Statute of Limitations on Medical Bills

A couple weeks ago I received three envelopes in my mailbox from a collection agency. This fact itself was not shocking as invoices of mine have been sent to medical collections several times since I became ill. The shock came when I realized they were for Dr. appointments I'd had before I even became ill and while pregnant with my daughter.  Due to my low income at the time, I'd qualified for Medi-Cal which is medical coverage that's subsidised by the state of California. Many low income women in California qualify for this program (which incidentally, ends one month after your child is born). It's a great program but, like so many others, has it's definite flaws.  The invoices totaled over three thousand dollars for services that took place in 2009, almost exactly three years ago.

At first I thought, "how can they be demanding money for something that occurred so long ago"? I did some research and found that there is a statute of limitations on the collection of medical bills. It varies from state to state but typically falls into the three to four year range. California has a four year statute of limitations on the collection of medical bills. When I discovered this, I felt beaten for sure. I dusted off my pre- Fibromyalgia/ME/CFS medical files which are in with the rest of my life's paperwork. When I became ill I had to start storing all of my medical records that delt with these new illnesses in their own box since they took up about as much space as all of the other paperwork combined. Though I'm normally pretty good about filing important documents, I'd apparently cleaned out my files from my pregnancy because I couldn't find the invoices in question.  So silly of me to think that since the invoices had been paid three years ago, it was a done deal.  Lesson learned...don't throw away invoices even if they've been paid in full and the accounts have supposedly been closed.

My story does have a happy ending through, I think.  I collected all of the information I had and made appointments with the advocate I'd worked with during my pregnancy and a representative from the billing department.  I also contacted my bank, Medi-Cal and the billing service my doctor's office uses and asked for copies of records to be sent.  I finally convinced the billing department to drop the case - I think.  The last time I spoke with someone there, I was told they had recommended the invoices be "written off".  I haven't heard anything but I wouldn't be the least bit surprised if next month I get the same invoices from the collection agency.  It seems nothing ever gets done correctly the first time.  That's been my experience anyway.

Uninsured With ME/CFS and/or Fibromyalgia - Part 3 - Prescription Medications

This post is the third in a series concerning financial strategies for those who've been diagnosed with a chronic illness, are uninsured and living on a low income. Click below to see the original post:

What to Do When You're Diagnosed With ME/CFS and/or FMS and Don't Have Health Insurance

So, you've seen the doctor, had some blood work done and depending on the results, may have gotten a prescription to address your pain, fatigue or other symptoms.  Many prescriptions for ME/CFS and Fibromyalgia are new and really expensive.  This also means that there aren't generic alternatives.  One doctor I saw prescribed Cymbalta which has a three-hundred-fifty dollar per month price tag!  Incidentally, this particular doctor (a Rheumatologist) had almost no experience dealing with low income and/or uninsured patients as well as countless other faults.   I filled only half of the prescription and charged it on my credit card.

The clinic my GP (who I really like) practices at, has a person on staff who helps uninsured, low-income patients obtain prescription medications at discounted rates or for free, depending on the situation.  When I first started seeing this patient advocate few years ago, it all seemed like magic.  My doctor wrote the prescription and had it forwarded to the advocate.  I made an appointment to see her, she explained which financial papers I needed to provide, she'd fill out some forms and I'd sign them.  In about two weeks, I'd go back, she'd hand me a bag of name-brand prescription bottles, I'd thank her and walk out the door without paying a dime.  Later I started catching on to what she was doing.  The best part is, anyone can do it!

The advocate was simply contacting the pharmaceutical companies and applying for financial assistance on my behalf.  I thought, I'm pretty smart, I can do this myself.  It ended up being easier than I ever imagined.

When I first learned about the high cost of Cymbalta, I started to panic, thinking I'd never be able to afford it.  Then I looked back in my records at the forms my advocate had filled out.  I tried to mimic what she had done. 

The pharmaceutical company that manufactures Cymbalta is Lilly, the same company that makes Prozac. I went to the Lilly website, searched around a bit and finally found a financial assistance form to download.  I can't remember exactly which financial documents they required, but I believe I sent a copy of my previous years tax return and a month's worth of my husband's pay stubs.  I put the application and accompanying documentation in the mail and prepared myself for the usual routine, complete with countless follow-up calls and re-submissions of my application.  To my overwhelming shock, the situation I'd come to expect, never materialized.

About two weeks after I submitted my application, I took out the copies of what I'd sent, took a deep breath and dialed the customer service number, poised for battle.  A friendly man answered the phone  and asked what he could do for me.  I explained that I was calling to check on the status of a financial aid form I had submitted.  After obtaining my name, he quickly pulled up my file.  I had expected the usual "I'm sorry, our computers are really slow today" line, but no excuse was needed.  He cheerfully reported that my application had been approved and the medication was already on its way to my doctor's office.  I thanked him profusely, and hung up the phone in utter disbelief.  His claims were not fiction as I picked up the four bottles of Cymbalta during my next doctor's visit.  My doctor, apparently not used to dealing with uninsured patients, did not handle the whole situation well at all and I never saw her again after that.  But that's beside the point.

What I'm about to write is also beside the point but has to be said. I found it interesting, to put it mildly, that the pharmaceutical company was so willing to mail me drugs with a value of approximately $350. It says volumes about how over-priced these drugs must be in the first place and how huge the profits are. You wouldn't, for example, walk into a grocery store, show them a copy of your tax return and get $350 worth of groceries. But, I suppose I shouldn't look a gift horse in the mouth (if you'll excuse the cliche) so I won't continue with this particular tirade

The point is, that it is possible to get prescription drugs at a discount. Most drug companies will give just about anyone (with a prescription from your doctor of course) a free one month trial. You can usually print the coupon out on your computer and give it to your pharmacist with your prescription.

In the next post, I'll tell you about third party drug distributors that offer huge discounts. Yes, it's legal and based in the USA.