Medical Professional Judgements for chronic illnesses

Paying for College
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<p>We just found out a few weeks ago that our child has a chronic disease. With all the deadlines coming up so soon, it doesn’t leave us very much time to figure things out. Also, because the child won’t have been diagnosed for all that long before the Financial Aid is given out and school starts, we already know that next year’s bills will be at least triple if not more than the bills we currently have ready to submit.</p>

<p>What are the chances that a school will factor in future medical expenses that will be incurred during the college years if a child has a chronic illness requiring daily meds, routine testing, and occasional hospital stays? </p>

<p>Do most schools only go by current expenses incurred the prior year? Or will they factor in the nature of the disease? Because 1 hospital stay last year versus 3 or 4 the next can make a huge difference in the bills. In a case where the bills may increase very quickly from what they were the year before, would a school reevaluate every year or factor this in from the beginning based on the nature of the disease? </p>

<p>Also, should you include information regarding the illness (explanations of what it is, how it progresses, etc.) to the school or only the medical bills when requesting the judgment?</p>

<p>I know this will vary from school to school. But does anyone have any experience with this type of situation? Any general idea of how things usually work on average? Any tips in general on applying for medical professional judgments would be appreciated.</p>

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<p>I don’t think they will factor in future medical expenses, just past ones, for the same reason you mention - 1 hospital stay vs. 3 or 4 can make a huge difference. You can ask the school for a professional judgment adjustment.</p>

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<p>You do have to reapply for financial aid each year though. So if next year your medical bills are higher you can ask them to consider them, but not all schools will. Also from what I understand they will only consider bills that you have already paid. So bills that have not yet been paid or future expenses would not be considered.</p>

<p>It also is not a dollar for dollar adjustment. For example if you have paid $20,000 in medical bills that does not mean they will increase the FA by $20,000, they may only increase FA by $1000.</p>

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<p>keep in mind that professional judgement will only take into consideration unreimbursed medical bills.</p>

5

<p>I know that the general formula is to add up the bills not covered by insurance and then subtract the amount already alloted by FinAid (I think its 11%) and then they try to give you somewhere close to the difference. </p>

<p>My issue is that when its time to file the FAFSA in January which if I understand right is the same time you file for the judgement, we will only have 1.5 months of medical bills and expenses available to sumbit. Since she was just diagnosed. </p>

<p>However this isn’t a one time type of medical emergency. There are 12 months in the year, and these monthly expenses are not going away. We will be paying the same amount out of pocket every month plus routine testing and possibly more hospital stays. I know a school can’t really factor in possible hspital stays, but prescription costs and routine monthly tests should remain about the same. </p>

<p>If she had been diagnosed last year, we would have had a whole years worth of bills to submitt which would have been a more accurate indicator of what our medical expenses will be next year. 1.5 months is not accurate at all as to what we will be spending on her bills next year. 1 months out of pocket expenses times 12 would be a better indicator. </p>

<p>Has anyone else run into this issue? Anyone with a child who developed a serious medical condition after their applications were already submitted? Its sort of a catch 22. She didn’t get to mark her applications that she has a disability, and the high costs aren’t going to register on paper for the 2011 year.</p>

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<p>What type of school will she be attending? I think the very generous aid schools (read top colleges) will be the most willing to work with you in advance of the expenses. The more typical colleges, who may or may not even help, would more likely expect you to show that year of expenses before they will even talk about it.</p>

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<p>My older Ds school met 100% of need & required PROFILE as well as their own forms.
We had medical expenses outside of the usual but as far as I could tell, they considered those in that they gave D package which was weighted with a grant as well as subsidized loans, but they did not go below our FAFSA EFC.</p>

<p>We also had reduced income after she began college & while we knew ahead of time, they couldn’t adjust it, until we actually had the paystubs in our hand showing lowered income.</p>

<p>Since your daughter isn’t attending yet- I couldn’t guess how accurate the aid depts predictions will be in how they will interpret the anticipated expenses.</p>

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<p>librogirl, you are correct in your assessment of how it works. You can request a professional judgment review, but it may or may not make any difference. If you add up the expected monthly costs that you know of for sure, apply the formula. The costs outslde of the 11% would be subtracted from AGI and the taxes would be refigured. That is how the medical costs generally come into play. It may not make a big difference in your EFC, as the EFC is not directly adjusted.</p>

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<p>Most schools require you to submit tax forms documenting that you have taken medical expenses as a deduction - that indicates it is a certain percentage of your adjusted gross income. This is what we have to do. If we don’t meet that, we have to figure out what medical expenses were not covered by insurance and submit all of that to the college. Through a discussion and the above information we did receive an additional grant for freshman year. Now each year, we submit a letter and financials and we receive a grant, but it does not come any where close to the expenses. Good luck.</p>

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<p>*If she had been diagnosed last year, we would have had a whole years worth of bills to submitt which would have been a more accurate indicator of what our medical expenses will be next year. 1.5 months is not accurate at all as to what we will be spending on her bills next year. 1 months out of pocket expenses times 12 would be a better indicator. </p>

<p>Has anyone else run into this issue? Anyone with a child who developed a serious medical condition after their applications were already submitted? Its sort of a catch 22. She didn’t get to mark her applications that she has a disability, and the high costs aren’t going to register on paper for the 2011 year. *</p>

<p>You mention FAFSA, not CSS Profile. Does that mean that your child is applying to FAFSA-only schools? If so, the situation may be moot. If the schools don’t “meet need” anyway, then you may be expected to pay a lot more than your EFC.</p>

<p>You’re new to CC, so we don’t know if you understand how FA works. Most schools do NOT have much aid to give. Most schools expect you to pay MORE than your EFC. </p>

<p>What schools did your D apply to? </p>

<p>What state are you in?</p>

<p>Since life isn’t fair, and you’re concerned about aid, is your D going to apply to any schools where she’d get a lot of merit scholarship money for her stats? If not, she should.</p>

<p>I’m not sure that having a chronic illness is the same as having a disability. My sister has had a chronic illness since age 10 (and has had two transplants) and she’s not considered to be disabled. </p>

<p>P.S. Are you saying that your D will likely be hospitalized several times per year for the rest of her life? If so, will she even be able to realistically do well in college?</p>

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<p>Thanks everone for all the info.</p>

<p>Waverly - she is looking at mostly smaller private schools with good Education and Foreign Languages programs in the southeast and 1 larger state school, Auburn, but she would be out of state there.</p>

<p>She has good grades (mostly A’s, a few unweighted B’s in a couple of her AP classes) and decent ACT and SAT scores (but not perfect), takes AP and Honors classes, is editor of the year book, president of some honor something English maybe and active in other clubs, but she’s not going to end up Valedictorian, isn’t a minority, and doesn’t play sports, so that makes her pobably around the average type of student these schools are looking for, maybe a litle above. With the exception of her being sick this year and in the hospital and still maintaining all A’s, she doesn’t really have anything that sets her apart from all the other overachieving A/B prep school students out there. </p>

<p>emeraldkity4 - What do you mean by “PROFILE” is that unique to the school you applied to? I have never heard of that? Is it something I should know about?</p>

<p>kelsmom l - that’s what I’m trying to figure out. Will they factor in that she was only diagnosed about a month before the FAFSA was submitted, multiply out of pocket expenses by 12 and then subtract the 11%, or will they just factor in the 1.5 months worth of expenses we currently have bills for? Or will it just deoend on the school?</p>

<p>It seems like by the time she reapply’s for FinAid her sophmore year none of this will be an issue because they will have the next 12 months worth of bills, but if we can’t figure out how to get her through her freshman year, it doesn’t really matter that they may adjust her package then.</p>

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<p>Well yes and no. Mst schools will never adjust her package. It totally depends on where she goes. My guess is an OOS like Auburn will probably not adjust aid for her medical expenses. They are not a school that meets need and especially not for OOS students. So it will still Be an issue sophomore year at most schools because they simply don’t have the funds for these adjustments.</p>

<p>Pofile is another form like FAFSA You fill out for schools that require it. Profile schools are the top, wealthy, high endowment colleges that do tend to adjust for special circumstances. They can do this because they they have lots of money. So if you’re hoping to get more aid, you should probably focus on these schools if your DD has the stats. The majority of Profile schools are looking or minimum top 10% of class and 2000 plus
SAT.</p>

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<p>CSS Profile is another financial aid form that the schools that give the best aid require.</p>

<p>If the schools that your D is applying to don’t use this form, then a concern is that she hasn’t applied to any schools that meet need.</p>

<p>You mention OOS at Auburn. OOS publics aren’t generous with need-based aid to OOS students. Auburn has some merit scholarships…what was your D’s M+CR SAT? </p>

<p>*she is looking at mostly smaller private schools *</p>

<p>Which ones? Most do not give great aid.</p>

<p>Has your D applied to ANY schools that you know FOR SURE that you have all costs covered? If not, then your D doesn’t have any safety schools.</p>

<p>*Well yes and no. Mst schools will never adjust her package. It totally depends on where she goes. My guess is an OOS like Auburn will probably not adjust aid for her medical expenses. They are not a school that meets need and especially not for OOS students. So it will still Be an issue sophomore year at most schools because they simply don’t have the funds for these adjustments.</p>

<p>*</p>

<p>I agree. That’s why I’m concerned that this child doesn’t have any safeties. I’m also concerned that the family may think that they only have to “bite the bullet” the first year, and then they’ll get more aid for the later years. That is not likely…which could mean that the student will have to leave her school.</p>

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<p>OK, we defiantly don’t think that we have to “bite the bullet” and then all this money will come in sophomore year. Everything I had read so far lead me to believe that the professional judgment had to be resubmitted every year along with the FASFA and would be adjusted based on that year’s info. I interpreted this to mean that this year they most likely go by the 1 month’s worth of bills, next year I submit the 12 months and they go by that. By your comment, I’m guessing that’s wrong. It’s all very confusing to me.</p>

<p>And I’m definitely not expecting a huge amount of money from all of this. I’m just looking for maybe a few thousand to offset the costs of medical expenses we had not planned for.</p>

<p>We already knew in advance that we might not be able to pull off sending her to her top choice depending on what was offered, so we did look at other less expensive schools and we do have an in-state safety school she has already been excepted to in place where we know she can get close to a full ride. </p>

<p>But I’m not going to tell her she has to go to her safety school just because she happened to get sick at an inconvenient time. I don’t want her to miss out on anything just because she has a chronic illness. If there is even a chance that a school will work with us, I’m going to do everything possible to make it happen.</p>

<p>We have been working with her college advisor since her freshman year (it’s a requirement at her school) on finding the right school for her and us. We didn’t just jump into this. We’ve put a lot of thought into the whole thing, and until recently, I honestly thought we had everything covered and still believe that if this sickness thing had not happened we would still be right on track. She might not be attending her top choice, but I don’t think she would have had to fall back on her safety.</p>

<p>We have been a little distracted this fall and to say that making the application deadlines alone was a nightmare is an understatement. She wrote her own essays and filled out her own apps which I’m not sure I could have done as sick as she was. Our main focus the last 6 months was figuring out what was going on with her and making the application deadlines, so she’d have a place to go to begin with. There wasn’t a lot of time to research all the intricacies of financial aid and scholarships, not when you’re worried your kid may be dying. </p>

<p>I started this thread because I wanted to make sure that we do get all our bases covered, so she has the best chance possible of going to a school she really loves. I also wanted a realistic idea of what we could expect, so that we can factor that into our plans.</p>

<p>I didn’t have months to get things figured out as a lot of people do who know they are going to apply for a professional judgment. I had only ever heard the word once at a seminar and at the time didn’t think anything about it because it didn’t apply to my family then. You always think it can’t happen to me, and then it does.</p>

<p>I would really appreciate hearing from any other people out there who have gone through this same type of situation. Any advice, anything I need to make sure to do? It’s all very overwhelming trying to juggle new meds, Dr visits, finding Dr and hospitals near the prospective schools, figuring out applying for disability, special housing needs, financial aid, etc at each school which all seem to have a different process and virtually no time to figure any of it out. Then add Christmas and a full time job on top of that. These are all issues we had no idea we needed to look into before. It’s too late to reevaluate schools or apply elsewhere. Yes, if she had been diagnosed back in the summer, we may have done things differently, but that didn’t happen, and we don’t have that luxury.</p>

<p>I’m sorry if I sound frustrated. I do really appreciate everyone’s advice. I’m just trying to make the best of a bad situation, and I’d like to make the fewest number of mistakes going forward as possible.</p>

<p>Thanks</p>

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<p>Let me preface by saying that we have never applied for PJ (knocks wood…my D also has a chronic health problem) but I don’t believe there’s any reason that you need to request it in January, nor is it typical to do so. From reading many, many threads on PJ over the years it seems one can request it at any time (though a school may have more aid to give earlier in the season) and that schools need to see that the job loss or other situation is ongoing and will have an impact on the current years income beyond that which is allowed for in the formula. I would think a letter from a medical professional combined with 4-6 months of consistent medical expense documentation might have an equal chance of success. Make sure the doctor knows that this is for financial aid purposes as it shouldn’t be necessary to go into great detail on her medical condition.</p>

<p>Have you called the FA office of her intended schools for advice? That’s where I would start since PJ is very school specific.</p>

<p>Hoping for the best for you and your daughter!</p>

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<p>*But I’m not going to tell her she has to go to her safety school just because she happened to get sick at an inconvenient time. I don’t want her to miss out on anything just because she has a chronic illness. If there is even a chance that a school will work with us, I’m going to do everything possible to make it happen.</p>

<p>*</p>

<p>Nobody is saying that RIGHT NOW, you should tell your D that she may have to go to her safety school. All I said was that make sure that she has a safety school where you’re sure all costs are covered so that you have something to fall back on in case NO OTHER school gives you a workable aid package. </p>

<p>Are you saying that you’re not going to have a safety on her list at all? If so, then you’re deciding to pay whatever a school expects you to pay…gaps and all. I realize that you don’t want to curtail your D’s dreams in response to this diagnosis and expense, because she’s had to absorb so much with this new information. But, you also don’t want to have her enroll in a school and then have to leave because you can’t balance health expenses and school expenses. </p>

<p>We have been working with her college advisor since her freshman year (it’s a requirement at her school) on finding the right school for her and us</p>

<p>Most school college advisors focus on major and fit. They often do NOT **fully **take into acct financial aid. They may know that X school gives out “good” aid, but they may not know that you need to have 100% of your need met so that you can still afford to pay any extra medical costs. </p>

<p>Has your GC explained that most schools will “gap” you? (that means that although you might have $30k in determined need at a school that costs $55k, a school may only give you $13k in aid…leaving you with your $25k EFC to pay **PLUS **another $17k in gap for you to cover.</p>

<p>A school that is known to be generous with aid may cost $55k and typically give $25k per year in aid (a combo of grants, loans, and work-study). That may sound great to a GC, but not so great to a family who can’t pay the remaining $30k - especially if their EFC is only $20k and they can’t also pay for that $10k gap. </p>

<p>Has your GC discussed whether the schools on your list meet 100% of aid? Since you’ve only mentioned FAFSA, it sounds like these school may not meet need. Since Auburn is on the list, we know that school will give little need-based aid to an OOS student. Auburn does give merit scholarships for high stats, but the amounts have decreased in recent years. Do you know if your D qualifies for any of Auburn’s assured merit scholarships?</p>

<p>I understand that you’ve spent 3 years working on this list with a school GC, but if there hasn’t been insufficient attention to whether a school “meets need,” then that may be a problem. Since you didn’t know what CSS Profile was, that suggests that the GC doesn’t really pay a lot of attention to the FA side of college searching. </p>

<p>It sounds like your D goes to a private high school. If so, then there may be an assumption that the family can/will pay whatever a college expects them to pay after submitting FAFSA.</p>

<p>Also, are you aware that most schools will include Work-Study in their financial aid? Will your D be able to work this work-study (usually about 2500 per year)? W-S typically involves that the student work about 8-12 hours per week. If your D’s health won’t allow for that, then you’d have to cover that aid yourself with more money. </p>

<p>Hopefully someone on CC has been in your situation where a chronic disease is diagnosed during senior year. </p>

<p>I agree with Sk8trmom that you don’t have to submit your new med bills in January. You can wait till spring when you have all of the FA offers to see which school will work with you. Then later, when there are more bills 2012, maybe the school will revisit the issue. </p>

<p>I don’t know if a school will do **any projecting from 3-4 months of bills, but maybe they would if you accompanied the bills with a letter from her doctors **confirming that her illness is long-term and the expensive treatments and likely hospitalizations will be on-going. </p>

<p>I understand how shocking all of this is for you. My mom was a wreck after my sister was diagnosed and worried about her constantly. Hoping for the best for you and your D.</p>

<p>**Lastly…and really may be more importantly…**you mention that your D will be hospitalized a few times per year. Since your college list was made prior to the diagnosis, then distance from home may not have been a consideration. Are any of these schools a good distance away from home? When your D is hospitalized, are YOU going to want to rush there to be with her? If so, then distance will be a big concern. Being able to juggle multiple hospital visits while working your job may be an issue if your D is several hours or a plane ride away. My own son was hospitalized as a frosh in college, and thankfully his school was only a 2-3 hours away.</p>

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<p>Lastly…and really may be more importantly…you mention that your D will be hospitalized a few times per year</p>

<p>I don’t know if these can be scheduled around breaks- but be as clear with the colleges as you can, some schools are going to be more flexible than others.</p>

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<p>Perhaps you would consider having her take a year off and doing her applications a year from now.</p>

<p>That way, you’d have a better handle on her health circumstances and what her needs and limitations will be, which will help you choose a school that can accommodate them.</p>

<p>In addition, you’ll have a better picture of the financial toll this is likely to take to provide to financial aid offices.</p>

<p>As the parent of a child with a chronic disease, I know it takes some time to adjust to the idea that illness might interfere with the trajectory your child has been on all this time, but consider this mantra: “It’s not a race. She will get there. Wherever she gets, when she gets there, it will be fine.”</p>

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<p>mom2collegekids - Thanks, your comments are helpful; they are the kind of stuff I’m trying to figure out. Like do we have to send everything in in January or can we send in more information later? Do we need to include Dr notes, etc.?</p>

<p>We do have a safety in place, instate, only a few hours away that we can afford. She doesn’t hate the idea of going there, but it’s at the bottom of her list. I do realize it may be where she ends up.</p>

<p>If we could do things differently, I would definatly have had her apply to a few of the schools we ruled out that we knew we could get some money from. At the time, a few thousand dollars wasn’t going to make a difference, now it will.</p>

<p>We had also planned on her working, and now I’m not sure if that will be possible or not.</p>

<p>thanks</p>

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<p>If she is able, there is still time to get a few more applications in to some schools that you know may offer money. If you don’t like the idea of the instate safety as the only option for financial reasons, many students find that having a choice between two or more safeties to be more palatable. At least they had a choice and weren’t left with only one option.<br>
The other option as mentioned above is to see how the chips fall. She may decide to accept an offer and request a gap year to gain health and perspective. She may decide that she doesn’t want to accept an offer and would prefer to to take a gap year and re apply to a fresh set of schools that take into consideration both the changes in her health and financial status.<br>
Kids can be resilient if options are framed in the correct manner–as broadening her choices (and isn’t that a great thing!!) rather than a negative (you have an illness and must limit your choices).</p>