Managing the Cost of Terminal Illness

Understanding the Financial Landscape of Terminal Illness

The journey through a terminal illness is fraught with myriad costs, many of which are often unforeseen or underestimated. These expenses can be broadly categorized into direct medical costs, indirect medical costs, and non-medical costs, each contributing significantly to the overall financial strain on individuals and families. Understanding this multi-faceted landscape is the first critical step toward effective management.

Direct Medical Costs: These are the most obvious and often the largest components of the financial burden. They include a wide array of services and treatments:

• Hospital Stays: Frequent or extended hospitalizations for acute symptom management, procedures, or complications.
• Physician Visits: Consultations with specialists (oncologists, cardiologists, neurologists, etc.), primary care physicians, and other healthcare providers.
• Diagnostic Tests: Regular imaging (MRI, CT scans, PET scans), laboratory tests, biopsies, and other diagnostic procedures necessary for monitoring disease progression and treatment efficacy.
• Treatments and Therapies: Chemotherapy, radiation therapy, targeted therapies, immunotherapies, surgeries, physical therapy, occupational therapy, and speech therapy. These can be incredibly expensive, particularly for novel treatments.
• Medications: Prescription drugs for treating the primary illness, managing side effects, controlling pain, and addressing co-morbid conditions. Specialty drugs can easily cost thousands of dollars per month.
• Palliative and Hospice Care: Services focused on providing relief from the symptoms and stress of a serious illness, aiming to improve quality of life for both the patient and their family. While often covered, co-pays and specific services might not be.
• Medical Equipment: Wheelchairs, hospital beds, oxygen concentrators, nebulizers, and other durable medical equipment (DME) that may be required for home care.

Indirect Medical Costs: These costs are less direct but equally impactful, often stemming from the need for specialized care outside of traditional settings or unforeseen complications.

• Home Healthcare Services: Skilled nursing, personal care aides, and other support services provided in the home, allowing patients to remain comfortable in a familiar environment.
• Caregiver Support: While family members often provide unpaid care, sometimes professional caregivers are needed, incurring hourly or daily rates.
• Transportation: Costs associated with traveling to and from appointments, treatments, and specialists, especially if specialized transport is required.

Non-Medical Costs: The financial impact extends beyond healthcare services, affecting daily life and long-term financial stability.

• Lost Income: Patients may be unable to work, leading to a significant reduction or complete loss of income. Family caregivers may also need to reduce work hours or leave their jobs to provide care, impacting household earnings.
• Home Modifications: Expenses for adapting a home to the patient’s needs, such as ramps, grab bars, wider doorways, or accessible bathrooms.
• Legal and Estate Planning: Costs associated with drawing up wills, trusts, power of attorney, and other legal documents to ensure the patient’s wishes are honored and their estate is managed appropriately.
• Emotional and Psychological Support: While some mental health services are covered by insurance, out-of-pocket costs for counseling, support groups, or specialized therapies can arise.
• Funeral and Burial Expenses: While not directly related to illness management, these are inevitable costs that families often face shortly after the passing of a loved one, and pre-planning can mitigate this future burden.

The cumulative effect of these various expenses can quickly deplete savings, accumulate debt, and create immense stress for families already grappling with profound emotional pain. Acknowledging this comprehensive financial picture is essential for developing a proactive and strategic approach to managing the costs of a terminal illness.

Navigating Health Insurance and Government Programs in 2026

In 2026, understanding the intricacies of your health insurance coverage and the various government programs available is paramount to managing the substantial costs associated with a terminal illness. The landscape of health coverage for Americans is dynamic, and the specific policies and priorities of the new administration can significantly impact accessibility, affordability, and the scope of benefits. Staying informed about these changes is not just advisable; it’s essential.

Private Health Insurance: Many Americans rely on employer-sponsored health plans or individual plans purchased through the Health Insurance Marketplace (often referred to as Obamacare or ACA plans). Key aspects to review include:

• Deductibles: The amount you must pay out-of-pocket before your insurance begins to cover costs.
• Co-pays and Co-insurance: Fixed amounts or percentages you pay for specific services after meeting your deductible.
• Out-of-Pocket Maximum: The most you will have to pay for covered services in a policy year. Once this limit is reached, your insurance typically covers 100% of additional covered costs for the remainder of the year. This is a critical figure for anyone facing high medical expenses.
• Formulary: The list of drugs covered by your plan. Ensure that necessary medications for your condition are on this list, or understand the process for exceptions.
• In-network vs. Out-of-network: Using in-network providers and facilities will significantly reduce your costs. Understand the implications of seeking care outside your network.

Government Programs:

• Medicare: For individuals aged 65 and older, and certain younger people with disabilities or specific diseases. Medicare is divided into several parts:
  • Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Hospice care under Part A is a vital benefit for terminal illness, covering comfort care, medications, and support services.
  • Part B (Medical Insurance): Covers doctor’s services, outpatient care, medical supplies, and preventive services. This includes many treatments, therapies, and diagnostic tests.
  • Part C (Medicare Advantage): Private insurance plans that provide Medicare Part A and Part B benefits, often including Part D (prescription drug coverage) and additional benefits. These plans may have different rules, costs, and network restrictions.
  • Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs. Understanding your plan’s formulary and potential gaps in coverage (the “donut hole”) is crucial.
  • Medigap (Medicare Supplement Insurance): Private insurance that helps pay for out-of-pocket costs not covered by Original Medicare, such as co-payments, co-insurance, and deductibles.
• Medicaid: A joint federal and state program that provides health coverage to low-income individuals and families, including those with significant medical needs. Eligibility requirements vary by state, and coverage can be comprehensive, often covering services not fully paid for by other programs.
• Veteran’s Health Administration (VA) Benefits: For eligible veterans, the VA healthcare system can provide extensive medical care, including palliative and hospice services, often at reduced or no cost.

How the New Administration Will Impact Health Coverage for Americans in 2026: The political climate significantly shapes healthcare policy. As of 2026, the specific impacts of the new administration will likely be clearer, but potential areas of focus could include:

• Affordable Care Act (ACA) Revisions: Depending on the administration’s stance, there could be efforts to modify, repeal, or strengthen aspects of the ACA. This might affect subsidies for Marketplace plans, coverage for pre-existing conditions, or the scope of essential health benefits. Families managing a terminal illness must monitor these developments closely, as changes could alter access to critical services or increase out-of-pocket costs.
• Medicare and Medicaid Reforms: The administration might propose changes to Medicare eligibility, benefits, or drug pricing policies (e.g., direct negotiation of drug prices). Similarly, Medicaid funding and eligibility rules could be adjusted, potentially impacting vulnerable populations.
• Emphasis on Specific Healthcare Areas: There could be increased funding or policy directives towards certain areas like mental health integration, telehealth services, or home-based care. These shifts could indirectly benefit patients with terminal illnesses by expanding access to crucial support services.
• Patient Assistance Programs and Drug Costs: The administration might influence pharmaceutical pricing regulations or encourage greater transparency, potentially affecting the cost of high-priced specialty drugs crucial for many terminal illnesses.

It is imperative for individuals and families to proactively research and understand how these potential policy shifts could affect their current and future healthcare coverage. Consulting with a benefits specialist or a patient advocate can help decipher complex regulations and ensure you are maximizing all available benefits. Understanding the nuances of your policy and governmental support programs is not just about saving money; it’s about ensuring access to the best possible care when it matters most.

Proactive Financial Planning: Strategies Before a Diagnosis

1. Build a Robust Emergency Fund:
An emergency fund is your first line of defense against any unexpected life event, including health crises. Aim to have at least 6-12 months of living expenses saved in an easily accessible, liquid account. This fund can cover immediate needs, such as lost wages during initial treatment, unexpected medical bills, or travel expenses for specialists, without forcing you to dip into long-term investments or incur high-interest debt.

2. Maximize Savings and Investments:
Beyond an emergency fund, consistent saving and smart investing are crucial. Utilize retirement accounts like 401(k)s and IRAs, and consider taxable investment accounts for greater liquidity. The goal is to build a substantial nest egg that can provide financial security and, if necessary, be drawn upon for extraordinary medical expenses or to maintain quality of life during illness. Diversify your portfolio to balance growth and stability, aligning with your risk tolerance and time horizon.

3. Consider Long-Term Care (LTC) Insurance:
LTC insurance is designed to cover services not typically covered by health insurance, Medicare, or Medicaid, such as assistance with daily activities (bathing, dressing, eating) in your home, an assisted living facility, or a nursing home. While it might seem geared towards elderly care, terminal illnesses can necessitate similar levels of prolonged care at any age. Research policies carefully, considering benefit periods, daily maximums, elimination periods, and inflation riders. Purchasing LTC insurance when you are younger and healthier can result in lower premiums and easier qualification.

4. Explore Critical Illness Insurance:
Critical illness insurance pays out a lump sum if you are diagnosed with a specified critical illness (e.g., cancer, heart attack, stroke). This cash benefit can be used for anything: medical costs, living expenses, lost income, or even experimental treatments not covered by traditional insurance. It provides financial flexibility during a time of great need. Understand the specific conditions covered and the payout structure before committing.

5. Understand Life Insurance Policies:
Review existing life insurance policies. Many permanent life insurance policies (whole life, universal life) have cash value components that can be borrowed against or withdrawn in an emergency. Additionally, some policies offer accelerated death benefits or living benefits riders, which allow policyholders to access a portion of their death benefit while still alive if diagnosed with a terminal illness. This can provide crucial liquidity when facing significant expenses.

6. Comprehensive Estate Planning:
Estate planning isn’t just for the wealthy; it’s a fundamental component of financial preparedness for everyone. While often associated with post-mortem arrangements, it provides critical guidance during a terminal illness.

• Will: Ensures your assets are distributed according to your wishes and designates guardians for minor children.
• Living Will (Advance Directive): Specifies your wishes regarding medical treatment should you become unable to communicate them yourself. This can prevent disputes and ensure your values are respected.
• Durable Power of Attorney for Healthcare: Appoints someone to make medical decisions on your behalf if you are incapacitated.
• Durable Power of Attorney for Finances: Grants someone the authority to manage your financial affairs if you are unable to.
• Trusts: Can be used to manage assets, provide for dependents, and potentially avoid probate, ensuring a smoother transition of wealth.

Connecting to Business Acumen: The importance of proactive financial planning extends even to entrepreneurs and business owners. Consider, for example, how to run a successful HVAC business. A successful HVAC business owner understands the necessity of robust financial planning for their enterprise: budgeting, managing cash flow, securing business insurance, and planning for expansion or potential downturns. They also have contingency plans for equipment failure, supply chain disruptions, or employee issues. This same disciplined approach must be applied to personal finances. A business owner’s personal health crisis can directly impact their ability to lead and operate their company, potentially jeopardizing their business and their family’s financial security. Therefore, having personal emergency funds, appropriate insurance, and comprehensive estate planning is not just a personal safeguard but also an indirect protection for their business legacy and its future operations. The resilience built through personal financial planning mirrors the resilience needed to run a thriving business, ensuring stability no matter what challenges arise.

Managing Costs After a Diagnosis: Immediate Steps and Long-Term Strategies

Receiving a diagnosis of a terminal illness is overwhelming, but taking immediate, structured steps to manage the financial implications can prevent further stress and ensure access to optimal care. This phase requires meticulous attention to detail, proactive communication, and leveraging available resources.

Immediate Steps Post-Diagnosis:

• Review Your Insurance Policy Thoroughly: Obtain a complete copy of your health insurance policy document. Understand your benefits, limitations, deductibles, co-pays, out-of-pocket maximums, and appeal processes. Identify covered services, preferred providers, and any requirements for pre-authorization. This is your most powerful tool.
• Consult with a Patient Advocate or Social Worker: Many hospitals and healthcare systems employ patient advocates or social workers who specialize in navigating complex medical and financial systems. They can help you understand your benefits, connect you with financial assistance programs, and assist with billing disputes.
• Organize Medical Records and Bills: Create a meticulous system for all medical records, correspondence from insurance companies, and every bill received. Keep track of dates, services rendered, and payments made. This organization is crucial for disputing errors and monitoring your out-of-pocket expenses.
• Communicate with Your Healthcare Team: Discuss treatment options, their associated costs, and potential alternatives with your doctors. Ask about generic drug options, participating in clinical trials (which often cover treatment costs), and referrals to in-network specialists.

Long-Term Strategies for Cost Management:

• Negotiate with Providers and Facilities: Don’t be afraid to negotiate. For services not fully covered by insurance, or for large bills, contact the hospital or provider’s billing department. They may offer payment plans, discounts for upfront payment, or charity care programs, especially if you demonstrate financial hardship.
• Explore Patient Assistance Programs (PAPs): Pharmaceutical companies often have PAPs that provide free or low-cost medications to eligible patients who cannot afford their prescriptions. Non-profit organizations and foundations also offer disease-specific financial assistance for treatments, travel, and living expenses. Websites like NeedyMeds.org or the Patient Advocate Foundation are excellent resources.
• Consider Clinical Trials: Participating in clinical trials for new treatments can provide access to cutting-edge therapies that might otherwise be unavailable or prohibitively expensive. While there are risks, the trial often covers the cost of the experimental treatment and related care.
• Understand Palliative and Hospice Care Benefits: As the illness progresses, palliative care focuses on symptom relief and quality of life. Hospice care is specifically for those with a prognosis of six months or less, focusing on comfort and support. Both are often well-covered by Medicare, Medicaid, and many private insurance plans, and can significantly reduce the burden of aggressive, high-cost treatments that may no longer be beneficial.
• Home Healthcare vs. Facility Care: Evaluate the costs and benefits of receiving care at home versus in a skilled nursing facility or assisted living. While home care can be more comfortable, it may require significant family involvement or professional aide expenses. Facilities offer comprehensive care but come with their own substantial costs. Analyze what your insurance covers for each option.
• Legal Considerations and Advance Directives: Ensure your legal documents (will, powers of attorney, living will) are up-to-date. This ensures your wishes are respected and can prevent costly legal disputes later. A medical power of attorney can ensure someone you trust makes financial and medical decisions if you become unable.
• Utilize Crowdfunding and Community Support: Platforms like GoFundMe can be effective for raising funds from friends, family, and the broader community. Local churches, community organizations, and disease-specific support groups may also offer financial aid or connections to resources.
• Investigate State and Local Programs: Many states offer programs that assist with healthcare costs, prescription drugs, transportation, or caregiver support for individuals with chronic or terminal illnesses. Your state’s Department of Health or Aging services can provide information.

Navigating these options requires persistence and a willingness to ask for help. Building a support network of family, friends, and professionals is invaluable in managing the financial and emotional complexities of a terminal illness.

The Holistic Impact: Beyond Financials and Supporting Well-being

While financial management is a critical component of navigating a terminal illness, it is imperative to acknowledge and address the profound holistic impact this journey has on patients and their loved ones. The costs extend far beyond monetary figures, encompassing immense emotional, psychological, social, and spiritual tolls. Supporting overall well-being is not merely an act of compassion; it is integral to the patient’s quality of life and the caregivers’ ability to sustain their vital role, indirectly influencing their capacity to manage the financial burdens.

Emotional and Psychological Toll:
A terminal diagnosis triggers a cascade of intense emotions: grief, fear, anger, anxiety, depression, and a sense of loss—not just of life, but of future plans, independence, and identity. Patients often grapple with existential questions and the psychological burden of impending mortality. Caregivers, too, experience significant distress, including burnout, anticipatory grief, guilt, and overwhelming stress.

• Mental Health Support: Access to mental health professionals (therapists, counselors, psychiatrists) is crucial for both patients and caregivers. Many health insurance plans cover mental health services, but understanding the extent of this coverage and finding in-network providers is essential.
• Support Groups: Connecting with others facing similar challenges can provide a sense of community, reduce isolation, and offer practical coping strategies. Disease-specific organizations often host such groups.
• Mindfulness and Stress Reduction Techniques: Practices like meditation, deep breathing exercises, and gentle yoga can help manage anxiety and improve emotional regulation.

Social and Relational Impact:
Terminal illness can profoundly alter social dynamics and relationships. Patients may withdraw due to fatigue, symptoms, or embarrassment, while friends may struggle to know how to offer support. Caregivers often find their social lives shrinking as their responsibilities grow. Intimate relationships can be particularly strained.

• Maintaining Connections: Encouraging patients and caregivers to maintain social connections, even if in modified ways, is important. Virtual meetups, short visits, or delegating tasks can help preserve these vital links.
• Caregiver Respite: Providing caregivers with regular breaks is essential to prevent burnout. This might involve other family members stepping in, professional respite care services, or community programs.

The Connection Between Sexual and Mental Health:
Terminal illness can have a significant, yet often overlooked, impact on sexual health and intimacy. The physical changes brought about by illness and treatment (fatigue, pain, nausea, body image changes, hormonal shifts) can directly affect libido and sexual function. Furthermore, the immense emotional and psychological stress of a terminal diagnosis, including depression and anxiety, can severely diminish desire and impact a person’s sense of self and attractiveness. This often creates a ripple effect on mental health, relationships, and overall quality of life. Patients may feel a loss of their former self, leading to feelings of inadequacy or isolation, which further exacerbates mental health challenges. Caregivers, too, can experience changes in intimacy due to stress, exhaustion, or shifting roles within the relationship. Addressing these concerns is a vital part of holistic care. Open communication with partners, seeking counseling from therapists specializing in sexual health, or discussing options with healthcare providers (e.g., managing side effects, exploring alternative forms of intimacy) can help maintain an important aspect of human connection and well-being. Recognizing and validating these complex feelings is crucial, as a healthy sexual and mental health connection contributes significantly to a person’s overall quality of life and resilience during such a difficult period.

Spiritual Well-being:
Many individuals find comfort and meaning in their spiritual or religious beliefs during a terminal illness. Exploring spiritual questions, connecting with faith leaders, or engaging in practices that foster inner peace can be a profound source of strength. Hospitals often have chaplains or spiritual care providers who can offer support regardless of religious affiliation.

Quality of Life Focus:
Ultimately, managing a terminal illness is about maximizing quality of life within the given circumstances. This involves balancing aggressive treatment with comfort, respecting patient autonomy, and creating opportunities for joy and connection. Palliative care, introduced early in the illness trajectory, is designed precisely for this purpose, focusing on symptom management, pain relief, and emotional support to enhance the patient’s and family’s well-being. By integrating comprehensive support for all aspects of well-being, families can navigate the terminal illness journey with greater dignity, peace, and resilience, even amidst profound financial and emotional challenges.

Leveraging Professional Guidance: Financial, Legal, and Healthcare Advocates

Navigating the complex landscape of terminal illness costs, legal requirements, and healthcare systems is not a journey to embark on alone. Leveraging the expertise of various professionals can provide invaluable support, ensure optimal decision-making, and significantly reduce stress for patients and their families. These experts form a multidisciplinary team dedicated to safeguarding well-being and financial stability.

1. Financial Advisors Specializing in Healthcare Costs:
A financial advisor with expertise in healthcare planning can be a cornerstone of your support team. They can help you:

• Assess Your Current Financial Situation: Evaluate your assets, liabilities, income streams, and insurance coverage to create a realistic picture of your financial resources.
• Develop a Comprehensive Financial Plan: Create a strategy for covering medical expenses, managing lost income, and preserving assets for future needs or beneficiaries.
• Optimize Insurance Benefits: Help you understand the nuances of your health insurance, long-term care insurance, and critical illness policies, ensuring you maximize benefits and avoid costly mistakes.
• Navigate Government Programs: Guide you through eligibility requirements and application processes for Medicare, Medicaid, veteran benefits, and other state or federal assistance programs.
• Manage Investments: Advise on how to access funds from investments or retirement accounts in the most tax-efficient way, if necessary.
• Identify Resources: Connect you with patient assistance programs, charitable foundations, and other financial aid opportunities specific to your condition.

Look for advisors with certifications like Certified Financial Planner (CFP) who also have experience in elder care, healthcare planning, or special needs planning, as their expertise will be most relevant.

2. Estate Attorneys and Elder Law Specialists:
Legal professionals play a critical role in ensuring your wishes are honored and your affairs are in order. While an estate attorney generally handles wills and trusts, an elder law specialist has specific expertise in issues affecting older adults, which often overlap with terminal illness concerns for individuals of any age. They can assist with:

• Wills and Trusts: Drafting or updating these documents to ensure your assets are distributed according to your wishes and to minimize potential probate issues.
• Powers of Attorney: Establishing durable powers of attorney for both healthcare and financial matters, designating trusted individuals to make decisions if you become incapacitated.
• Advance Directives (Living Wills): Documenting your preferences for medical treatment, such as life support or palliative care, to guide your healthcare team and family.
• Guardianship/Conservatorship: If necessary, assisting with legal processes to appoint a guardian or conservator to manage your personal or financial affairs.
• Medicaid Planning: For those who may eventually need to qualify for Medicaid to cover long-term care costs, an elder law attorney can provide legal strategies to protect assets while meeting eligibility requirements.
• Understanding Patient Rights: Advising you on your legal rights as a patient, especially concerning treatment decisions, privacy, and end-of-life care.

3. Patient Advocates and Social Workers:
These professionals are often unsung heroes in the healthcare journey. They serve as navigators, communicators, and problem-solvers within the healthcare system. Many hospitals, cancer centers, and community organizations employ patient advocates or social workers. Their roles include:

• Navigating the Healthcare System: Helping you understand your diagnosis, treatment options, and care plans.
• Insurance and Billing Assistance: Explaining insurance benefits, assisting with claims, resolving billing disputes, and helping you appeal denied coverage.
• Resource Connection: Connecting you with local, regional, and national resources, including support groups, transportation services, meal programs, and financial aid.
• Communication Facilitation: Acting as a liaison between you, your family, and your medical team to ensure clear communication and coordinated care.
• Emotional Support: Offering counseling and emotional support to help patients and families cope with the psychological impact of illness.
• Advance Care Planning: Guiding conversations around end-of-life wishes and ensuring advance directives are documented and understood.

4. Hospice and Palliative Care Teams:
When a terminal diagnosis is made, engaging with a hospice or palliative care team early can significantly enhance quality of life and provide comprehensive support. These teams are multidisciplinary, including doctors, nurses, social workers, chaplains, and volunteers. They focus on:

• Symptom Management: Expert pain and symptom control.
• Emotional and Spiritual Support: Addressing the psychological and spiritual needs of patients and families.
• Care Coordination: Ensuring seamless communication and care across various settings (home, hospital, facility).
• Bereavement Support: Providing grief counseling and support for families after a patient’s passing.

Building a strong team of professional advisors is an investment that can yield significant returns in terms of reduced financial stress, improved care coordination, and greater peace of mind during an incredibly challenging time. Don’t hesitate to seek out these experts; they are there to help you and your family navigate the complexities of terminal illness with confidence and support.

Frequently Asked Questions About Managing Terminal Illness Costs

What is the average cost of terminal illness care in 2026?

The average cost of terminal illness care varies widely based on the specific condition, stage of illness, duration of care, geographic location, and types of services required. In 2026, costs can range from tens of thousands to hundreds of thousands of dollars, or even millions for prolonged, aggressive treatments. For example, the cost of cancer treatment can easily exceed $100,000 per year, and for conditions requiring extensive home care or long-term facility stays, annual expenses can be substantial. Palliative and hospice care, while often more cost-effective than aggressive curative treatments, still involve significant expenses for medications, equipment, and professional services. These figures highlight the critical need for comprehensive insurance and proactive financial planning to mitigate the potential financial burden.

Does Medicare cover palliative care for terminal illness?

Yes, Medicare generally covers palliative care, particularly when it transitions into hospice care. Medicare Part A (Hospital Insurance) covers hospice care for individuals who have a terminal illness with a life expectancy of six months or less, as certified by a doctor. Hospice benefits include doctor and nursing services, medical equipment and supplies, prescription drugs for symptom control and pain relief, physical and occupational therapy, speech-language pathology services, social worker services, dietary counseling, and grief counseling for the family. While palliative care can be provided at any stage of a serious illness, its comprehensive coverage under Medicare typically aligns with hospice eligibility. It’s important to understand that electing hospice care means foregoing curative treatments for the terminal illness, although care for other conditions remains covered.

How can I protect my assets if I receive a terminal illness diagnosis?

Protecting your assets after a terminal illness diagnosis involves several key strategies. First, ensure all estate planning documents, such as your will, trusts, and powers of attorney, are up-to-date. A financial power of attorney grants a trusted individual the ability to manage your finances if you become incapacitated. Second, review your insurance policies; life insurance with accelerated death benefits or cash value can provide liquidity. Third, consult an elder law attorney if you anticipate needing Medicaid to cover long-term care costs, as they can help with legal strategies for asset protection (e.g., establishing specific trusts) while adhering to Medicaid eligibility rules. Finally, be proactive in understanding your health