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As an organizer of medical and financial records for seniors and others affected by age, illness and disability, I get this question a lot.  A person with multiple medical conditions can quickly acquire cartons of paperwork from Medicare, doctors’ offices, and health insurance companies.

It’s helpful to start with what medical EOBs prove:

• The services the doctor, hospital, or other healthcare entity has provided.
• The amount the doctor, hospital, or other healthcare provider has billed for those services.
• The amount the medical insurance company and/or Medicare have paid.
• The amount for which you, the patient or insurance subscriber, are responsible.

So, medical EOBs can be useful for:

• Creating (or re-creating) a health history for yourself or someone under your care.
• Documenting billing errors – or even fraud.
• Ensuring that you are receiving the full insurance benefits to which you are entitled.
• Proving that you’ve met your annual deductible, if your health insurance policy has one.
• Demonstrating what you have paid if you take the medical expense deduction on your annual IRS 1040 Schedule A.

Obviously, keeping medical EOBs is worthwhile for some period of time.  What to do with it all and how long to keep these records will vary with your personal situation.  Here are two sets of guidelines for medical EOB retention periods and good practices – one for people in normal health and one for people with chronic, debilitating or terminal health conditions:

Normal Health

1.  Keep medical EOBs in a file for one year.  As the bills and EOBs for a medical service come in, match related items together, and address any discrepancies you detect.  Examples might include double billing or your health insurance company overlooking the fact that you have met your deductible.

2.  If, at the end of the year, you find you have paid enough in medical bills to qualify for the medical tax deduction, file the medical EOBs with your tax documentation, and keep for seven years.

3.  If you do not qualify for the medical tax deduction, and the medical bills have been paid in full by you and all providers, and you are no longer doctoring for the condition, you can safely shred last year’s crop of medical EOBs while you’re wrapping up your taxes.

4.  If some bills are still outstanding or the patient is still receiving treatment, keep the related EOBs for another year, and repeat the process.

Serious Health Condition

1.  Keep a current file close at hand for this year’s medical EOBs.  As the bills and EOBs for a medical service come in, match related items together, and address any discrepancies you detect.

2.  At the end of the year, store all of these records in date order, keeping items you’ve matched up together, in a less prominent place.  You could use a file cabinet in another room or a cardboard file box in a dry, mildew-free storage area.  If you claimed the medical tax deduction, put a note in your tax records cross-referencing these health files.

3.  Keep these medical records according to this timeline:

a.  For five years after the serious health condition has cleared up.

b.  For seven years if you’ve claimed the medical deduction.

c.  Indefinitely, if the patient is chronically ill.

d.  Until the executor informs you that the estate is completely wrapped up, if the patient has passed away.

In both of the above situations, you can keep the medical records on paper or scanned onto a computer based on your preference.  If you keep paper files, keep them out of areas where they can get wet, e.g., a basement floor.   If you go the electronic route, be sure to back up your data reliably.

One final note:  Don’t panic if you need one or more medical EOBs or haven’t kept them according to the above guidelines.  All health insurers, including Medicare, can replace an EOB, because they store them electronically.

When my mother died in June 2007, my father came to live with me.  He had advanced cases of prostate cancer and Parkinson’s disease, and my life soon became a whirlwind of visits to doctors, hospitals, and testing facilities.  I quickly discovered that these visits were much easier to manage when I developed a one-page summary of all Dad’s pertinent medical information that I could hand the health care providers at each facility.

Do you have medical conditions that cause you to doctor frequently?  Do you care for someone who does?  Then you, too, would benefit from a brief document listing all of your diagnoses, drugs and doctors.  Use your favorite word-processing program and include the following:

Contact Information

• The patient’s full legal name (important for Medicare and other medical assistance programs), street address, home phone, cell phone and email address.  Dad didn’t have an email address, but I provided everything else.
• If the patient has given anyone a Health Care Power of Attorney, give that person’s same full contact information too, along with the indication that they are Health Care POA.  In my case, this was my brother.
• If the patient has a regular caregiver who should be contacted with updates or reports, give that person’s full contact information as well.  On Dad’s summary, this was me.

Diagnoses

• List each condition for which the patient has a formal diagnosis from a physician.  If you can, include the diagnostic billing code, obtainable from the billing department of the doctor who made the diagnosis.  Also include the date of diagnosis if you know it.  Even noting only the year can be helpful.  Dad’s diagnoses included prostate cancer and Parkinson’s; they also included medication-related depression, Parkinson’s-related dementia, and prostate-related urinary incontinence.  The point here is to note secondary conditions, too.  They all have a bearing on the patient’s treatment.

Medications

• List each drug the patient is taking, along with the dosage and frequency.  Example:  “Levaquin, 500 mg., 2x/daily.” Later, if a medication is removed, leave it on the list with a note “Discontinued, [date.]”  It’s all about sharing useful information.

Doctors

• List the name, address, telephone number and specialty of each and every physician the patient sees, including their primary care physician.  Doctors often send reports to the other physicians treating their patients, and this information simplifies that process.
• If your patient has multiple medical conditions, as my father did, it can be challenging to fit all the information on one page.  Fiddle with font sizes, margins, spacing, and the use of tabs and columns to try and get everything on one sheet.  What is true for employment seekers’ resumes is just as true for patients’ resumes:  The more concise they are, the more likely they will get read and used.

Store the document on your computer, and update after each medical visit that causes a change in the information. Create a header or footer with the notation “Updated [date.]” Print out a fresh, updated copy for each new medical visit. Keep a couple of current copies on hand for “grab and go” situations like emergency room visits and ambulance transports.

Throughout the two years I cared for my father, I was told over and over again by doctors, nurses, billing clerks, testing technicians and others how helpful this information was, and how much time it saved them as they cared for Dad.  In turn, it gave me satisfaction to know that I was doing something concrete and beneficial for my father.  This can be so important for the caregiver facing the discouragement of tending to someone with a difficult, chronic or terminal illness.

I recently heard about a young child who was just diagnosed with Diabetes.  At first, I felt sorrow for this child whose life has drastically changed.  But then my thoughts turned to these ‘newly diagnosed’ parents, and my heart sank.

I can empathize, because my child was diagnosed with Juvenile Arthritis at the age of six.  I was so overwhelmed, that although I am a professional organizer, my house was a cluttered mess.  I was too emotional to focus on what needed to be done.

I finally asked a close friend for help.  It was easy to put toys, books, and shoes away because everything had a home.  My trouble came when we reached the new items – the reminders that my child has an incurable disease.  The medication, paperwork, and supplies were everywhere, and I couldn’t look at it without tears.

We started in the living room.  All physical therapy supplies went into an attractive container in the corner of the room for easy access.  In the kitchen, an easily accessible cabinet shelf held a small bin for medication and supplies.  The cabinet door had a medication schedule, to make sure we did not miss a dose.

The paperwork was harder, because it needed a filing system. We created an arthritis box, and stored it far away from my daily files. My friend did the tedious part of labeling the files and handling the papers. All I had to do was tell her where it goes.

By reorganizing my home to incorporate my child’s special needs, the arthritis became an ordinary part of daily life instead of an entity in itself.  This reduced my overall stress, but more importantly, brought me closer toward acceptance.

If you are ‘newly diagnosed’, ask a friend for help.  Or better yet, hire a professional organizer!