Health care—and the medical insurance coverage to help pay for it—is important, particularly to families with existing medical problems. Those who require regular medical treatment, maintenance drugs or ongoing therapy are particularly vulnerable to the dangers of being without medical coverage.
But just because you are without insurance and are short of income doesn’t mean that no health care is available for your family. We will look at how and where to get health care and medical supplies for little or no cost.
Remember: When laid off or on strike, maintain your health insurance if possible. Check with your union representative and/or the company insurance office to see what is required under the union contract or under COBRA to carry your employee group health insurance after you leave the plant. If you are able to afford the premiums, this is your best option. Even if can’t keep up the premiums, your employee coverage usually extends 30 days after the premium date. Find out about your coverage.
“My nightmare,” a laid-off California steelworker told her AFL-CIO Community Services Liaison, “would be my son needing an operation before I can find another job with insurance.”
Medicare is a Social Security program funded by the federal government. It provides hospitalization and other types of medical care for:
Benefits and payments are determined by Congress and are the same across the country. Apply through the local Social Security office.
Medical Assistance (Medicaid) is a government program that provides a range of medical benefits to:
Medicaid receives state as well as federal funding. Benefits, level of payment and days of hospitalization may vary from state to state. Call your state Medicaid office to determine what programs are available in your state.
The State Children’s Health Insurance Program provides health care coverage to children (under 19) whose families earn too much to qualify for Medicaid but are unable to afford private coverage. Children are covered if their families earn up to 200 percent of the federal poverty level ($34,000) or more in some states. Contact your local state Medicaid office for information, or call 1-877-KIDSNOW.
County health departments usually offer a range of health services at little or no costs. These services may include:
Check with your county health department to see what services are provided in your area.
Look for a Hill-Burton Hospital
The 1956 Hill-Burton Act states that some hospitals must provide a certain amount of services free, or at reduced cost, to patients who are: unable to pay, uninsured or ineligible for government benefits.
Check with the business office of your hospital.
Or, call 800-638-0742 to see whether your hospital is required to provide care under Hill-Burton. If it’s not, ask for the hospitals in your area that operate under Hill-Burton requirements.
If your hospital doesn’t fall under Hill-Burton, some hospitalization may be available through public grants, private nonprofit trust funds or other sources. Ask the hospital business office.
In communities with more than one hospital, your doctor normally would determine where you should be treated.
Your doctor may select a hospital for a specific medical reason. For example, a certain hospital may have a specialized heart or cancer unit, or it may be equipped to conduct special scans or tests.
But when routine medical tests, procedures or minor surgery is needed, your doctor may choose your hospital based on criteria unrelated to medical questions. For instance, the doctor may have:
The hospital the doctor uses may be a problem for you. If it is a private, for-profit hospital, it may be difficult to make payment arrangements. A nearby public or university-based medical facility—or a Hill-Burton hospital—may be much easier to work with.
Have a frank and open discussion with your doctor when he/she recommends that you go the hospital:
Remember: Sometimes doctors can make admitting arrangements that you may be unable to make. Ask your doctor for help in getting the lowest possible cost.
You are a consumer in the health care market. If there isn’t a medical reason for using a particular hospital, you may benefit from shopping around just as you would for any other service.
It usually pays to find out which hospitals or clinics are easiest to work with before you need one.
Most hospitals will provide care and work out a payment plan for paying the charges. These arrangements must be negotiated with the hospital business office, sometimes before you go to the hospital.
Be careful! Don’t agree to higher payments at more frequent intervals than you can afford.
Most hospitals have a standing arrangement with a local lending institution or bank to loan you the money to pay your hospital bill. Under this arrangement, the hospital is paid, but the patient owes the installment loan to the lending institution.
Consider this option carefully—you now will owe the amount of the hospital bill plus interest on the loan.
If you are in a severe financial situation, chances are the bank won’t make the loan anyway. On the other hand, this option might be worthwhile if it is the only way a member of your family can receive the care he or she must have.
Be careful if you are asked to secure a loan with property or other collateral.
If this loan can be made unsecured (that is, without collateral), and your financial situation worsens, the debt may be restructured under a Chapter 13 adjustment or washed out under a Chapter 7 bankruptcy.
When dealing with hospital billing, loan or payment plans:
In a life-threatening emergency, go to the nearest hospital emergency room or direct the ambulance to go to the nearest facility. Hospital emergency rooms usually won’t haggle over money where a life is in danger. Later, work out the best terms possible for repayment.
Your family doctor has benefited from serving your family over the years when you were working. Don’t be shy about discussing your financial situation honestly.
Your doctor may be willing to wait for the fee or to see you without charge. You won’t know unless you ASK!
See if the American Medical Association (AMA) chapter in your state has a Physician Referral Service. It may be able to give you the names of doctors who are willing to provide some uncompensated heath care.
The state medical association usually is headquartered in the state capital and generally is named for the state; for example, the “Georgia Medical Association.”
Many communities have public or voluntary-supported low-cost or free health clinics serving low-income households. Medical examination, prescription drugs or other services often are available through these programs.
Examinations, vitamins and other prenatal care usually may be arranged by the uninsured or low-income family through local health departments, clinics or public or university hospitals. Medicaid may be applicable in some states. Check with your doctor.
Prenatal programs in most cases arrange birthing at public or other hospitals with which a standing arrangement exists. Arrangement for paying the birthing bill should be made with doctor and hospital.
If a doctor prescribes medication which you cannot afford, or if a family member takes medication regularly, try the resources listed below:
Ask the prescribing physician. Doctors usually have samples or starter supplies in the office.
In many communities, agencies such as the United Way, Salvation Army, Easter Seals, American Red Cross, Epilepsy Foundation, American Cancer Society, American Diabetes Association, American Lung Association, American Heart Association and others can help you get the life-sustaining medications you need.
Voluntary or public clinics and hospitals may offer prescription medications free or at low cost to low-income households. Ask!
Usually, prescription drugs only are available through a health department after examination by a health department physician.
The Salvation Army, Catholic Social Services or Catholic Charities, church or human-service agencies and local community action agencies often have discretionary funds they can use to provide emergency assistance for prescription drugs.
Drugs for treatment of psychological, emotional or behavioral disorders often are available through your local mental health center.