no med insurance.... what do I do?

[bardgal]

I have had medical insurance all of my life, until I lost my job a year ago. well, it's time for my annual girlie-checkup (pap/mam) and I don't know what to do.

How does "county" stuff work?

I'm looking into doing a basic coverage at $106 a month, even though I can't afford it, and if I get really sick I'll be bankrupt regardless of having insurance since I won't be able to pay the 25% copay stuff....

help

[Beaverhausen]

1. When I had no insurance I went to Planned Parenthood

they will do the exam for nothing or they will ask for a donation. They also can refer you to clinics for the mamogram.

[Zing Zing Zingbah]

20. I go to Planned Parenthood too...

but they charge $75 for pap test. Maybe some of them ask for donations, but those Planned Parenthoods probably have a lot more money. I've never heard of anyone getting free services from Planned Parenthood, just cheaper services. They also charge any where from $15 to $20 a month for different formulations of the pill.

[Beaverhausen]

22. they do it on a sliding scale

so you may make too much $$$ to get the free care they offer. Or maybe in California where I am they are better funded. I never had to pay for the tests or the pills.

[Zing Zing Zingbah]

38. Hmmm....

I qualified for sliding scale fees for my son's doctor visits. I'm not sure they have them at the planned parenthood in my area Orlando, FL. I imagine they are a lot better funded in CA. They never mentioned sliding scale fees and never requested any financial information. They seem to charge everyone the same fee, but they try to make it a low fee. I imagine they don't get enough donations in my area to operate with a sliding scale fee. The majority of the women that go there would qualify for the free or reduced health care, if they offered the sliding scale.

[Padraig18]

2. Check with your state health department.

Illinois has a program for low-income women to provide annual PAP smears and mammograms. Your county medical society or health department could also tell you if your state has something similar.

Good luck. :)

[autorank]

3. Look at Blue Cross-Blue Shield.

If you're in CA, I strongly suspect that there is some regulation that says CA insurance companies have to take everybody. If you're young, you can get single coverage directly from them for a fairly low price. There may be other options but BC/BS plans can be very good and are generally very competitive. Also look into Kaiser Permanente. They're headquartered in CA. The BC/BS plan would put you in a network of physicians and other providers. You may have some choice with that. The Kaiser plan would be a straight HMO. If you are pushy, you can make these work for you.

Good luck.

[mermaid]

4. Beat Me To It

I was gonna recommend Planned Parenthood. They usually operate on a sliding scale from zero to whatever you can give.

Better idea than getting basic coverage at $106 a month....just SAVE 106 dollars a month, and then, if you happen to need to go to the doc, you'll have the money, and not some shtty insurance company that'll STILL make you pay 25%.

I saw something on the Net a while back about "health-care contracts" or some such, where individuals actually go to individual doctors, and execute a contract for basic preventative care and routine checkups, where for a certain agreed amount, you see that doctor all you need to.

And just hope nothing catastropic happens...or get yourself a cheap catastrophic only policy. Such things do exist.

But, the short answer to your question...what do you do?? You just go without health care...after all, according to Bush and his ilk health care isn't a right, anyway...it's a privilege...and, if you can't pay for it, then you got no right to get sick...or you better just suffer being sick. You are poor, so you don't have a right to be healthy. Why the fuck should THEY care?? After all, THEY got theirs...why should they give a shit if YOU get anything?

SELFISH FUCKIN' BASTARDS!!

I'm in your same boat, by the way...I, also, have no health insurance.

I think I got a pinched nerve or something in my foot, because it hurts like a bitch. But I gotta just deal with it...because I am not WORTHY of being healthy, whole, and pain-free. Go figure...my DOG has veterinary insurance (12 bucks a month) but I have no health insurance. What does that say about life in Amurika?

Welcome to 1984.

Goodbye, America, I loved you!

[Merlot]

7. My favorite fantasy TV show is ER

Imagine going to a ER and being treated without being asked if you could pay. I'm not sure how it works on the TV ER, but in the real ER's here in CA (the ones left open after arnie's budget cuts) they expect insurance up front. I don't know what would happen if I walked into an ER, but hopefully will never find out.

[Beaverhausen]

8. ER takes place in a county hospital

they have to treat everyone who comes in...insurance or not.

[amazona]

14. er, not really they don't

They have to stabilize you. That is it. They don't have to treat breast or cervical cancer. By the time cervical cancer is an "emergency," you are dead anyway.

The conservation movement is a breeding ground of communists
and other subversives. We intend to clean them out,
even if it means rounding up every birdwatcher in the country.
--John Mitchell, US Attorney General 1969-72

[Merlot]

5. If you go to PP take a book

When I called them they told me it would be a four hour wait before I got the test. I decided to save up my money and go to a local ob/gyn. The exam cost me over $200, but I saw a doctor, and I'm not sure if you see a doc or a nurse at PP. But PP is a good option.

Obviously I don't have insurance, I just stay as healthy as possible. Like you say, if you get reallly sick, you won't be able to pay the 25% anyhow. And that's 25% of the covered costs. Sometimes they don't cover the costs, and the doctors expect you to pay the difference. I just gave up on the whole insurance thing for now.

[Ilsa]

10. A nurse practitioner might be a better visit.

A nurse is more likely to want to do patient teaching, answer questions, etc. That's been my experience. If I had to choose between a doctor who just got out of OB residency and a really experienced nurse practitioner, I might choose the NP.

I'm a nurse, but not a nurse practitioner.

[Heddi]

16. Most are NP's at Planned Parenthood

I've never seen an actual MD at Planned Parenthood...always Nurse Practitioners. I'm a nursing student :) and one of my instructors (ARNP) is an employee at PP and I've actually had him do one of my depo shots in the past :)

[mourningdove92]

6. You could also check with your county hospital. All counties

are supposed to have a specified county hospital. Most will take you on a sliding scale.

[Ilsa]

9. Do you need a mammogram every year?

I'm in my forties, no family history, regular BSE. I get one about every two years. But do whatever is comfortable for you.

[bardgal]

11. I have been.....

I'm 45. no history. but I have had bad paps come back, and had to have a cold cone to remove some pre-cancer cells back in 97. I don't want to go too long without a test.

[Ilsa]

17. Those are good reasons.

Anytime a patient is uncomfortable with the possibility of putting off a test, I'd say go do it. You have to go with your gut instinct on these things, too.

I hope all the news is good news so you won't have any further medical bills.

[Samurai_Writer]

12. Go to Planned Parenthood

They do PAPs on a sliding scale fee. Don't know about the mammogram... been putting off mine, since my insurance sucks and I would have to pay a $3000 deductible before it kicks in.

[amazona]

13. get the insurance first

While in my area you can get free/low cost mammograms, I have to think you would have to be insane to look for breast cancer before you had coverage. If they found something, you just became un-insurable, which means no treatment. Get the insurance FIRST before getting a check-up.

Right now, you have no pre-existing conditions as far as you know. Keep it that way.

I was un-insured for many years but you have to be smart about it. Getting the free/low cost check-ups are a trap if they mean you can't receive treatment for your illness.

Getting treatment and then going bankrupt because you couldn't afford all the co-pays is WAY better than not being able to receive any treatment in the first place because you have no insurance contract.

The conservation movement is a breeding ground of communists
and other subversives. We intend to clean them out,
even if it means rounding up every birdwatcher in the country.
--John Mitchell, US Attorney General 1969-72

[Heddi]

15. Like others have said, go to Planned Parenthood

I don't know what it's called in other states, but in Washington, it's called "Take Charge". You fill out a paper and list your income and your expenses and if you fall within a certain guideline, you get:

Free Paps
Free GYN exams
Free birth control (including the pill, depo, IUD, the patch, cervical cap, AND TUBAL LIGATION ((if that's your thing)))

Here in WA, Take Charge lasts for 1 year, and then you can reapply. I've qualified for 3 years running and I get my latest depo shot tomorrow.

You pay NOTHING. Nada. Zip. Zero. Zilch

And the first year I applied, I wasn't working and didn't have insuracne but my household income from the previous year was aobut $40k. I was really worried that I"d be disqualified b/c of my previous year's income but they don't care about previous year. They care about right now. Today. How much money do you have NOW?

They're very good wrt women's health AND mens' health. Because *I* qualify for Take Charge, my husband does as well and can get free sterilization if he wanted it (he doesn't want it)

[mondo joe]

19. Also in WA state the BCHP will pay for breast exams and mammograms

Also in WA state the BCHP will pay for breast exams and mammograms if you are uninsured.

[Heddi]

21. What is BCHP?

I'm a nursing student and this week was caring for a 29 yr old female who had no health insurance and needed references for community services to help her with her meds, etc.

I was able to find some sources out here in Yakima, and I refered her to PP for the pap's, but I'm keeping a list of places that can help the uninsured for basic medical services, and I'm not familiar with BCHP and would like to add it to my 'resources' list to give to patients who need it.

Thanks!

[mondo joe]

24. Washington Breast & Cervical Health Program

It's state $ allocated through community health centers (and maybe other providers as well?) to fund breast and cervical cancer screenings.

The $ have shrunk over the years so even those with the $ may be more careful with rationing them (as in they may use them for established patients only, or may have other screens).

[Heddi]

27. Great info! Thanks

I'll check into it and see if it's something I can use to give to my patients who are economically disadvantaged (read: 98% of them) if they need those services!

I and my patients THANK YOU :)

[mondo joe]

28. You might also look into the Susan G Komen Foundation...

... to see if there are programs they fund in Yakima - I don't know the area so I can't say.

I'd also suggest your uninsured patients look into the Basic Health Plan, the WA state coverage option.

[Heddi]

30. I think that Basic Health is no longer taking enrollments

They had an open enrollment period back in September and it lasted 3 days I believe, then they closed it and a week later announced that I think 40,000 people were being dropped from basic health because of lack of funds.

:-/

[mondo joe]

31. Actually, enrollment is back on. I'm pretty sure.

One of the negative effects of closing enrollment is that now a lot oof people think it's not available.

[Heddi]

32. You are just the greatest source of info for me today

Thank you SO MUCH!!! As of Friday, I had about 8 local contacts for my patient.....I was hoping to get at least 25 before the quarter was done and just keep adding to it as I found different services.

Thank you SO much. You really don't know what a help you've been to me, and ultimately to the patients that I will care for throughout my career.

I really do appreciate it.

[mondo joe]

36. Good! Glad to help. I'm actually in Olympia today....

... asking* legislators to do a few things, one of which is to at least maintain BHP enrollment.


(*I'm here as one of many people - my "ask" isn't as personal as it may sound here.)

[philosophie_en_rose]

34. 1-800-826-2444 for Washington residents

www.basichealth.hca.wa.gov/

Basic Health enrollment is currently open and it's important for people to sign up, because it could close at any time.


Sign up by calling 1-800-825-2444 or downloading the forms at http://www.basichealth.hca.wa.gov/forms.shtml .


**********************************************************

Is Basic Health enrolling new members?

Important notice: Basic Health is currently accepting new applications and anyone interested in enrolling for coverage is encouraged to complete and send in a Basic Health application. You can download and print an application and instructions, or call 1-800-826-2444 to request one. Applications will be processed on a first-come, first-served basis.

If we reach enrollment limits you may still apply if you meet the guidelines listed below.

• Children applying for Basic Health Plus
  
• Pregnant women
  
• Licensed foster parents and their eligible family members
  
• New members of an existing tribal sponsor group
  
• Personal care workers contracted with Department of Social and Health Services (DSHS) and their eligible family members
  
• Employees of state-contracted home care agencies and their eligible family members
  
• New employees of an existing employer group and their eligible family members
  
• Current members’ eligible family members added due to marriage, loss of other coverage, birth, adoption, or custody change
  
• Current members transferring to a new account, for example due to divorce, separation, child's ineligibility for coverage under parents' account, or loss of Basic Health group coverage
  

[mondo joe]

18. Look for the nearest Community Health Center

You can get very good care primary care from a Community Health Center (CHC).

Your profile says you are in LA so you might look here: http://www.ccalac.org/gwHome.asp

There is a Find a Clinic link on that page.

[NV Whino]

23. It looks like you're in CA

Check out Kaiser. I went without med insurance for a looooong time. Then I got Blue Cross, who promptly doubled my payments when I hit 45. Then I went without for a looong time again. Had a little health scare and then found Kaiser. At your age the payments shouldn't be too bad. What convinced me was 100% hospitalization, no deductable. Bad things happen, it's the hospital that eats up your money.

[bardgal]

25. Like amazona said, I render myself uninsurable .....

if they find something wrong. Even if I go to a clinic, will they treat me if something is wrong?

As for Kaiser, they're cheapest plan is $190 mo. I can't afford that.

[mondo joe]

26. Depends on the clinic

In answer to your question, treatment depends on the system.

In WA state some centers have relationships with specialty care providers and hospitals.

I don't know CA well enough to comment on what might be - but they may be able to help.

It's worth a phone call at least.

[Heddi]

29. This is what I do for my patients who are uninsured/low income

who need help with either followup medical care, medication, etc:

(note, I'm in Washington State, so some of these might not apply to you, but try them out)

1) YOU must be your own advocate. Sadly, no one is going to advocate for you. Be persistent. Keep a journal--when you call facilities, note the time you called, the person you spoke with, and keep good notes with regards to what they told you.

2) Start off by calling your local Department of Social Services. You may not be eligible for federal programs like Medicaid and Medicare, but they MAY (may!) be able to refer you to clinics that service low-income populations and work on sliding-scale fees

3) Call your local health department. Many will have certain days of the week set aside for screening programs---blood pressure, cholesterol, etc. It may not be exactly what you need, but any amount of free service can help you, you know

4) Call local shelters, missions, and clinics that service economically depressed clientelle. You may be eligible, again, for sliding-scale services (out here we have a Union Gospel Mission Clinic that gives free med appointments 2 days a week for those that qualify, and very reduced pay (as in $10-15 per visit) for those that don't qualify for the free program

5) ALSO ASK ABOUT MEDICATION VOUCHERS---many places will either give you free or very reduced cost prescriptions if you qualify. Others will give you 'vouchers'--a patient I had this week couldn't afford her asthma medication, and although she wasn't homeless, a local homeless advocacy group was able to secure her a $25 voucher for asthma medication. THey give you the $25 voucher, then they charge you very discounted prices for the medication---she was able to get about $80 worth of meds for the $25 voucher

6) Check out local food banks in your area. They can't help you with your health or medication needs, but if you can save $40 a week by getting food from the food bank, that's $40 you can put towards medication or medical care

Then, there is this option which I think should be your last option:

7) Hospitals legally cannot refuse to serve you even if you do not have insurance or do not have means to pay. If you are sick, and you have to go to the ER, GO TO THE ER even if you know you cannot pay the bill. THEY MUST SERVE YOU AND TREAT YOU.

Equally, they must ALWAYS serve you when you present yourself to the ER, even if you have outstanding hospital bills. That was the situation my asthma patient was in. She couldn't afford her meds, so when she had an attack, she'd have to go to the ER. She was hospitalized 12 times in the last 2 years b/c of Asthma Attacks. She estimated that she owed the hospital upwards of about $40,000 for her hospitalizations....obviously if she can't afford an inhaler, she can't afford an ER bill...but they (the hospital) were REQUIRED TO TREAT HER WHENEVER SHE PRESENTED HERSELF REGARDLESS OF HER ABILITY TO PAY.

So if you find yourself in a situation where you need medical treatment and you cannot pay for it any other way, use the community hospital system. As a medical professional, this is an abuse of the system (in the sense that ER's aren't set up to handle people with non-emergency situations), however if that's the only way you can get treatment, then you do what you need to do to get treatment.

Of course the downside is that you'll have substantial debt due to hospital bills, your credit may be ruined, and any state income taxes you may be entitled to reveive via refunds may be held to pay off your debt. But those are choices YOU need to make, and I absolutely CAN NOT condem someone for using what is for many people the only available means of treatment that they have.

perhaps if we had some kind of...oh I don't know...UNIVERSAL FUCKING HEALTH CARE poor people wouldn't clog up the ER's with ear infections and asthma attacks. But they have no other choice, no where else to turn, so they go to the ONE place that MUST treat them---the ER.

[DU GrovelBot]

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[bardgal]

35. thanks everyone!

right now, I think I'm going to go with a Health Net minimum coverage at $106 a month. I can't afford it, but it's better to be alive and file a BK than untreatable.

[mondo joe]

37. I again urge you to check in with a local community health center

If they're a Federally Qualified Health Center they can't turn anyone away based on lack of insurance or inability to pay (not that they'd WANT to turn anyone away).

They're also often quite good at helping sort out programs you mmay be eligible for.

[Zing Zing Zingbah]

39. I found this web page about free pap and mammograms

http://www.rk4cure.org/uninsured.htm

It seems most states have a program for free pap and mammograms, but mostly only for older women (like at least 40+). It depends on the state. NH (also VT, WV, NC) seems to have the best program (women 18 to 64 qualify). Maybe this is why some people are getting the tests for free. I'm only 25 and in Florida, so I have to pay for my pap tests.

[bardgal]

40. thanks this is great info!