into two.

His left eyelid drooped and then swelled shut. His left arm and leg got so wobbly he could “hardly walk, or hardly stand up.”

Despite this and other problems with blood pressure and prostate cancer, Williams said he had to stop seeing a neurologist. Skipping his medication and much needed visits could lead to emergency, which can be a strain on anyone and result in massive medical bills – even for folks with a job and insurance.

To bridge these gaps, Michigan is offering a host of incentives for doctors and potential doctors. The program includes:

• Grants and medical school loan repayment to doctors working in shortage areas
• Federal funding to improve health care facilities
• Better coordination to assign uninsured patients to a single doctor
• Programs to match students with training and jobs in shortage areas

However, many of these programs take time – and money – to take effect. Until they do, many people like Earl Williams may continue to struggle getting access to health care.

While still in the womb, doctors detected a rare heart defect in Josh that would require several complex and urgent surgeries. The surgery is uncommon, and the Lemacks family looked for more experienced surgeons outside of their regular care network.

Although they live in Virginia, the Lemacks found a skilled team in Philadelphia soon enough and were able to explore their coverage options with their insurance company, Anthem Blue Cross and Blue Shield of Virginia.

The two surgeries Josh needed, which involved reconstructing the aorta, still left him with only a 5 percent chance of survival.

There was elation and then there was heartache. From the story:

The initial surgery in 2003 was a success. But what the relieved parents didn’t realize was that their financial life would be drastically impaired. They ended up with $70,000 in doctors’ bills that their insurer, Anthem Blue Cross and Blue Shield of Virginia, refused to pay – even though it had approved the couple’s choice of surgeons. After the second surgery, they were responsible for $15,000 more. Debt collectors have been calling ever since.

The discrepancy came about because of what’s known as “balance billing.”

When a doctor, hospital or lab tech charges more for a procedure than an insurance company will pay, the patient will sometimes be stuck paying for the difference. This is a balance bill, and these medical bills can add up quick.

Most often this happens if you seek care with an out-of-network hospital or doctor where your insurance company hasn’t negotiated rates. But sometimes you may not have a choice. From the story:

For patients who voluntarily chose an independent caregiver over in-network options, the additional bills, while often unwelcome, are generally considered justifiable. But consumer advocates want the government to protect people who unwittingly end up out of network because of an emergency, such as when they are taken to the nearest hospital after a car crash; or who get an insurer’s permission to see a specialist out of network; or who were unknowingly treated by out-of-network doctors while at an in-network facility.

In the Lemacks case, they received care at an in-network hospital from an out-of-network doctor and his team. The family was still stuck with massive bills even though they did work up front, including obtaining letters and recommendations from doctors and the insurance company, to ensure they would be covered.

While the Lemacks were able to negotiate for reduced medical bills with some medical providers, they are still deep in medical debt. But there is a light at the end of the tunnel, and their son Josh is as happy and healthy as other children his age.

Both the state and the house legislative chambers approved a new measure that would make New Jersey the 14th state to allow for the legalization and use of medical marijuana. Gov. John Corzine has said he will sign the bill into law before he leaves office on Jan. 19.

The Star-Ledger reports that the bill passed easily, although there are some details left to be worked. Observers have also said that the law is more stringent than some states.

In New Jersey, the drug would be dispensed at licensed “alternative treatment centers,” and any caregivers collecting the drug for infirm patients will need to pass a criminal background check. Also, unlike other states, New Jersey law will not allow patients to grow their own pot.

It will be up to individual health insurance providers to set a standard for when marijuana is covered. In some states, such as California, the drug may be paid for by insurance companies in certain situations.

The New Jersey laws says that medical marijuana will only be available to patients if other drugs have not worked.

However, many medical marijuana advocates say that marijuana is more effective and less habit-forming than traditional prescription medication.

Specific illnesses that may be eligible for the drug under the new law include cancer, HIV/AIDS, glaucoma, multiple sclerosis, Lou Gehrig’s Disease, muscular dystrophy, Crohn’s disease and a host of diagnosis relating to muscle spasms and seizures. Marijuana may also be used in terminal illness situations.

For New Jersey residents with severe illness this could affect your medical bills. Health insurance coverage of medical marijuana usage will vary from plan to plan. Like any other drug, it will be up for the company to stipulate how and if they will compensate you.

However, in some cases, marijuana could be cheaper for patients that regularly need this type of medication.

And while a final bill hasn’t been passed yet, there is a good chance that it may be fully approved in early 2010. But what does this mean for you and your medical bills in the new year?

While many of the most dramatic changes won’t take place for three or four years, the St. Louis Post-Dispatch offers a glimpse possible medical bill relief that people could see this year if the bill is passed.

Most of the immediate medical bill relief would come for Medicare patients with high prescription drug bills.

Because different versions of the bill from the House and Senate have not been combined yet, it’s still too early to say exactly what could happen. But the bills do share some similarities, From the story:

• The prescription drug coverage gap could shrink by $500, and drug companies would have to reduce the prices for on brand name drugs for anyone in the gap.
• Coverage may be more easily available to sick people who can’t find health insurance.
• Children could stay under their parents coverage longer, possibly until the age of 27.
• Insurance companies may have more difficulty pulling your coverage. Instead of dropping you willy-nilly, they will only be able to rescind coverage in cases of fraud.

We’ll keep you posted as the legislation moves forward.

Last week, Meyer announced that he was stepping down due to health reasons. He has since changed his mind, and his future with the program is unclear as rumors about his health continue to swirl.

There has been speculation that the high-stress, high-profile demands of coaching and recruiting have caused Meyer to experience heart problems, dehydration, headaches and other stress-related symptoms, some of which could be become life-threatening.

While Meyer weighs returning to coach full-time with quitting or taking a lesser role, this is a good time to weight the stress costs of your current job.

Stress and Your Medical Bills

Many people see stress as just another part of their job. Even the best paying, most glamorous jobs come with their own stresses.

But these stresses can quickly take on a life of their own. According to WebMD, stress can result in:

• Headaches
• High blood pressure
• Stomach problems, including ulcers, heartburn and IBS
• Aggravated asthma
• Muscle and joint pain
• Weakened immune system

In other words, your stress could be making you sick, and it could lead to more visits to the doctor’s office.

So if you can lower your stress level you just may be able to lower your medical bills.

Lowering your work-related stress doesn’t necessarily mean quitting your job, but it may require you to find a better work-life balance.

Here are some tips on reducing your work-related stress and your medical debt.

• Don’t take work home with you. Leave the office at the office, wherever that office may be. Set hard rules for yourself about answering work calls or checking emails during off hours. If you need a moment to decompress after your day, build that time into your schedule.
• Take breaks. This includes regular breaks during you shift, and regular vacations. Regardless of what type of work you do, make sure you get some time away to clear your head.
• Don’t take your work vacation. And when you do get away, make sure you leave work at home.
• Find your stress relievers. Many people just come home, turn on the TV and zone out. While it’s nice to let your mind relax, this may not actually reduce your stress. For many people, to truly relieve stress they must engage in something. Maybe you take out some stress on a punching bag at the gym, or relax with a book and a latte at a local coffee shop. Whatever your stress reliever – be it playing music or video games – set aside specific time each week to engage in this activity

But proper chronic care, and how it can reduce health care costs, is more often overlooked.

Writing on the opinion page of the Atlanta Journal Constitution, Paul Serini takes a look at the health care cost issues in Georgia caused by insufficient care of chronic issues.

His analysis follows a similar path as arguments for better preventive care. He cites figures that show 75 percent of medicare spending is on chronic conditions.

While recurring conditions will naturally cost more than a one-time illness, he says that improved regular care – preventive-style check-ups, maintaining treatments and therapies – can limit the long term costs:

The harsh reality reflected in these numbers is that the nearly 79,000 Atlanta-area seniors in traditional Medicare with chronic conditions simply fall through the cracks that exist in the current program, suffering repeat admissions to the hospital and experiencing a frustrating and downward spiral of progressively poorer health and sky-rocketing medical costs.

While chronic conditions may require regular care and treatment, if you can stay on top of these then you are less likely to suffer larger costs.

For example, a regular prescription drug cost can quickly become a burden. But if skipping your medication causes problems you could end up in the hospital – escorted by a ride in the ambulance – that costs many more times the price of maintaining your prescription.

So while it may seem another tough item to balance in your budget, when it comes to managing medical bills you sometimes have to look long-term.

Earlier this year, as part of the stimulus package passed in Congress, the federal government helped unemployed workers pay for their health insurance under COBRA.

COBRA allows unemployed workers to get health care coverage, but they must pay for the full coverage, including what their employer formerly covered. The stimulus bill cut these costs by about 65 percent for workers laid off in 2008 and 2009, reports the AP.

But those benefits start running out today, and many people will face difficult choices about whether to continue their medical care benefits. The AP outlines the touch choices:

A report being released Tuesday by the advocacy group Families USA finds that, on average, unemployed families who lose the COBRA subsidy will see their premiums increase from $389 per month to $1,111 per month, an amount that few long-term unemployed families will be able to afford, the group says.

It finds that premiums of $1,111 would consume 83.4 percent of the average unemployment check, leaving little for food, housing, and other necessities. In nine states — Alabama, Alaska, Arizona, Delaware, Florida, Louisiana, Mississippi, South Carolina and Tennessee — COBRA costs would actually exceed unemployment benefits.

Talk about being stuck between a rock and a hard place.

While congress is considering extending the assistance, there is no plan currently in place. The COBRA help expires based on when it was claimed, and people will be responsible for the full costs starting this week.

Are any of you affected by these changes? Any plans on how to cope? The insurance is certainly expensive, but medical bills could be higher without insurance covering part of the cost. Difficult decisions, indeed.

Not only can pet medical bills climb into the thousands of dollars, often the pets and owners are equally deserving of real medical bill relief.

Take the case of Sage, as reported by KOAT7 Albuquerque. A 10-year-old border collie with a distinguished record of service, Sage has served proudly:

• At the Pentagon after the 9/11 attack
• In Iraq, searching for missing soldiers
• Along the Gulf Coast after hurricanes Katrina and Rita
• On the trail of Natalee Holloway in Aruba

Earlier this year doctors found cancerous tumors likely caused by toxins inhaled at diaster sites. The resulting surgeries and treatments cost thousands of dollars.

Sage’s owner, Diane Whestler, told the New Mexico TV station:

“There’s not a lot of glory, I guess, seen by finding human remains, but if you ask the families of the people who are missing and they want that closure, it’s important.”

Whestler said she is seeking donations to help pay for the treatment. Taking care of the medical bills of a loved one is a situation we can all identify with.

As she left a courthouse meeting with her estranged husband, a New Hampshire woman bit the court-appointed mediator.

A New Hampshire judged ordered the woman to pay more than $300 in medical bills for the bitten mediator, UPI reports.

Well, that’s one way to get your medical bills covered.

The debate over how health care reform should be handled has been raging for months – the Wall Street Journal calls the talks over the weekend “theatrical” even.

But after all the talk – much of which fell along party lines – a health care reform bill is moving onto the Senate. Detaisl of the bill from the WSJ:

The measure spends $1.05 trillion over a decade to provide health insurance to an additional 36 million Americans and creates a new public insurance plan by 2013. It requires most Americans to carry insurance, creates a new exchange where they can shop for it and gives the lowest earners tax credits to help them pay for it.

What do you think of this plan? The word out of the papers is that the plan won’t survive intact in the Senate, where Republicans, some Democrats and some Indepedents disagree with much of it. President Obama said he wants a bill by the end of the year, but this version narrowly passed the House and will face a more difficult road in the Senate.

What provisions do you think are absolute must-haves for the final health care bill? We’ve written on here before about the problems with “pre-existing conditions,” complicated billing and lack of real coverage for even the insured.

We’ll keep you posted as this bill moves along, and see if changes are really on the way, or if medical debt will continue to build up as before.

The Austin American-Statesman takes a look several cases where hospitals ignore a federal law stating that a living organ donor should not pay medical bills related to their donation and post-operation care.

The story starts with Philip Knisely. In 2008, Knisely donated one of his kidneys to a co-worker and father of three, Jose Vara. In weeks leading up to the surgery, Knisely was assured that, per federal law, he and his insurance company wouldn’t be billed. Those costs would go to the recipient’s insurance company or Medicare. Instead:

Knisely, a 53-year-old tax analyst for the state comptroller’s office, has received numerous notices that his insurance company was billed thousands of dollars by the hospital, doctors and other medical providers for treatment of post-surgery complications such as pancreatitis, an inflammation of the pancreas. Knisely said he also has been billed directly several times and has been contacted by a collection agency because he wouldn’t pay.

“I’ve been appalled about how this has been handled,” he said.

The American-Statesman outlines several other cases with similar outcomes. In some cases, a living organ donor has even been dropped by their insurance or denied care on the grounds that their donation constituted a “pre-existing condition.”

One woman in Texas who donated a part of her liver to her sister had to provide her insurance information to get pain medication. She later received a bill that should have gone to someone else. In many cases, the newspaper says, organ donors are paying out-of-pocket for bills they should not have received in the first place.

The advice of one of the organ donors: Take a notepad with you. This is good advice for anyone seeking medical help. Ask questions. Get treatment and billing information up front and in writing. Read your medical bills closely.

Serious medical debt can affect anyone, but there are laws in place to protect organ donors. Don’t get stuck with someone else’s bill.

You can take precautions. You can save and get insurance. But what if that’s not enough?

That’s the problem so many people face with their medical bills and medical debt. Even with medical insurance and a healthy savings plan, you could be put in a devestating spot if hit with tens of thousands of dollars in medical bills. Many people file Chapter 7 bankruptcy to help eliminate their medical bills.

But as details about new health care bills in Congress start to emerge, there are some encouraging signs, reports David Lightman for McClatchy newspapers.

Separate bills in the House and Senate would set a cap on annual out-of-pocket medical expenses. The limits, as they are in the bills now, would be around $5,000 for an individual and $10,000 for a family. Most medical costs would count towards this limit, says the story:

“Out-of-pocket expenses are expected to include co-payments for medical services and prescription drugs, deductibles and co-insurance.”

This type of regulation would be a welcome relief to people who find themselves owing tens of thousands of dollars in medical debt for reasons out of their control. Accidents and unexpected, unpreventable disease can ravage your financial life, too. And, sadly, insurance often doesn’t offer enough protection.

But, if the bills are passed as-is, everyone could get some protection. From the report:

“You get a lot of security for very little cost,” said Sen. Ron Wyden, D-Ore.

There are some loopholes, however. If you have a chronic or recurring disease you would most likely have to reach the maximum each year. Also, monthly premiums for insurance wouldn’t go towards the minimum cap, which means that the actual annual expense could still be upwards of $15,000 for some people.

The good news is these bills aren’t in their final stages yet, and you still have time to tell your elected officials how you feel.