Wasn’t sure if this was the correct forum. Move it if it’s appropriate. Mods, I am not asking for medical advice but rather asking about information that will lead to me making the proper decisions in seeking medical advice from professionals. Hopefully that’s okay.
I don’t have insurance. I’ve been pretty healthy and have managed without it. I have an irregular job with an irregular income. I sought out private health insurance at one point but because I weigh around 300 pounds I was either not qualified for most policies, or the few that would take me wanted to charge several times the normal premium. At this point I can’t afford it.
A few months ago I had what seemed to be a very serious (and yet mysterious) medical condition. I went to the emergency room because I thought I was in serious danger of dying. After a CT scan and various blood tests they weren’t able to find a problem. The cost was high (and out of my means to pay)… I get the impression they only expect payment from a fraction of uninsured patients, and they end up charging several times the actual cost so that those who can afford to pay subsidize those who can’t to some extent.
The problem lessened quite a bit on its own although I haven’t felt totally healthy since then. Recently, within the past few days, the problem has grown more acute again. I’m not the type to seek medical treatment lightly - something is clearly seriously wrong.
I have no idea what my options are, except to go to the emergency room again if necesary. My 2007 income was low enough that I might qualify for some sort of assistance if there’s even anything like that available. Back when I lived in Ohio there was local assistance for low income care, but I have no idea if there’s anything like that where I live (North Las Vegas).
How do I go about finding potential medical treatment? Is there some sort of agency I can call to find out my local options? Is it at all typical for doctors to offer sliding scale fees? How would I go about finding out which ones would?
I have no idea where to start. Any help would be appreciated.
Look into something called a Community Health Center. This is an option that frequently makes sliding scale health care available. If Google doesn’t bring something up, check with a local nonprofit that might know where to refer you. United Way 211 may be able to point you in the right direction http://www.211.org/
Hospitals may realize that a lot of bills go unpaid but that doesn’t mean they won’t sell your debt to a collection agency, which will hound you and seriously mess with your credit rating, so it isn’t something to be taken lightly. Unpaid medical expenses send people into bankruptcy every day. Also, hospitals actually charge insured patients less than uninsured ones, because the insurance companies leverage their large customer pool to negotiate better prices. The hospital can’t afford to price out Aetna, but they can safely demand Joe Schmoe pay full price. As for whether they are overcharging, that’s debatable. Hospitals have massive overheads, the fancy equipment, highly skilled human resources, and of course they have to pay insurance too. Some hospitals do make a ton of money but I wouldn’t characterize the industry as a while as awash in windfall profits (unlike pharmaceuticals).
So basically, you’re in a tough spot. I would seek out any state or federal health programs you can take advantage of. If you have a disability of some kind you might be entitled to social security benefits, and if your income is substantially low there is also SSI benefits. Some states (not sure if Nevada is one) have started programs specifically to help lower income citizens who cannot afford health care. Other than that you can look for free clinics, but they are few and far between and the quality of care is inconsistent to say the least, not to mention the waiting times are astronomical. Lastly you can always try putting yourself on a weight loss program and getting to a size the insurance companies deem acceptable. Easier said than done, I know, but not only would it make health insurance more affordable for you, it would likely make you less likely to require using it.
May I also suggest that you begin making a regular monthly payment to the hospital even if it is a small amount such as $20. Be consistent and be regular. You may owe them $5,000, but a best effort regular monthly payment may make a difference.
I found this clinic in North Las Vegas. They have a number of clinics, offer sliding scale fees to the uninsured and they say no one will be turned away for inability to pay. I don’t know anything about them, but maybe they’re worth a phone call?
OK here’s what you do, first of all for the hospital, go there and see a person who deals with this. There are a LOT of government programs to cover bills, hospitals won’t look for them unless you make them. Inform them you cannot pay and you wish the amount to be written off. They will refuse. Offer them 10¢ on the dollar. If they don’t go for it. Tell them you wish to see their counselor for financial aid.
Is the hospital non-profit? In most areas they are required to provide a certain amount of charity care.
Whatever you do do NOT put this money on a credit card. Creditors can see you owe a hospital and understand that. They cannot understand why you didn’t pay a Visa bill.
Now the best thing you can do is take anything you own of value and put it in a friend or relative’s name. The problem with free healthcare is you have to be next to being homeless before the aid kicks in. For example in Illinois they have a program to help you with your rent but it won’t kick in till AFTER you are two months behind in your rent. In some ways I can see why they do that but still it doesn’t help much.
In most state you can only have between $1000 - $2000 in assetts before you are “poor” enough to get help.
Once you’re poor with no assets you can get on medicaid and food stamps. Even if you’re working enough to buy food and shelter, you need to get your hours cut back so you can qualify.
Lastly if you have no money go to an ER and bring no ID. Go in and be scared and disoriented and give them a fake name. Say you ran out of the house without your wallet. This won’t work for repeated visits, if you live in a small city without many hospitals.
Also look into places like the Salvation Army. They often have connections to volunteer doctors and dentists who will do somethings for you. Often if you offer to volunteer to help the Salvation Army they will arrange a dental check up or a medical checkup in return.
I suggest you do not do this. It’s known in the legal realm as “fraudulent conveyance” i.e., transferring assets to avoid paying a legal debt. If the hospital, or any creditor, believes you have done this, they can get the assets back and apply them to the debt with legal action. I’m not saying they will (depends on the value of the asset(s)), but be forewarned. Plus, even if you get away with defrauding the hospital and governmental agencies, what happens if the friend/relative declines to return it to you?
IAAL, but I do not represent you and this is not legal advice, but is good common sense, if you know the law. Good luck.
This is good advice. When my insurance refused to pay for a treatment (long story) I ended up owing $2,000. Soon after I left my job and was subsisting on minimal income. The hospital (University of Michigan Medical Center, for the record) set me up with a paymeny plan of $75/month, no interest. As long as I sent them something each month they were content, even if I couldn’t make the $75 on every occasion.
I also know someone who has been paying off a emergency helicopter airlift for their baby to University of Virginia Med Center in $50-100 increments for about 15 years, no interest there either.
Unfortunately, medical costs have been skyrocketing in Thailand for the past couple of years. It’s much more expensive than it was a few years ago.
In 2001, I had a salivary gland removed at an excellent private hospital, Samitivej Hospital, and the entire bill – operation, two-night hospital stay, surgeon’s fee, everything – came to about US$750. Today, that would run into a couple or three thousand easily if not more. Also in 2001, I had some tiny warts lasered off of my chin at the same hospital. That was about $35. A couple of weeks ago, I went to the same hospital and the same doctor for one large wart that developed on my neck. She cut it off, no laser involved, and that alone was $130. Prices are rising, and although still cheap by US standards, Thailand is simply not as good a deal as it once was.
These days, I recommend people go to India for their health care.
I’ve run into the problem that I’m too poor to qualify for sliding scale fees, apparently. I didn’t have any income last year - therefore I have no tax return. And I don’t have a pay stub. I can’t prove that I have no income due to lacking any documentation, and therefore I’m not eligible to apply for their sliding scale discounts.
Don’t let them pull this shit. Homeless folks have no documentation either.
Be forcefull and creative. Go ahead and file the zero-income return; file an affidavit of no income; provide 12 months of your bank statements, etc etc. There has to be some degree of flexibility on their part, so don’t just take “no” for an answer.
Different hospitals have different programs, and som are much more generous than others. Research the charity programs of all medical facilities in your area and find the best one. Some hospitals provide free services for the absolutely destitute.
If you’re on medication, check the pharmaceutical companies to see if you qualify for their charity programs. Most of them do have charity programs of some sort. Also, get a list of the Walmart $4 meds, and consult with your docs to determine if you can save money there.
You’re in a tough spot. I hope things turn out well for you.