W/o getting into a debate about the health care companies I am wondering what all options are there if you cannot get affordable health coverage due to pre existing conditions.
Off the top of my head:
Move to a guaranteed issue state like Vermont where insurers must cover everyone
Move to a state with a high risk pool that has guaranteed issue
Move to another country if possible (in Mexico supposedly you can get health insurance for $250/yr).
Pay out of pocket for treatment in India or Singapore
Go to a low cost or charity clinic.
Find a job that offers health coverage.
Marry someone who has a job that offers health coverage.
Try to manage the condition yourself.
Nothing.
Wait to turn 65 and get medicare.
Anything else? I’m not sure if this is GQ material, but I’m looking for factual answers more than a debate on the ethics of health insurance industries.
There are complicated needs-based eligibility rules, and it doesn’t cover everything, but in general Medicaid will provide some coverage if you are:
A. on a low or fixed income that meets the current eligibility standards, and
B. meet one or more health-related eligibility requirements, including children with disabilities, pregnancy, blindness, HIV, and a long list of other problems.
You missed an obvious one that is often done.
Pay for the services of local health care provider. Work out a payment schedule that takes years to pay off if you must. Don’t miss a monthly payment or you can go to collections.
Actually that doesn’t sound that far-fetched. I knew a girl who spent some time in jail and she said though it wasn’t a hellhole, the worst she went through (besides obviously lack of freedom) was intense boredom and bad food. Doesn’t sound all that different from my present life!
Yeah, you can get care just by paying for it. Some people, I believe, choose to live this way - instead of paying monthly premiums they just take it on the chin every time they have to go to the doctor.
A question for the OP - are you talking more about pre-existing conditions that require regular medical care like diabetes, AIDS/HIV, cancer or kidney problems requiring dialysis? People under those circumstances probably do things a lot differently than your run-of-the-mill uninsured person. They probably do consider most of those options.
People who were denied because of something we might consider “trivial” (only thing I can think of is my own case, when I was nearly denied because I have PCOS (a not-terribly-complicated female thing)) more likely than not just deal with it. In my case, the only thing I need to manage my PCOS is The Pill and I can just pay cash for that at Planned Parenthood. People get denied because of all sorts of stupid little things, that don’t necessarily warrant a lot of medication or doctor visits over the course of their lives.
And, one other point…not everyone who doesn’t have insurance doesn’t have it because they were denied. Everyone I know who doesn’t have it either doesn’t have a job, doesn’t have a job that offers it, or can’t afford the plan their employer offers. They also just take it on the chin when they need care.
Teaching hospitals (especially state run ones) usually offer some types of free or very low cost programs for people that qualify even for things like cancer or dialysis. They aren’t “clinics”. They are research institutions that tend to provide very high quality care in order to train new doctors and nurses. Likewise, someone can enroll in research studies for cutting edge treatments. Not only are those free but you usually get paid a little to be in them. You are a test subject but they usually give the best care available to make the study work and some follow-up care after it is complete. I have done that twice myself.
The last resort is simply to go to the emergency room every time you have a medical need even if it is several times a week. They can’t turn you away and, if you are so broke you can’t afford any type of insurance, you just ignore the bills…forever. It is a terrible solution but you will get the care that you need no mater how much it costs. The hospital just has to eat your expenses.
The expenses associated with the U.S. health system are a mess but almost anyone can get great care somehow regardless of their financial situation but it takes a little research.
I didn’t know that and I find it interesting because one of the supposed “advantages” of my employer’s high-deductible (HSA) insurance is that, while you are paying premiums and also almost every medical cost until you meet the deductible for that year, you get the “advantage” of the insurance’s negotiated price instead of the “regular” price. If providers are providing a discount for cash patients, too, then who pays this “regular” price?
For my family, who has never met the deductible in any year since they started this plan, it would seem to make more sense to have no insurance at all. Why pay premiums and then still pay out of pocket for almost everything? Of course, we keep the insurance in case Something Bad Happens, especially something that would give one of us a Pre-existing Condition.
Not anyone I’ve gone to here. Most providers I’ve been to charge more, sometimes twice as much, for non-insured cash patients. A hundred-dollar to insurance company A costs 150 to 200 for me, uninsured person. Something about bulk rates, contracts, and guaranteed repeat business due to being the “next” person on the list to be referred to. Meanwhile, I’m a one-off, and they can’t enforce the “she comes back to me for anything else” rule, so they can’t rely on any future moneys. Apparently I also expect unreasonable levels of competence, bedside manner, and information, and won’t just get the test done at X clinic (like the insured people do) without knowing more about the test, why it’s needed, what it’s for, and why THAT clinic, and not this other one that I like and regularly go to. This all affects price.
I want to say that I’m not slamming doctors or whatever. Most doctors are a good fit for someone, just not necessarily me. However the ability to shop around makes many doctors, not all, not trust the patient to come back, and that affects price, as in “we have to make a new chart for you for this first visit, and that costs money we can’t expect to recoup in repeat business”, so the uninsured price can be higher for these reasons as well.
I put 4 and 5 up to support that idea of paying yourself for medical care.
Pay out of pocket for treatment in India or Singapore
Go to a low cost or charity clinic.
If you have a severe problem and need $300,000 worth of medical treatment in 2 years, you might have to go to a different country to have it done (Singapore, India, Mexico, Thailand, China, etc) for 50-90% less. But it would still be out of pocket and on a payment plan.
But if you have a chronic condition that costs $10,000+ a year to manage, then a payment plan isn’t necessarily going to work because the bills will keep adding up.