I was talking to a friend yesterday about the hardships of being chronically ill, uninsured and living on a very low income. I was giving her some advice about getting her medications at a reduced rate and thought it would make a great subject for a blog series. I've learned so much in the last two years, being uninsured, suffering with ME/CFS and Fibromyalgia and having to take a long, unpaid leave from my job.
I haven't had health insurance for a long time - about ten years I think, which was the last time I had an employer who offered it. When I was laid-off from my job, doing books for a software development company in NYC, I wasn't able to afford Cobra since I only received one month of severance pay and health insurance. After that that I had lower paying temp jobs that didn't offer health insurance at all. I didn't earn enough to pay $200 per month for insurance and believe me, I looked everywhere for something I could afford. I simply didn't make enough to pay rent ($900), utilities ($100), car payment ($300), food, gas, etc and health insurance on top of all that. You may be wondering why I'm going into all this personal detail about my finances. I know there are many people out there under the delusion that health insurance is available to anyone who works. I hope my story will open some eyes to the hardships many US citizens endure simply because they become ill.
When I lost my job in NYC, I was twenty-five years old and healthy. The occasional visit to the doctor and some anti-biotics to treat a sinus infection, for example, was expensive but doable. I recently turned thirty-nine and I spent about six thousand dollars in 2011 on Dr. visits, blood work and prescription medications and a large sum the year before as well. This is far from doable for me.
There are exactly four people (including myself) who work at the very small hotel I manage. The owners do not offer health insurance because it would take a huge bite out of their profits, making the business not worth having. Large companies can get group discounts on health insurance for their employees, but this is simply not realistic for small businesses. Two other small business owners I've worked for apologetically reported the same findings.
As my mysterious illness progressed during the last two years, I was forced to take a medical leave from my job which made paying for my mounting medical expenses increasingly difficult. I'd set up payment plans for most of my bills, but it was becoming difficult to even pay those amounts each month. I did learn some really valuable lessons along the way though, about reducing many of my medical expenses.
If your income is low enough, you can usually qualify for many different programs. Unfortunately, if you're a person who has a mid-to-low-range income (a single person who makes less than around $25,000 per year, more if your married and have children), you can get caught in "no man's land" where you don't qualify for assistance but your income isn't high enough to pay cash for your medical expenses or for private health insurance each month. I would guess that a very large percentage of people in the USA fall into this category. But I won't get on my political soap box because that isn't what this post is all about.
Your battle plan should start even before you walk through the door of your doctor's office. When you make an appointment, ask the person on the phone if their practice offers a sliding scale or other financial aid for uninsured, low income patients. Even if you're not sure whether or not you fall into the "low-income" category, fill out the forms anyway. You may qualify for something. I've found that doctor's office staff seldom offer this information so you have to ask! My doctor, for example, offers a twenty-percent discount if you pay your bill on the day of your visit. This brings the total, for me, to less than $100 per visit. Even if I don't have the full amount that day, I put it on a credit card and pay when my bill is due. Try to avoid paying in cash as it's harder to prove how much you've paid towards medical bills. You may need hard proof of these expenses in the form of bank or credit card statements in the future.
I should warn that some practices do not treat people without health insurance. This came as a huge shock to me the first time I encountered it. I was desperate to see a doctor I'd read really good things about and offered to pay the full amount in cash before even seeing the doctor, but I was turned down. I'm still a bit confused as to the motivation for this policy.
My doctors office also offers "Charity Care", a program based on income level that provides discounted or free services. I'll emphasise that you have to talk to an administrative person about this, not the doctor. Doctors, I've found, are frequently unaware that these programs even exist.
In my next post, I'll write about how to get discounted or free prescription medications and more.
Also - This is my 93rd post - 7 more till my 100th, where I'll post the coupon code for 20% off your entire order at Catalina Inspired on Etsy.
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