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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Cash Flow

Related Article: Instructions For Completing The Chart: My Cash Flow On Disability


For the year ended

INCOME (in dollars, do not use commas) Weekly Monthly Yearly % of Total Income
Make an entry in the monthly column. The other columns will be completed automatically. If an income source doesn't apply to you, skip it.Include all of your income BEFORE deductions. Also include all investment income even if it is not withdrawn or is automatically reinvested. Job
Spouse's/Partner's Job
Other jobs
Self-employment income
Alimony and Child Support
Social Security
Pensions and Annuities
Interest and Dividends
Other income
HOUSEHOLD AND LIVING EXPENSES Weekly Monthly Yearly % of Total Income
  Utilities: Phone, gas, electric, cable, cell phone, etc.  
  Housing: Mortgage, Rent, co-op/condo maintenance fees  
Not including insurance premiums. Medical & Dental: Not reimbursed or paid by insurance  
These expenses can be difficult to nail down. Estimate as well as you can. Think of a typical week. Food: Groceries, take-out, restaurants  
Services : day care, cleaning, gardeners, repairmen  
Furnishings & Maintenance  
Personal care: Clothing, haircuts, makeup, laundry, etc.  
Recreation: Travel, entertainment, sports, hobbies, books  
Gifts and charitable contributions  
DEBT REPAYMENTS Weekly Monthly Yearly % of Total Income
Add the interest and fees you paid over the last twelve months. Allocate the rest of your credit card payments into the categories on which the money was spent. Credit Card 1 Interest and Fees Only  
Credit Card 2 Interest and Fees Only  
Credit Card 3 Interest and Fees Only  
Car Loan 1 Interest  
Ask your lender for a breakdown of interest and principal you paid on each loan over the past twelve months. If you can't get this infrormation, enter your entire payment in the principal boxes. Car Loan 1 Principal  
Car Loan 2 Interest  
Car Loan 2 Principal  
Bank Loan Interest  
Bank Loan Principal  
Other Interest  
Other Principal  
INSURANCE Weekly Monthly Yearly % of Total Income
Include insurance premium contributions that are deducted from your paycheck. Also include Medicare Part B premiums deduction from your Social Security. Health  
Long-Term Care  
SAVINGS Weekly Monthly Yearly % of Total Income
Include any deductions made from paychecks toward retirement plans or automatic invesment and savings plans. Also include any interest that remained in an account or dividends that were reinvested. Money Market, CD, Savings Account  
Stocks & Bonds  
Retirement Plans  
TAXES Weekly Monthly Yearly % of Total Income
  Federal Income  
  State Income  
  Local Income  
  Social security  

Cash Flow Monthly Yearly
Total Income
Total Expenses
Net Cash Flow

Expense analysis Monthly Yearly %
Paid in Interest (other than mortgage)
Medical Care & Insurance

Emergency+Fund Needs
Three-month Emergency+Fund
Six-month Emergency+Fund
One-year Emergency+Fund