Calculating Additional Transplant Expenses

1. Personal	2. Income	3. Expenses	4. Summary Report

After you have collected the amounts for your income and household expenses, it will take about 15 minutes to complete this planning tool.

Your report is displayed after entering information. You can print the report or use your Internet browser to save the report to your computer. Until you exit the tool, you can change the information as often as you like.

1. Personal	2. Income	3. Expenses	4. Summary Report

Transplant Information

Many transplant patients are in the hospital for several weeks or months. The length of the hospital stay depends on the patient's treatment plan, the transplant center's procedures and the patient's recovery time after transplant.

Health care insurance often covers many transplant expenses. However, most patients have additional expenses that are not covered by their insurance. The transplant information will help transplant center staff and patients estimate specific additional costs.

Location During Transplant

State:

Choose State Alabama Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Minnesota Mississippi Missouri Nebraska New Hampshire New Jersey New York North Carolina Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Wisconsin

Transplant center:
Please select a state.
Patient: Relocating or staying local (within 90 miles of home)	Relocating Staying local
Caregiver: Relocating or staying local (within 90 miles of home)	Relocating Staying local
Transplant Type
Autologous (patient's own cells) Related allogeneic (family member's cells, incl. cord blood) Unrelated allogeneic (volunteer donor's cells, incl. cord blood) Not sure
Transplant Preparation	Myeloablative Nonmyeloablative Not sure

1. Personal	2. Income	3. Expenses	4. Summary Report

Patient Information

Household size refers to the number of people living within the patient's home.

The patient's age and household size can help identify financial needs, such as health insurance, child-care, tuition and retirement. Age and household size may also be used to determine eligibility for specific programs and resources.

Age of patient
Household size

1. Personal	2. Income	3. Expenses	4. Summary Report

Income 1

Often the primary income source is the patient or the patient's spouse. When the income is from another adult living in the household, such as a domestic partner or adult child, sometimes this income is included.

Enter a monthly amount for each item that applies. If this person will not continue to receive regular pay during the transplant, this tool automatically notes the monthly take-home pay as a change in household income on the report.

Please do not use commas or dollar signs. The system will automatically round amounts to the nearest dollar.

Income 2

Sometimes the patient or the patient's spouse provides a secondary income. There may also be another adult who contributes to the household (such as a domestic partner, adult child or parent).

Enter a monthly amount for each item that applies. If this person will not continue to receive regular pay during the transplant, this tool automatically notes the monthly take-home pay as a change in the household income on the report.

	Income 1	Income 2
Current monthly take-home pay (after taxes)
Will this person continue to receive regular pay during the transplant process?	Yes No	Yes No
Short- or long-term disability income (from employer)
Social Security income (retirement or survivor, disability (SSDI), or Supplemental Security Income (SSI))
Private work insurance
Other Monthly Income
Alimony and child support
Rental property, retirement income, investments
Other (reverse mortgage)
Additional Resources
Emergency savings
Loan (home equity, IRA, life insurance)
Other (fundraising)

1. Personal	2. Income	3. Expenses	4. Summary Report

Medical Expenses and Health Insurance

Estimate monthly amounts to the nearest dollar for all members of the patient's household.

Co-payments (visits and medication)
Current medical debt
Health insurance premium
	Deducted from take-home pay Billed separately
Other monthly medical expenses (wigs, sperm/egg storage, etc.)	$

1. Personal	2. Income	3. Expenses	4. Summary Report

Household Expenses

Enter a monthly amount for each item that applies to the patient's household.

Mortgage or rent
Home owner's or renter's insurance
Utilities (electricity, heating, phone, household operation)
Car (loan, insurance, repairs, gasoline)
Credit card payment(s)
Food
Miscellaneous (internet, cable, pet care)

1. Personal	2. Income	3. Expenses	4. Summary Report

Other Living Expenses

Enter a monthly amount for each item that applies to the patient's household.

Child-care
Alimony and child support
Education and enrichment classes (tuition, classes, activities)
Charitable contributions and tithing
Savings / Investments (retirement, 401k, investment funds, vacation, college)
Other (entertainment, gifts)

1. Personal	2. Income	3. Expenses	4. Summary Report

Relocation Expenses

When the patient or caregiver move to a location near the transplant center for several months, additional costs such as lodging, food and local transportation need to be considered. Indicate the items that apply to the patient, caregiver or both.

Child-care	Yes No
Number of children	0 1 2 3 4 or more
Lodging	Yes No
Lodging Type	Apartment Hotel / Motel Hospital-sponsored housing Ronald McDonald House Hope House Other
Food	Yes No
Laundry	Yes No
Travel (roundtrip between home and the hospital; additional visits home)	Yes No
Transportation and parking (to and from the hospital and visits home)	Yes No
Pet boarding	Yes No
Other monthly expenses	$

1. Personal	2. Income	3. Expenses	4. Summary Report

Local Living Expenses

When the transplant center is near the patient's or caregiver's home, you still need to look at these items. Your current expenses may change or you may have new expenses. Indicate the items that apply to the patient, caregiver or both.

Child-care	Yes No
Number of children	0 1 2 3 4 or more
Food	Yes No
Transportation and parking	Yes No
Pet boarding	Yes No
Other monthly expenses	$

1. Personal	2. Income	3. Expenses	4. Summary Report

After Transplant and Returning Home Expenses

To prepare for the patient's return home, the transplant center staff will give suggestions such as:

• Clean the house thoroughly to prevent infections
• Consider adjustments to improve the patient's mobility. For example, a ramp may be needed for a wheel chair. Or, the patient's sleeping arrangements may need to be moved to the main floor.

Sometimes new clothing is needed because of a significant change in weight. Sometimes extra soft clothing may be needed if the patient's skin becomes sensitive.

To plan for these additional costs, indicate the items that may apply to this patient's needs.

Child-care	Yes No
Number of children	0 1 2 3 4 or more
Cleaning	Yes No
Travel (transplant center and office visits)	Yes No
Pet boarding	Yes No
Clothing	Yes No
Other (different food needs, insurance premiums when patient is not employed)

A Summary of Your Income, Current Expenses and Future Additional Expenses

Summary Report

Total Monthly Income   (including other resources)	Current Household Monthly Expenses	Potential Additional Monthly Expenses
$0.00	$0.00	$0.00

Viewing a summary of income and expenses can be overwhelming. We want you to know that people and resources are available to help you prepare for potential additional costs and to help you manage your current household expenses. This financial summary is a useful first step in developing a financial plan for transplant. We encourage you to review the following information with people familiar with transplant and/or your financial situation, including:

• Family and caregivers
• A professional financial advisor
• A case manager at the NMDP Office of Patient Advocacy
• Your transplant center team

Click on the Next button below to find more items to help you prepare your finances related to transplant and to view an itemized version of your report.

Itemized Income, Current Expenses and Future Additional Expenses

In the following sections of this report, you will find more items we have prepared to help you understand, discuss and plan your finances related to transplant.

• Understanding Additional Transplant Expenses (PDF)
• Links to additional resources
• An itemized report of the information you have entered

Additional Resources

• Advocacy Resources
• Financial Assistance
• Housing / Lodging
• Transportation
• Home Care

Itemized Report

Monthly Household Income
Income Sources	Primary Monthly Income	Secondary Monthly Income
Current take-home pay (after taxes)
Short- or long-term disability income (employer)
Social Security income (retirement or survivor, disability (SSDI), or Supplemental Security Income (SSI))
Private work insurance
Other Monthly Income
Alimony and child support
Rental property, retirement income, investments
Other
Monthly Income Sub-total	(none)	(none)
Additional Resources
Emergency Savings
Loan
Other
Other Resources Sub-total	(none) Lost monthly wages during transplant process: (none)	Lost monthly wages during transplant process: (none)
Other Resources
Total Monthly Income

Current Household Expenses
Medical Expenses and Health Insurance
Co-payments (visits and medication)
Current medical debt
Health insurance premium
Other
Household Expenses
Mortgage or rent
Dwelling insurance
Utilities
Car (loan, insurance, repairs, gasoline)
Credit card payment(s)
Food
Other
Other Living Expenses
Child-care
Alimony and child support
Education and enrichment classes
Charitable contributions and tithing
Savings / Investments
Other
Your Household's Current Monthly Expenses	(none)

* Costs based on national averages.

Your Potential Additional Expenses
Relocation Expenses
Child-care
Number of children
Cost of child-care
Lodging
Food
Laundry
Travel (to hospital, return home, visits home)
Transportation and parking
Pet boarding
Other monthly expenses
Local Living Expenses
Child-care
Number of children
Cost of child-care
Food
Transportation and parking
Pet boarding
Other monthly expenses
After Transplant and Returning Home Expenses
Child-care
Number of children
Cost of child-care
Cleaning
Travel (transplant center and office visits)
Pet boarding
Clothing
Other
Your Potential Additional Monthly Expenses	(none)

* Costs based on national averages.