1 How to Get Health Care While Uninsured | The Billfold

How to Get Health Care While Uninsured

A couple of years ago, I had a cold for about four months. I thought I had somehow caught five colds in a row, which I thought was no big deal, because they were just colds after all.

But then I started dropping a lot of weight while eating a lot of chocolate cake. My hair started falling out, and I had the shakes so bad that my handwriting—which I used to be proud of—became illegible. My short-term memory stopped working. It was difficult to have a conversation, because by the time I neared the end of a sentence, I had already forgotten what I was talking about.

Things were bad, but I had no health insurance, which I thought meant that the only thing to do was try to ignore it, and hope that whatever was wrong with me would go away on its own. Each new symptom added another few hundred dollars to the imaginary doctor’s bill in my head, which meant that as things got worse, I had more incentive to pretend that I had some sort of temporary bug that would eventually go away.

Then one day, I got up to go to work— at the time, I had a part-time job copyediting product labels and PowerPoint presentations—but I couldn’t make it out the door. About halfway through my morning shower, I started panting, and my heart was beating out of my chest. It was as if I had just run a mile, when I had actually just walked 20 feet from my bed to the bathroom. There had been signs before this incident: The day before, I found myself so nauseous and out of breath during my four-block walk to work, that I turned around and went straight back home. 

It took near-complete incapacitation for me to bite the bullet and go to the doctor. It turned out that I have Graves disease, a congenital, autoimmune hyperthyroid condition that I’ll have for the rest of my life. Missy Elliot, George H.W. Bush and Barbara Bush also have it. Graves disease affects every cell in your body, so it gets bad if it goes untreated. But it’s very manageable as long as I take my pills, see my endocrinologist and get a blood test every six weeks.

As a freelancer, I still don’t have health insurance. But at this point, I’ve gone to a bunch of doctors, and have learned some things along the way about getting health care without health insurance. The more I know about the health care system, the less I do stupid things like get so sick I can’t function anymore.

1. Doctors aren’t just for the insured.

If you don’t have health insurance, the immediate reaction is not to go, and to chew on a couple of echinacea pills and hope for the best. I thought of health insurance as some kind of entry card to the entire health care system, but it doesn’t work that way. Plain old cash can get you through the door too. A trip to a doctor costs around $150–$200, or about the price of a nice dinner.

If you’re too broke to go for nice dinners, then look for community health clinics, like Ryan-NENA in New York City, which has a sliding scale for people without health insurance. I used to go there for routine check-ups when I was a student, and they were very nice. I don’t remember getting a bill for more than $5. If you’re skirting the poverty line, which is an annual income of $10,890 for a single person, then you might qualify for Medicaid, and you should definitely apply.

The other thing to keep in mind is that unless it’s a true emergency (severed limbs, heart attacks), don’t go to the emergency room. Go to an urgent care clinic for things like broken bones, pink eye, and other non-life threatening illnesses, or a private walk-in clinic. They’re more pleasant, faster, and much, much cheaper. Call ahead to ask how much, but they usually fall in the $150–$200 range to see a doctor. I went to one in San Francisco, and they were the ones who ended up diagnosing my illness. Last time I had a tear in my cornea, I went to this place in Manhattan.

Sometimes specialists don’t cost much more than a generalist, depending on what you need. The endocrinologist I go to in New York charged $300 for the initial consultation, then $175 for each visit afterwards. While general practitioners are accessible and great, it’s nice to have a specialist who knows a lot about my disease. If you’ve had insurance before, you may have heard that you need a “referral” before going to a specialist. That’s insurance provider bureaucracy, and you don’t need one if you don’t have a health insurance company to answer to.


2. Always ask for a discount at the moment when you are handing over your debit card.

Even if you’ve made a huge deal since the moment you walked into the doctor’s office that you don’t have health insurance, they often won’t give you a discount unless you ask for one, point-blank. If you’ve called ahead to make sure they give discounts, be sure to ask again at the counter. It’s up to their discretion, but the discounts I’ve gotten have been around 20 percent off. And since I go to doctors pretty often, I’ve had a chance to test this out. When I’m too shy to ask for a discount, I usually end up paying more.

The trick is to remember that you’re making them do less work because you don’t have health insurance. They don’t have to pay an administrator for filling out insurance paperwork. They don’t have to wait for the insurance company to send a check. They don’t even have to send out a bill. When the office gives you a discount, they’re not just being nice: You’ve saved them from doing a lot of work, and deserve one.


3. Blood tests are very expensive, but they also offer big discounts.

I really hate needles, but the thing about blood tests that scared me the most was the bill. Before I got the right diagnosis for my illness, I went to a doctor who ran $1,200 worth of blood tests. They were all the wrong ones, and told me nothing useful, but I still had to pay for them. It was horrible. I didn’t know that discounts existed, so I didn’t know to ask for them.

These days, I still have blood tests every six weeks, but my doctor gives me a form to fill out called the “Patient Financial Assistance Application,” which I send to Quest Diagnostics, a testing company. I declare my income, and depending on how much I’m making with my footloose and fancy-free freelance job(s), I fall into either the 50 percent off bracket, or the 75 percent off bracket. Instead of paying around $400 every six weeks, I pay around $100.


4. Drugs can be really, really cheap. Don’t assume that you can’t afford any medicine at all without health insurance. 

As with everything else on this list, it all depends on what you have and what you need to treat it, but if the patents on your drugs have lapsed, the generic version will be dramatically cheaper. I got a prescription for alprazolam (generic Xanax) for anxiety related to a spike in hyperthyroid symptoms, and a bottle of 30 pills cost $20. Cheap.


5. Medical tourism isn’t as sketchy as it sounds, and it is less sketchy than just being sick for years.

You know how health care costs so much more in America than anywhere else in the world? That’s a huge topic that can and should be talked about, but here’s how it played out for me. After getting a blood test that showed that my thyroid levels were completely out of whack, I was told that before I could start treatment, I needed to take two more tests. Large machines and radioactive liquids were involved. That sounded expensive.

I called a specialist to ask how much it would cost without health insurance. They estimated that it would be $3,000 to $7,000. Not just expensive, but prohibitively expensive.

I’m from the Philippines, and my cousin is a doctor there, so I called him. He was appalled at the price that I was quoted, and told me to go to the Philippines to get these tests. Here’s why: Each of those two tests cost $20. For a total of $40, or the price of a cheap meal for two in the U.S. and—just to give you some perspective of relative prices—$40 is the price of a nice meal for two in the Philippines. Add the price of a ticket, some doctors fees ($14 per visit) and a trip to the beach, and I spent maybe $2,200. My doctor was the head of endocrinology at a big hospital there, and was educated in the U.S. She was, by far, the most capable and knowledgeable doctor I’ve dealt with so far. The experience was easy, pleasant and safe. There was even a man playing a grand piano in the lobby of the hospital.

There are risks (and probably some discomfort) to going abroad, sight unseen, to get medical treatment, so do your research. But with limited access to health care and rising costs in the U.S., medical tourism is something that millions of people do each year. I suggest involving your doctor in the U.S. Mine wrote down exactly which tests I needed to come back with, and I called my endocrinologist in the Philippines before booking my tickets to make sure that all the logistics worked out. If you don’t have a connection in another country, there are whole associations dedicated to facilitating medical tourism, and there are a couple of hospitals who have made their name treating foreigners, like Bunrumgrad Hospital in Thailand.

Everyone’s health care experience is going to be different, but the aim of this is to demystify the health care system enough to help you start using it. Just because you don’t have health insurance, it doesn’t mean you’re not going to get sick. Remember that you have options.


Aurora Almendral is a freelance writer in New York. She loves economics and has a coral named after her. Photo: Shutterstock/ampyang


116 Comments / Post A Comment

EM (#1,012)

Thank you for discussing medical tourism! I’m from Canada, where your illness would be totally paid for through the provincial health care system (everything is as long as it’s provided by a physician or within a hospital; that excludes most pharmaceuticals, a lot of mental health care, dentistry and optometry, so it ain’t perfect). It staggers me to think of what a chronic illness would mean to someone without health care, and while medical tourism isn’t ideal, it needs to be talked about as long as there are so many people whose only options are (1) go bankrupt or (2) go without treatment and possibly die.

kwind (#1,181)

@Michelle I wish I lived in Canada. It is devastating. I have chronic conditions such as kidney disease and have no health insurance or a way to get it or afford it even with HCR as it is now. I have to pay out of pocket for all my many lab tests, medications, doctor visits, etc. I could never get a transplant here becaue I already talked to Meicare here and they said I would not be covered even though kidney patients when they get down to dialysis or a transplant are suposed to get some coverage. I’m not there yet, but I just plan on dying as peacefully as I can when I get there. Our politicians don’t care and even though most Western countries provide some form of health care for their citizens, this ountry doesn’t. If I had had decent doctors in the first place, I never would have gotten in this condition, but they were bad doctors and never diagnosed the problems I was having. It took me nearly dying and ending up in ICU before those doctors found the truth. I am ashamed of my own country for the lack of ccaring they have towards sick people. Plus I am unble to work now due to even more conditions besides this one, I never took a dime from the government either. I struggle to pay the medical bills and trying to pay off old hospital bills. It just adds more stress to people that are already struggling.

@Michelle : I have relatives in Canada, & they are absolutely SHOCKED at our lousy system here, in the U.S. When people here, in the U.S., tell me how TERRIBLE Canada’s system is, I always ask them: HAVE YOU EVER HEARD A CANADIAN SAY THIS ABOUT THEIR OWN SYSTEM???? I never have. And until I do, I refuse to believe the garbage our own U.S. citizens say about another country’s system.

@Michelle Like Michelle said, It (Canada) isn’t great, it misses quality. Many Canadian’s still come here ex: maternaty because imagine having your baby on the hottest day of the year in an unconditioned delivery room, thereby putting your child in distress.
Now, ours isn’t great either. Doctors and hospitals with 1000% mark up and no answers just to keep billing you more like Michelle said for bloodtests. Better we have Sweden’s health care and include total health such as Dentist, eye, hearing and Mostly catastrophic. No one should go bankrupt trying to stay alive to provide for their children. Good luck to all on this. By the way save your Social Security Benefits-You’ve paid for them, your entitled to receive them just like your car insurance policy. And while we are on subject-Be sure to demand to stop the corporate sponsoring and gifting and super-pac grafting of favors to political candidates in America. Return campaigns back to the people and restore democracy by forcing them to only receive the public funds of the people. Countries should maintain freedom of socially democractic-Capitalism is a tool for businesses and markets only.No more corporate or private wealthy sponsors dictating the peoples lives in U.S. or abroad. Regardless of what they tell you, or what your parents were…When in doubt-vote democracy or Green instead:)

Doctors charge so damn much because of all the people who DON’T pay!

@kwind I have always done this with dentists as the prices are just nuts…just to have a tooth removed cost me only one hundred after shopping around..Some were 400 or 500….I doubt the doctor made much money off me as he had a very difficult time removing my wisdom tooth thats roots were tangled or so he said.If i hadn’t gotten the price up front i know i would have paid several times that amount for his time and all the extra meds he had to give me..I always negotiate the price,,Did the same thing with Lasik eye surgery..Got both my eyes done for 1000 …was very happy with that..every thing is negotiable except probably with very busy offices who have too many customers or regular hospitals who don’t have time to negotiate

keepitreal (#5,532)

@Susie Smith@facebook

keepitreal (#5,532)

@Susie Smith@facebook HAHA SUSIE SMITH …WHO ARE YOU??? SATAN?

Elaine (#6,763)

@EM Wonder if there is anyone on this thread that has Chronic Lyme disease. WHAT A MESS. In 2002, I was a healthy mom getting ready to drop my 2 kids off at school. Got bit by something and the local ER did not recognize the bulls-eye rash on my leg. Ten months later, diagnosed with Acute Lyme disease. Many main stream medical doctors believe this illness cannot be chronic. IT CAN BE. Lyme specialists almost practice in secrecy for fear of losing their licenses. They prescribe long term antibiotics which is as necessary for me as insulin would be to a severe diabetic. Most Lyme specialists do not deal with insurance companies and insurance companies will seldom cover long term IV/oral treatment programs. In 2009, went through a divorce, relapsed, back on several months of IV treatment. Lost my insurance, my credit score, etc. Diagnosed with degenerative brain disease due to infection from the Lyme disease. Government for the most part, turns a blind eye to what is becoming the fastest growing epidemic the world has ever known. I make $12,000 per year part-time job. Ex pays $ 1200 per month alimony. Going on year 4 fighting for disability. Because I make $23,000 per year, I make too much for medicaid and OBAMACARE choices were something like $ 293, $ 318, $ 390 ???? or something like that. Have one child and no child support. Cannot afford an attorney…….so rich ex was awarded custody in 2013 without me even making an appearance. Oh ……and I still have my son. What a screwed up system we have. Don’t know which is more screwed up….the government, the healthcare system, or our court system ???

This is terrifying. I’m glad you’re able to get treatment and have figured out a way to not bankrupt yourself in the process!

MuffyStJohn (#280)

This is one of the best damned articles on the Billfold. I would never have thought about asking for cash discounts. And the medical tourism thing does sound super sketchy but it’s really intriguing that the author had such a positive experience with it. I wonder if the author’s connection to a high-level, American-trained doctor in the Philippines was standard or if it was due to her family connections.

@MuffyStJohn Cash discounts really is pretty genius.

@MuffyStJohn I can vouch for Bunrumgrad Hospital. I was evacuated there for a knee injury while I was in the Peace Corps. I signed off on all my bills and I think the total for an MRI, several consultations with the orthopedicist, and two weeks of daily physical therapy was maybe $800. The actual diagnosis and MRI process took less than an hour and cost, if I remember correctly, $261.

Recently, I injured my knee in the same way in the United States, and the process has been a million times more obnoxious and nearly as expensive, *even though I have health insurance*. Urgent care was $30, two visits to my GP ($20 each time), a visit to the specialist ($40), an MRI ($40), and another visit to the specialist ($40) to read the results — add in some crutches, ice packs, and painkillers and that’s well over $200, plus many hours of paid time off.

I mean, thank GOD I have the insurance, especially if I end up needing surgery, but presumably we’re talking about thousands and thousands of dollars being paid by my insurance company for what amounts to less than an hour of attention from a trained medical professional.

I’ve also received medical care abroad in the United Kingdom, the Czech Republic, and Kyrgyzstan, and in each case it has been dramatically cheaper, quicker, and all around more pleasant than dealing with the US system (in the past that system has also driven me to do things like take out stitches myself, leaving a permanent scar, and fake an illness to score an antibiotics prescription for an uninsured friend with an ear infection).

Just because our system is the most expensive doesn’t mean it’s significantly better than anywhere else.

@MuffyStJohn I’m glad you liked the article! My family happened to know a very good doctor, but sitting in her waiting room, I didn’t get the idea that she treated an elite group — it seemed like a mix of middle class people, which is to say, I think it was standard care…

I worked in dentistry for seventeen years as collection specialist. Most offices have always made exceptions to keep seeing the un-insured, or referred them to someone that does. Hospitals, as stated in their emergency rooms, are required by law to provide enough treatment to stop you immediately from dying. ex: I couldn’t have tumor surgery, until it ruptured, then I could have life saving surgery, at least enough to keep me alive. Not a winning solution at all. But, neither is paying $500 monthly for health ins, just to find you then have to pay even more for deductables and out of pockets and uncovered to boot.

sox (#246)

Yes, this is exactly what I love about the Billfold! Great fodder for discussion!
Something I learned about three years ago, and is still haunting my credit score both directly and indirectly due to related financial woes to an illness, is that doctor’s office also take payments. Always call or talk in person and ask about payment options. Generally they’re really nice about it, especially if you don’t have insurance!

Bonnie (#284)

This really is the most informative piece I’ve ever seen on the topic. Excellent work.

And, you have a coral named after you?!

@Bonnie thanks! I’m glad you find it useful. (My grandfather was a marine biologist from the 1940s, he got in on the ground floor and got to name corals after all his grandkids!)

In regard to the part about not going to the emergency room unless it’s really an emergency: It might depend on the particular clinics available and/or the area you live in. A couple years ago, after feeling sick for weeks, I went to several clinics, none of which diagnosed me properly, before finally giving in and going to the emergency room. Though it was 3 times as expensive, the doctor there noticed symptoms that none of the other doctors had, and provided an accurate diagnosis and the proper treatment. So maybe sometimes you get what you pay for?

@Amanda Webber@facebook
Just please don’t count on that method. Myself (and many others) been demanded by physicians time and again during Urgent Care office EEG monitor picking up irregular heart beat with pain to seek ER immediately. Mostly, Why people see ambulances outside offices. Just to be told by ER docs haven’t a clue what’s causing irregular beats and pain, except it does seem to be actual heart-attack,but go back to doctors, because not quite full cardiac arrest yet.
I under-gone repeatedly over and over for last 2+ years, sent all around from ER, to everyone else, including cardiologist, PT and exercise.
At over $1250 a pop,($1000 for only 2.5 hours ER, plus all the hidden ala carte style lab and doctor readings that come seperately afterwards, is why I and many others now wait for full seizuring, knowing the terror in loved ones not wanting you to die in front of them, but trying to save them from financial ruin in doing so.
As urgent care won’t see emergencies, are now not open after hours or weekends.
Forget jewelry’s unreasonable mark ups, why are hospitals charging $500 an hour, when your only there 2.5 hours, only have a doctor total of 6 minutes, including reading test results, and a best 3 aids,maybe 1 nurse for discharging telling you to return to your doctor for better diagnosis or come back if they are wrong and you go into actual seizure?

ladyJade (#3,084)

@Amanda Webber@facebook : I know a lady that went to the ER and complaint about the chest pain and the congestion feeling that was not normal, but doctor sent her away without further testing but to tell her to get cold medicine. She past away outside the parking lot. she make be in her mid 40′s. Don’t count on it but DO always get medical help if needed regarding of money as mentioned by Aurora. Money can always be there for you to make, but your life is only ONE to live. God bless everyone! Amen

NoReally (#45)

This is great. Can we get a followup on how she might get insured someday? If she got a job with benefits, the new company’s insurance provider would be obliged to cover her, but could jack up the company’s rate, because she made their group more expensive? And then they couldn’t fire her for making their premium go up, but they might be more motivated to find fault in other areas? But only if they knew she had health issues and was the one jacking up the cost? And maybe they wouldn’t if she kept it a graveyard secret? Or they would anyway?

And if she decided to buy her own, many companies wouldn’t sell it to her at all? But in some states she could join an assigned risk pool and have the option to pay a lot, but get it?

So many questions. Learn us more, The Billfold.

@NoReally Great idea for a follow up, though unfortunately I don’t see getting employer-provided insurance in my particular career horizon. Your point makes me really curious about how that would play out, and how it has played out for other people. Do you know people who have gotten surreptitiously fired for being too expensive?

On the buying my own part, I’ve tried but since it’s now a preexisting condition, I would have to buy insurance for about $400/month, and pay for my current doctor’s visits and tests on top of that for a year, since they won’t cover this condition. I may have rejected them before they had a chance to reject me. I’m hoping that if the health care reform sticks and the preexisting condition clause is taken off in 2014, I can maybe justify buying health insurance. Or just stick to catastrophic health insurance and continue to pay the rest out of pocket.

NoReally (#45)

@Aurora Almendral@twitter
I don’t know anyone that’s happened to, but I’ve heard that it does. The company I work for is very small, and we all know each other’s business. And every year the employee share for health insurance goes up by the maximum amount allowed, apparently because one employee has a child with big expensive health issues, and every year the provider jacks the premium up as hard as they can, and tries to get us to leave.

So the people I work for are cool, and this guy has never had trouble, and for sure the law is on his side. But it makes me think that if I were working for a mean, nasty or desperate company, I would definitely keep my health issues to myself. And I do wonder how much the guy who’s dealing with the insurance company knows about claims.

@NoReally I don’t think it works like that — my understanding is that group plans are usually aggregated across companies. One of the core ideas of the ACA (which I’m not sure made it into the final version) was allowing individuals to buy into those big group plans at group rates.

NoReally (#45)

The company’s insurance costs going up when employees have big expenses? That is definitely a thing. “Because there are fewer employees enrolled in small business plans, it only takes a few large claims to raise premiums for all those employees”

@Aurora Almendral@twitter

Yes, it happens all the time. Its the job of their HR personnel to detect or uncover any illnesses, or get let go themselves, whether or not it will actually impede your performance.

First they do a pre-hire exam.
If you pass that, Then, start monitoring any missed time, by requiring a doctor’s excuse outlining the nature of your illness or reason.
Always remember, legally you don’t have to divulge any medical condition that doesn’t interfer with your ability to perform for the position you were hired for. Time off, does this. Wearing braces to work does this also, unless very short term, but raises questions to lay you off first.

And, especially “don’t risk getting hurt at work” because then it goes into all your work history against prospective employers because your required to be treated by “Their Clinics” for first 10 days, which goes into your work record for perspective employers also. (mainly why smart people pass the buck, rather than simply pick up load of copy paper themselves. No employer will hire you, once they’ve check previous employers histories. Its the first thing they ask for (any absentee-ism, any work comp. claims, etc.) Even if you’ve healed, they shy.

But lord help you if you are injured at work. Because to not file properly and immediately will just get you fired, laid off, at their very first convenience, only then without workmen’s comp. covering the bills and no employer willing to hire you either.

So Never, EVER Trust the Employer who offers to pay for your injury under the table. Its a well know trick to only pay a few while finding a reason adequate reason to fire or lay you off, then you won’t be able to go back and sue to collect un-paid medical bills or lost wages. And Un-employment rules state You Must be available and ABLe for full time work. so you won’t get that either.

You’ll end up out of work, trying to cover your bills with no income. So if you do get hurt on the job, even if it seems minor-Claim It or get hit in rear end or trip on city sidewalk.

Because, wake up and look around. Only on T.V. are speach impaired, walking impaired, previous heart-attacks, employed.

Convicts can. Medical conditions no, unless they run their own companies.

So again, if you don’t expect it will interfer with your ability to perform, your not legally obligated to disclose it and hope the pre-employment doctor doesn’t un-cover it.

The worst thing you can do is risk an on the job injury. Find another employer where you don’t have to risk needle pokes or finger caught in machinery. Workman’s Comp requires a lawsuit, even though your supposed to be covered. And Your paid for Social Security Disability benefits are also denied unless you sue them as well and can take 7-10 years with absolutely no income coming in and no employer/paycheck either.

Why many who get hurt on job don’t say anything, but wait until someone rear ends their car or instead trips over city sidewalk. because ssd is pretty grim even though your paying for it each paycheck. Many are smart people who pay for in between coverage from Aflac. Its expensive, but they kick in in times when others don’t and have saved many a house payment, also good to get disability/unemployment ins with your home owners policy.

Eat an apple a day, exercise regularly and get better educated to avoid those work environments that risk getting ill/injured, even at home, to stay well away from doctors, their costs and their recording stuff, until such time they reasonably bring down costs, offer superior coverage for risky environments. This exactly why most don’t understand sport players getting the money the do. It because a person generally earns a couple of million over 25 year average work period. But sport players, not the coaches or administrators, are the ones using up their bodies for only 3 years, then spend rest of life un-able to work. So must purchase a bar, or get endorsements if ultra lucky. Blue and even white collar personnel can’t mortgage the roof over they’re head to risk funding a business start up-even with rehabs agencies help.

And, state agency assistance absolutely won’t attempt to work with you if your illness only allows for part-time capabilities. Vets are fighting for it now, cause Medicaide won’t kick in either for part-time, and why many will drink until they get the nerve to commit suicide from hopelessness.
So like VETs, fight for your entitlements. There’s a reason why they are labeled “entitlements”. Its because you paid for these out of your own pocket with each paycheck, your entitled to receive them just like the home owners insurance you also pay for.

Don’t con yourself into denial, like most of us have done. Be wise, ask questions like this and Look around with your own eyes to get these facts.

ALWAYS go to the urgent care clinic rather than emergency. Unless an ambulance is taking you to emergency. For one thing, most people should be going to UCC but go to ER instead. So it’s way more crowded. Also of course they take the most serious gun shot wounds first. I would bet liability on whatever you have does not require ER but you can go to UCC.

BUT if you go to UCC and they can’t handle what you’ve got because it actually is serious enough to warrant ER, they’ll ambulance you to ER and your problem will be considered one of those actual serious gunshot wound problems!

ugh one time I took my grandmother to ER because she was convinced she was having a heart attack, whereas I was convinced she could go to UCC as she was having a panic attack over thinking she was having a heart attack. She waited in ER until 5 in the morning to find out that she indeed did not have a heart attack. UCC? Would have seen her way faster.

Plus people who think they need to go to ER when they don’t are clogging up the health care system.

elizabeast (#629)

As long as we’re on the subject of health insurance, I need to ask a question:

I’m about to start a job that will not offer me health insurance because the company is “too new” to be able to provide these benefits. Meaning, they can totally afford to pay for it, but apparently insurance companies don’t want to work with a company that hasn’t been around for a certain amount of time. I haven’t been able to confirm this with anyone and it sounds sort of untrue?

Also, it will be MY JOB to procure health insurance for the employees, so it’s in my best interest to get on this as soon as I can.

Employers are not required to pay for employee health programs, they just have to make one available if they have over a certain amount of employees.

Employees now, more than ever are required to pay for own coverage, either through work sponsored programs or privately.

Why they generally don’t offer because they are new, is most employers not only employ people, they wait until enough people give them enough money to become self insured. This where they take your money, invest it and make money off of it. then tell you what they will what little they will cover,

…and, by the way, since they are your healthcare provider, has all access to your health record claims. So if your treated for anything embarassing or can be used against your position, they magically lay you off, or worst: find a reason to fire you.

They aren’t attempting to do you any favors by offering health ins t their employees. Go find a private company that has decent rates. Then your health info is truly covered by privacy release, away from your employer, unless you divulge it to them because it is interferring with your position.
And don’t ever let this happen, because once it causes required and re-occuring doctors excuses with reasons, it will become part of your work record for future employers. You’ll be out of a job, misteriously fired or laid off, wondering why no one will hire you even with your advanced skills.

All HR call previous employers. Don’t make the mistake of your employer being your health care provider to boot. Get your if possible.

Once that wasn’t possible, but the democrats alone removed the requirement of employer only sponsored health-care.

One way is join a membership. they are all over the internet, even Avon offers discounted health care companies for being a rep. (no you don’t have to sell Avon to be a rep. just maintain at small order of $50 order every 6 weeks such as shampoos, bras, deoderant for youm, wedding gifts and family, all at discounts. if your good, you can even cover all your costs if you do decide to sell on the side so your health care will barely cost you anything-its one of the best kept secrets of staying an Avon rep-you get discounts on everything from Tv to auto insurance and life ins.)

@elizabeast there’s lots of benefits companies that aggregate plans for small companies. If your company is based in NYC, companies like Insperity run benefits for quite a few of the tech startups in the city.

piehole (#290)

great topic–what’s even worse is that when you get that 20% discount, you are *STILL* paying much more than what the doctor gets from the insurance company. If the specialists’ official rate is $200 and you’re paying $160, the insurance company would have reimbursed him/her probably $87.89. Hospitals are much worse–if you are uninsured, NEVER pay without haggling. You really get shafted in this country w/o insurance!

@piehole…. Only if you were right….from your lips to Gods Ears…I as a Physician,a specialist, solo practice…will not charge you a cent if Insurance company were to pay me that amount.

Something about living in NYC for nearly a decade makes people crafty about money…this is the second Billfold piece I’ve stumbled across in the past week that was written by a person I know in real life. (*waves* Hi, Aurora! This is Josie…Chloe’s friend?)

@mirror_father_mirror hey josie, fancy seeing you here!

Gianni (#1,142)

A note about Graves’ Disease, which I also have. In some cases, it can be beat with nutrition. After being diagnosed 4 years ago, and being told that I’d have to have my thyroid destroyed with radiation and put on synthetic hormones for the rest of my life, I went on a vegan diet with juicing every morning. The Graves went away. I mean it disappeared. It took about two years to taper off the medicine, as my immune system was repairing itself, but now I take no medicine at all and my levels are normal.

This episode was a window into the medical system which tries to take what amounts to a ‘condition’, and treat it like a terminal illness, requiring the purchase of medicine for the rest of one’s life.

That old Italian saying is really true in this case: You can pay the grocer, or you can pay the doctor.

LRMG (#890)

This was great, and I did a lot of these things as well when I had no health insurance and chronic migraines. Some things I might add, don’t be to embarrassed or whatever to ask for free samples of drugs. I would straight up ask for samples and let the doctor know I was a cash patient. They would usually hook me up with samples the drug reps gave them.

Also! If you have expensive meds and are in the US you can buy them online through Canadian pharmacies. It takes a little bit of planning and time but I saved a lot. For six doses of migraine meds in the US it would have cost over $300 but in Canada cost $86.

mouthalmighty (#165)

This is great! And yet, somehow, so sad.

VolcanoMouse (#420)

Fantastic and educational article.

Does anyone have experience with having really shitty insurance that’s useless unless you live, say, within a 50 mile radius of one sad Rust Belt city? I’m still on my dad’s company plan, since kicking in my share is cheaper than anything else, and it would help if I got hit by a bus or gave birth or something. But I’ve lived 900 miles from home for two years and don’t have any sort of GP.

So should I just act like I’m uninsured? It would be nice to know what to do if I got a UTI or if I decided to get this suspected-hypoglycemia thing checked out.

fonduewho (#617)

@VolcanoMouse I think I know which company you’re talking about. You might be able to submit the bill to them for reimbursement, but from experience, you’re going to need to call them daily to get anything done. My mom called for my sister who was away at college daily for six weeks before her bill got reimbursed. She had bitten through her tongue during a flag football game and got stitches in the emergency room, so it was expensive enough to be worth the effort of calling so much.

VolcanoMouse (#420)

@fonduewho Hurm. Even if it’s not the same provider (Independent Health out of Buffalo), that sounds exactly like ‘em. I am glad to hear that hassling such a company from in-network produces results!

I’ve had some comically bad experiences with them. Like the time they sent me to a gynecologist’s office (the doctor had moved to Georgia a year ago, the building was torn down, and IH billed me for a neurologist’s visit). Or the time the phone number they provided for an oral surgeon connected me to an auto detailing shop. Or the time they bumped me off the list by accident when they added my stepmother, and I only discovered I magically had no insurance when I tried to go to the doctor.

Grah. I’ve heard the Catholic Health system of WNY is also pretty bad.

I feel like most people know this, but I’ve run into several recently who haven’t, so:

If you’re American and want to get insurance but have a pre-existing condition, the high risk pools DO EXIST NOW. This is a thing that the Affordable Care Act actually did. You can probably get into one. (I did so, and I now no longer have a brain tumor. So, I’m very fond of them.) There are subsidies based on income level, though how good they are varies from state to state. This site has a tool that can help you figure out how to join yours.

Oh my God, American health care/health insurance is so depressing to read about. As a Canadian (and I realize that as soon as I type those words, someone out there is going PFFFFT at their computer screen), I just don’t understand why and how Americans live with this level of expensive-ass, unsocialized health care. I feel like folks should be marching in the street for it.

I go to Emerg, flash a card, and get care. Same with a clinic. Same with a doctor. Same with my yearly checkups and referral appointments. Some of my mental health care practitioners are covered. I don’t get a bill, I don’t pay down the road. It is shocking and shameful that Americans don’t have the same.

annie (#534)

@Kaitlyn Kochany@twitter agreed – I find it absolutely mindboggling that Americans talk like this is a normal, acceptable way to treat citizens of a wealthy country. I lived there for a few years and people just accept this completely shitty, unbelievably flawed system. It’s your health you’re talking about – and the health of your society – it should take priority for your lawmakers. I moved back to Europe (mainly because I have better things to do than navigate and pay through the nose for this system) and many of my American friends couldn’t believe I thought there was a better quality of life outside the US. I don’t want to be like ‘wake up sheeple!!’ but really…

sara moon (#650)

@Kaitlyn Kochany@twitter I could not agree more. I live in Australia and our system is the same. I have never paid for a visit to the doctor. The fact that people in the US think it’s totally normal to pay hundreds of dollars a month in health insurance premiums just for basic or emergency medical treatment appalls me.

Heather @twitter (#1,201)

@sara moon Same here. I’m Australian and articles like this make me want to weep.

My mother was sick and in and out of hospital with leukaemia for a year. They took fantastic care of her, and she usually had a private room because she was immunocompromised. We didn’t pay a thing. She died, so that sucked, but I can’t imagine how much more horrible it would’ve been if we’d had to sell her house to pay for her treatment as well as having to deal with the fact that she was dying.


@Kaitlyn Kochany@twitter Living Close To The Mexican Border, They Have A System That “All” Illegals Pay Nothing. The Rest Pay For The Illegals, Plus. God Bless America.

I like how he refers to $150 as the price of a nice dinner. My food budget for 2 people for a week is less than $100. We literally go out for fast food when we splurge. If you can afford to spend that much on one dinner, why wouldn’t you be able to afford health insurance?

I also have no insurance and read this tip-to-tail. Late last year, I went the medical tourism route and had dental work done in Bangkok, Thailand. I will absolutely go back for more (plus I loved Bangkok). I wrote about the whole experience (with photos) here, if you’re considering doing the same: http://www.jaunted.com/story/2011/10/11/125413/89/travel/Travel+Confessions%3A+'I+Was+a+Dental+Tourist+in+Thailand‘ Before that, I was traveling with a friend and she hurt her ankle and went to the ER in Dublin, Ireland. She was seen, treated and came out with crutches and didn’t spend more than $200 total.

@Cynthia Drescher@facebook ..people often go to Columbia for dental work but i bet this is cheaper in asia as well…

kwind (#1,181)

Thanks for the article Aurora. I tis hell to be chronically ill in America without insurance. I struggle every day with it. I’m very glad that my nephrologist and the lab they use do give me discounts, but some of the required tests are very expensive even without it. Wish I could move, but I’m too sick to.

@kwind The major reason we don’t have national health insurance here in the US is because it is far easier for a “special interest group” such as the AMA to prevent such things than it is under the more democratic parliamentary government design used in most of the rest of the developed world.

Former Texan (#1,222)

Also, keep in mind, not all generics are created equal. I used to pay $175/mo. for 12 pills of Imetrex (migraine medication) at Walgreens, using their savers card. Then I found a local, family-owned pharmacy that only sells generic drugs to people WITHOUT insurance. I could get 36 pills for $48. Yes, you read that right. Regular, packaged medicine, made in the U.S. I could not believe it. Why are drug companies allowed to gouge customers like this????

I recently moved out of state and still get my meds mailed to me by this pharmacy, called MedSavers in Austin, TX. They’re allowed to mail medication if it’s non-narcotic. You may even be able to find something similar in your own state, so look around. Amazing alternatives DO exist.

Our health care system in the States absolutely sucks. I fear what it’s going to be like to grow old, without insurance – and I take super good care of myself and my health already. Thanks for the great info. here!

Another thing that may interest people is that if you don’t have insurance, but *do* have AAA (auto service) some pharmacies give discounts on medication to AAA members. You will still end up paying more than a co-pay if you were insured, but you can still get a significant discount.

Thank you so very much for the entirety of this article, and to each of you who took time to comment with your personal experiences and/or advice. I’m personally in the process of researching how to get thyroid labs done, as am also uninsured. Uninsured, and temporarily out of work while I recover from back surgery. Luckily, for a ruptured lumbar disk, I made it into a clinical trial and haven’t had any medical expenses. I asked my specialist about some symptoms I was having and after a few questions, he said I had better see about getting my thyroid checked. He’s an ortho, obviously, but his wife was diagnosed with grave’s while at college. I suppose I lucked out a little there, a sports medicine guy immediately recognizing my symptoms, based purely on personal experience. Anyway, now the search ensues for affordable tests and diagnosis. Reading the article gave me hope that I might actually be able to get these tests DONE, and reading the comments reinforces a belief I’ve had for a while: having insurance quite commonly doesn’t save anyone a dime, it doesn’t pay for most things you would NEED if you got SICK, and finally that we are living in possibly the greediest, most amoral medical system
in the free world

We are also living in the laziest because you all think you are entitled to see a doctor for free, but how about becoming one and find out just how much FREE you would would give!

keepitreal (#5,532)


Thank you for sharing a wonderful article. At some places, Physicians like me,will not charge and will go out of their way asking other Physician Friends to assist.[ Based on the seriousness and the person ]In return, I have received my share of litigation threats, because now I am suppose to continue providing care to that person otherwise its called Abondonment Of Patient.There are simple ways ofcourse to write a letter,send by registered mail that you will provide emergency care for next 2 weeks or 4 weeks, meanwhile please find alternate Physician and, that will get you some legal protection.
India, is another country you will receive as good a care if not better.Many of such physicians are USA trained or British trained and India has its own brilliant Physicians who can teach us a thing or two as we can. To give you a personal example…..I needed Cipro 500 mgm twice a day for 7 days….Care to take a guess how much it cost me converting USA dollar to local currency [ 1 dollar will give you about 40 Rupees ( concider that as one indian dollar )….it costed me total of 22 american cents….for 7 day supply of Cipro. Agreed that was two years ago…….so price now be 50 american cents……

For anybody who needs lab testing done but does not want to pay high prices go to http://www.directlabs.com. You can get almost anything done at a fraction of the price.

I haven’t had health insurance for years because I’m self-employed and couldn’t justify spending $300-400 bucks a month for a high deductible plan when I’m pretty healthy, in alternative health care myself and have a network of professional friends who take care of each other. I broke my ankle at the beginning of the month and went to urgent care instead of the ER. The orthopedic practice I’m going to offers a 25% discount for paying at the time of service and has been very reasonable. I’m on a payment plan with the UCC center-they were very good about that. So far I have spent less than a deductible would have been and am getting good care.So I’m still not that keen on going out and getting insurance now, but wondering what will become available by 2014

I am an attorney who represents people too ill to work, who are trying to get Social Security Disability benefits. Another idea: I used to practice in Mississippi, & my clients could NOT get inexpensive/free medical care. WHAT WORKED: I had clients who had seen a doctor in the past, I contacted them, explained that my clients had no money to pay them now, but were excellent candidates to receive benefits, and would pay them when they received benefits. EVERY DOCTOR I EVER CONTACTED AGREED TO TREAT MY CLIENTS FOR FREE.

Maybe some are really to ill to work, but I am betting the overwhelming majority do the same things the rest of us do with the exception of working a job.

Pam512 (#1,762)

The scariest thing I find about being unemployed for 2-1/2 years is not having insurance (I am 59 years old). I hurt my back a couple of months ago and I went to the emergency room of the local hospital. I told them I didn’t have insurance or any money, but they took me anyway and gave me the paperwork to get financial assistance. I sent it in and I received a reply that I wouldn’t have to pay anything. Such a relief. Our county is opening a Senior Services Center this month for people aged 55 to 64 for medical purposes. I can’t wait.

My wife is a physician, and one of the biggest issue facing physicians is the physician’s personal cost of providing care to others. Everyone who has a job gets a paycheck. Why is it difficult to understand physicians also need to get paid? They spend years studying , years paying off student loans and need to provide patients with access to the office 24/7 with answering service fax, e-mail, pager system , patient portal and staff(who need to get paid with full benefits).

Overheads go up, insurance reimbursements go down but somehow everyone feels doctors should serve without expecting to get paid. most physicians always oblige and worked with payment plans with patients. Most are very reasonable. I think every patient can get care. It is to approach medicine as a service industry not a charity or non-profit because that is not what it is. It is like any other business and has it’s own overhead costs. Labs can give you a discount if cash is paid. You can ask for package pricing. Hospitals run charity events. Michigan association of physicians of Indian origin run charity clinics and do blood work. Pharmacies can give you discounts.there are several resources.
When patients without insurance are admitted to the ICU for instance my wife have alongside several sub specialists seen the patient everyday of the hospital stay , day, night, weekends and holidays and never gotten paid for the service. When on call and she can get patients, who have no primary care and sometimes no insurance, she can easily go without getting paid for the whole stay of the patients. Almost 30 % of our admissions go unpaid. How many service industries can say they serve a community and do not collect from 30% of clients?
So the system sucks when you try to play their game, but on a human to human level and if like with any industry you are willing to pay for a service health care is like any other industry. be reasonable and negotiate and understand the least you can pay is the cost of time and staff used in providing the care needed.

navigateher (#555)

@Selvakumar Vedamuthu@facebook I haven’t seen anyone argue that doctors shouldn’t get paid, or that anyone should provide care for free, I think everyone totally understands that. The issue here seems to be the American system, which essentially makes health care unattainable (is that the right word?) for too many people because of the costs, which in many cases are not in proportion to the actual cost of the procedure.

Also, I don’t think medicine is like any other business in the service industry, because health care should be a basic human right and everyone should be able to get it, regardless of whether they can pay for it or not. That’s why many countries have systems where you don’t need an insurance, and the government provides health care that’s either free or very affordable, while ensuring that the medical staff always gets paid and the hospitals have sufficient funding.

People like you are nuts! First you say that doctors should get paid and no one should provide care for free, then you go on to say health care is a basic human right and everyone should get it. Huh? Who exactly do you think is going to pay the doctors? The “government” in this country is the TAXPAYER. Other countries, as you say, who have “government” provided health care have not made it FREE, they are bankrupt because their country can no longer keep paying for everyone. If you, and people like you want the whole world to have “free” health care, then my advice is for you all to go to medical school and donate YOUR time as I am sick of being taxed top death to pay for all the free-loaders in this country. Most didn’t want to pay for insurance, they would rather have cell phones, texting plans, x-boxes, starbucks, etc. So, stop being so generous with MY money and put up or shut up.

@Susie Smith@facebook
Little harsh, Susie. Many of the people on this thread are poor and have at some point in their lives been unable to work due to illness. Most bankruptcies are caused by health problems. The whole western world is not going bankrupt due to caring for the ill, and doctors are paid by the government. Stop thinking of YOUR taxes; that’s a myopic view. And if suddenly you were no longer paying taxes, you can count on it, your salary would be decreased by the percentage you paid in. Salaries are based, in part, on the need to create and maintain a society with a functioning infrastructure, as well as a healthy, educated group of citizens. And if we declared that need none of our business, fine, there goes a chunk of money out of your salary that was never really yours to begin with.

joanlouise (#1,970)

this article is misleading,,,I have no job,,,I have no insurance,,,I do not have any money, let alone $150-$300 or $1200 for blood tests,,,if I had that much money,,,I would have health insurance….how about an article on how to get health care if no money,,,no job,,,,no health insurance….

@joanlouise If you don’t have income and need to go to the doctor, you should look into getting government-sponsored medicaid. Sometimes your local community health clinic can help you with the paperwork and any questions you might have.

There are a lot of people, like myself, who make enough money not to qualify for medicaid, but not enough to afford health insurance, which can cost around $300-$600 per month, plus the cost of maintaining pre-existing conditions. I may have $150 to go see a doctor, but not $700 to see a doctor and pay for health insurance on top of that. Hope this clarifies things, and good luck!

Witty2 (#1,995)

Traveling for dental care or medical care doesn’t have to be halfway around the world. My husband and I go to Yuma, Arizona and get major dental work done across the border at Algodones, Mexico. They are well known for their many excellent dentists within a 4 or 5 square block area. I got a root canal and cap done in 2 days and $500. My husband had periodontal surgery to scrape the roots and put in something to help the jawbone regenerate and it helped save one of his bottom teeth. California dentists said $10,000-14,000, Sylvia Gaona Morelos charged $2000 for the entire mouth. Hundreds of people go there to get their prescriptions and dental work done. Medical is available more in Mexicali, I understand, a much bigger town to the west.

Di (#2,040)

Dilemma here: Have no insurance but pre-existing conditions so signed up with the govt. plan PCIP for 270.00 month. Has 2,000 deductible which has to be paid before getting any care other than a routine physical. I’ve been having these weird chest pains/quick stabs but no other symptoms. I feel great. I got the insurance out of FEAR it may be my heart. I’ve had high cholestrol/triglycerides untreated for 17 yrs. Do I do the insurance even though I will have to again meet the deductible again after Jan? I will still get some discounts for docs etc, allowable something or other, forget name, but it still might cost a ton. Should I continue with this insurance or try something else? How expensive are EKG’s? Sent my first premium check in today and was torn on if I should even do that but it’s now on it’s way and not sure they will even send it back or cancel my coverage. Coverage doesn’t start until Sept. 1st. Don’t mind taking chances but what if I were in a terrible car accident and air lifted and ended up with 100,000 medical bill? So scary to be without insurance. You guys in Australia? How long must you be a resident to get affordable medical care there? I’m tempted!

Transplantwest (#2,066)

Prices listed in this article are only indicative of one area. of Dr. Visits and urgent Care/Walk in & testing, vary VERY much by state. In Florida, Dr’s appointment & walkin clinics can go as low as $40. ALWAYS ask, call around. Then negotiate with the Dr & the staff, many times one cant lower the price the other one can.

SnapHealth (#2,077)

Great article! You have provided some great advice for those who lack health insurance. To add to the list, companies such as Snaphealth.com give patients convenient access to affordable healthcare by providing them with a tool to search and compare doctors and their TRANSPARENT cash prices for healthcare services. Patients pay affordable cash-based prices through the website with no hidden cost, monthly fees or surprising medical bills.

This is great advice, didn’t know it before. Thanx

There is an even better way to get cheap health care if you don’t have insurance…go to your county hospital and register as MIA – medically indigent. Trust me I trained at a county hospital. It’s even better than Obamacare

RobinCT (#2,197)

I am currently uninsured, but had to see an endocrinologist. The fee that the doctor normally charges for an initial visit is $375.00. When I told the front office staff that I do not have insurance & that I could not pay that amount, they only charged me what they would charge as a co-pay for someone with insurance, which was only $40.00. So, I only had to pay $40.00 for the visit, and they told me that I could pay $10.00 per month, if that was all that I could afford. I also had to see a neurologist who’s initial visit was almost $400.00, and when I said I didn’t have insurance & I asked for a discount, they cut my bill down to $150.00, plus gave me a month’s worth of samples for the prescription drug that I needed. On the other hand, my family doctor’s office practically refuses to work with me on reducing any charges…they told me that I could get a 20% discount if I paid the entire bill at the time of my visit (which was more than I could afford to do).

we are like the only major power country in the world not to have universal health care they have it in Massachsusetts but Romney says its a failure but it seems to be working just fine ObamaCare is NOT universal health care

Elaine C (#2,280)

I live in So Florida and have recently found several Doctors clinics that have a discount plan RE: for any single person any age its $49.00 a month with a 10.00 per office visit co-pay, that covers most lab tests, and normal xrays, vaccines, etc., I have insurance thru my job but its really high because I’m 63 and high deductable, so an office visit is $40.00, lab tests cost extra, etc etc. (My policy at work 610.00 a month partly paid by my job) but still if I’m sick out of work I can’t afford to pay a 40.00 co-pay. My solution is I’m looking for a high deduct. major medical insur plan for emergencys and I’m dropping my insur to get this discount plan at the Doctors office. I can pay a 10.00 co-pay. Its Family Practice of Davie on University Dr.
Also, abt Group Insurance at work, mine was really high because of my age, so group doesn’t always help.

Aloha, I too am self employed and uninsured and have thyroid disease that sends me to the lab for bloodwork, ultrasound and then to my ENT about every three months …plus medication…at first i was embarrased to tell the clinic i have no insurance because they automatically ask for it when you check in..when i finally said sheepishly that i dont have any insurance i was pleasantly surprised that they offer 20% discounts for people without insurance…my ENT also extends me pretty nice discounts on all my visits …all in all it winds up costing me about $300.00 total every three months..it’s still less expensive then paying the insuranc epremiums every month plus copays!!!!

mediatale (#2,385)

I’m 59 and unemployed, waiting for social security disability to kick-in and then apply for medicaid and whatever I can get to help me maintain treatment for all my ailments; Spinal stenosis, Signs of ms, Serum calcium elevated, Disease of spinal cord, Lumbar nerve root disorder, Vitamin D deficiency, Vitamin B12 deficiency, Nerve disorder, Parathyroid hormone excess, Neurosarcoidosis, Lung Nodule. Any suggestions? Recommendations?

I’ll make this long story short. I am almost 65 years old. At 31 I was diagnosed with testicular cancer. I had insurance, got great care & alot of treatment in NYC where Ilived at the time. Eventually I moved to FL in my 40;s because my Mother lived here & wasnt well. I moved here with the promise that Empire BC & BS would keep me on an individual policy ( which would raise yearly. I accepted those terms. No sooner did I unpack when Patake became gov of ny & allowed empire to drop all out of state residents. I was uninsurable & self employed. Somehow I managed to put together an insurance portfolio consisting of 3 companies & the cost was 21 thousand a year in premiums. If I type what I wish this govt for abandoning me God would punish me, so I will resist. I paid those premiums for TWENTY ONE years, until an unrelated surgery disabled me making me eligible for medicare & disability at 63 years old. I will never forgive the medical profession, our politicians who didnt give a damn & the punishment I received JUST because I had had cancer which is the worst pre existing condition one can have. Now they are noticing that people shouldnt be turned down. NOW they are noticing that people like me held 3 jobs to feed my kids. MY adulthood was ruined by them. May future generation have beter luck. Amen

@Ron Santlofer@facebook Dear Ron, I just saw your post and you may not see this since it’s been a while, but wanted you to know I’ve been on both sides of this issue but no where near where you’ve come from. I worked in hospitals, physician offices – coding and billing. I’ve worked for every type of health insurance (Aetna – BCBS – Medicare – Medicaid – Commercial – USHC – WorkComp. – Union Indemnities – HMO’s – PPO’s -,… you get the picture) I sat on a panel in Washington creating HCPCS (coding levels of care for billing), CPT codes w/alpha modifiers (billing for procedures)DME, pharmaceuticals, dental, etc.,- I’ve negotiated contracts with corporations, insurance companies, physicians and sat in on negotiations with hospitals – coordinated benefits [COB], applied Type of Coverages {TOC Codes applied to different contracts}, designed Explaination of Benefits [EOB's], and gone all over the Nation to see what physician’s/hospitals use (expense off in a USUAL AND CUSTOMARY manner)for the care of these diagnosis. More often than not I ended up frustrated by 2nd rate insurance industry physician’s, nurses, psych docs and executives watching out for their bonuses which were directly attached to what they saved companies I worked for/with and negotiated binding contracts for/with. {this practice now said to be – by Congress and the AMA – “non-supportive of the level of ethical and moral standards in an industry which should herald in and reach for the highest ideals of such Hippocratic care of humanity.”} It came to the point that I was losing more and more cases like yours. Compassion was sucked out of the equations and “grandfathering” promises made to you by a company such as Empire began to tell on me and others. The law in NY changed – but the discretion of Empire and others was held to be outside this change to previously made contracts/agreements if both parties found common ground. I’ve represented as an expert for several cases analyzing the contracts and to the best of my ability found precedents to obtain coverage commensurate, equal or brought the insurance to at least maintain a 2ndary status. Working with others we were able in two cases to continue “Off Label or Experimental Treatments” being considered by the FDA having been denied for the reasons you state. The drive for profits and the assertiveness required to maintain pressure on these companies/providers/ suppliers/drug/institutions became too much. Looking at the compensation packages (even outside of bonuses) of a majority of Insurance Conglomerates makes Wall Street drool with envy and tempts ideas for career changes like no other time. I can only imagine that many physician’s support the Patient Protection and Affordable Care Act since the reimbursements have plummeted even in the past 15 yrs to a miniscule portion of their practice. It’s obvious why. One glaring item most American’s haven’t taken up ridicule and disgust with was the Obama proposal to mitigate the largest FRAUD being perpetrated on our system of pay and pursue on the “back-end” of Medicare and Medicaid. Obama wished to install prosecutorial ability on “providers” that obtain the master lists and submit claims all day everyday recieving checks Mon. Wed. Fri. of over $100,000.00. $300,000.00 per week. $15.6 MILLION a year. $60 BILLION total each year. Even those on the “front-end” getting a check(s) once a month couldn’t match that. Republican Committees denied this as not “Revenue Neutral”. Huh? Any time someone can spend $1billion to make $60 billion in a year,…isn’t that a good thing? This outlay would also cover “combing out” the master list of dead people more often. {A woman recieved 12 wheelchairs in a year claimed by these fake “provders” – it was paid. Not only couldn’t the Gov. “pursue” and prosecute because of policy – the woman, having a different wheelchair for every month of the year – she was deceased.) Someone dies – but disseminating this doesn’t happen instantaneously of course, and it’s paid so that if she were alive she wouldn’t be tossed out on the street or having her credit ruined when all her claims were delayed in payment to investigate and prosecute the perpetrator.

So Ron – with the debacle hitting you (no one can go back in time and recoup what they “might have done” with funds had they not been denied and cut off as you were). Doctor’s getting about $.23 on the dollar and the cry and wail from American’s about how their neighbor is sucking off the teat of the taxpayer – none of the real money will ever be captured. Europeans wish they could prevent on the “front-end” as we do (but they catch and prosecute Government Healthcare Fraud as we do NOT.) Having been in the middle of this Storm (I’m disabled now also) – it’s time for a change in each portion of our system. I helped folks like yourself, but I was in a unique position and feared when I walked in with my hand cart of documentation. No program is perfect – Medicare and SSI weren’t when made into law. PPACA won’t be either – but it’s a start – changes will be made to it – no doubt. It’s got to begin somewhere – Congress said it’s been being worked on for decades. It has been, but waiting for perfection has already let the buses go by this stop long enough. What’s going on right now – today – in the Healthcare Insurance Industry would curl many people’s toes – and they’re fingers are crossed Obama will lose. Greed, however, is not called one of the Deadly Sins for nothing. Best of luck! Hope all’s well – I’m sure you had other uses for all the money you were compelled to spend.

Katiedid (#2,435)

I was without health insurance for a 4-year period. I told my primary care doctor six weeks prior to the ending of my health insurance. She told me not to worry about it and to keep up my regular visits. She treated me for the 4-year period for my multiple medical conditions and wouldn’t tell me who was paying for my visits and various medical tests I needed; just told me it was being taken care of. To this day, I have no idea how she managed it. I’m extremely grateful for such a compassionate doctor. Rare, indeed!

Most states now offer affordable insurance to the uninsured if you have a diagnosis. Please check with you state’s insurance commissioner. Most states have this. I know a fellow awaiting a heart transplant, paying $250 a month for insurance and a $300 deductible. There is help out there.
BTW, most doctors will work with you on a payment arrangement.

Too bad now that insurance will be made mandatory through the “Affordable HealthCare Act”, we won’t be able to take advantage of this post to pay our own way on healthcare – we will have to pay in, or be taxed just as much as if we had. States also get to pay for bureaucracies called Health Exchanges, to *help* people buy insurance (like people can’t call a private company and ask questions directly.. seems costly and redundant, to me). Thanks, Democrats! Next time, educate yourselves, read articles like this before falling for the scare tactics and false promises. Obamacare isn’t free gov’t healthcare, it’s gov’t mandated healthcare that you & your state will foot the bill for, one way or the other.

Freddy-B (#2,742)

America should have universal health-care. You would think the richest country in the world would take care of the needs of its own people. Other countries that has a whole lot less take care of the health care needs of its own people. America is very cruel country that cares nothing about its citizens dying in the hospital without health insurance. Its cold-hearted and evil to let people suffer without the proper health insurance.

sybnann (#2,746)

Well, as far as going to the ER or to a clinic, I would suggest you call your hospital first and ask about their financial aid program and if they offer one. I have found that if they do, and if you are likely to qualify, it is better not to pay anything for their care (other than the doctor bill and any lab work) than to pay a lot at a clinic.

Thank you for this information. My question is, if you get treated for an illness when you’re uninsured, and then pick up health coverage, isn’t it excluded then as a pre-existing condition? I don’t typically use the conventional healthcare system for my problems. But my fear is that if I’m diagnosed with something serious when I’m uninsured, I’ll be stuck paying out-of-pocket for it for the rest of my life.

samueljey (#2,782)

am very sorry to go to the other side.
I am 19 years old boy suffering of chest pain for about
four years now.i went to so many hospital but still the same problem.
i was at the university of professional studies,Ghana in Africa
but due to this pains am at home now.
and the only solution to my problem now is surgical operation for the the chest.which should take place within two month from now.
please i need your support financially to survive on this earth.
is very argent if you can help.

thank for your help.

Kwind, Consider contacting Social Services, Social worker at any highly rated hospital. I hope they will at the most take you through the Medicaid or Medicare maze. Or ask if a Social Worker or office staff member at the hospital can give you the phone numbers for Medicaid and Social Security. Also, there are legitimate lawyers that specialize in obtaining Social Security/Medicare benefits for people who are ill. You do not have to pay this type of lawyer up front. They do not get paid until they win your Social Security case. Do not ever write a check, use a credit care or write an IOU or give cash to a Social Security lawyer. If a Social Security lawyer asks for money up front, the lawyers is a crooked! Social Security lawyers are limited by law to a specific amount of money they can charge and receive. In fact, when anyone obtain’s Social Security Disability Benefits, the Social Security Office issues the lawyers check from your benefits. Fear not! After you win your case from the Social Security office or in Social Security Court, you will be sent a check. The check is ‘back dated’ from the date you became unable to work full time, then minus the lawyers fee and you will be reimbursed with some survival money and you’ll have access to Medical care. I hope and wish you well. ACMTD

christine (#2,901)

I am unisured and i have not worked since Jan of this yr, i am needing a MRI. I can not afford one. Any ideas for me in what i should do? I live in Tn. I have no minor children and cant get medicare due to my age. 49yrs old.

i just want to share my experience and testimony here.. i was married for 6 years to my husband and all of a sudden, another woman came into the picture.. he started hailing me and he was abusive. but i still loved him with all my heart and wanted him at all cost…then he filed for divorce. my whole life was turning apart and i didn’t know what to do .he moved out of the house and abandoned the kids.. so someone told me about trying spiritual means to get my husband back and introduced me to a spell caster…so i decided to try it reluctantly. although i didn’t believe in all those things… then when he did the special prayers and spell, after 2days, my husband came back and was pleading. he had realized his mistakes. I just couldn’t believe it. .anyways we are back together now and we are happy. in case anyone needs this man, his email address abuluspiritualtemple@yahoo.com his spells is for a better life. again his email is abuluspiritualtemple@yahoo.com

ladyJade (#3,084)

When you put it that way it does make more sense and not as bad… but that’s only if you not encountering any major traumas that sent you to the ER. Just like people not carry any car insurance. And pray that you will not have any major accident that cause major damage or injury to another person or their car.

….I came here looking for alternatives and all I got was the same speech I get from everyone. $200 isn’t that bad? Are you kidding me? I barely have two pennies to rub together at the end of a pay period. Go to a free clinic? Yea, me and just about everyone else who doesn’t have insurance, and the wait for an appointment is nothing compared to the MOUNTAIN of paperwork and verification you need to even prove you’re poor enough to get service. When you’re really sick and can’t wait a week or two for an appt. at a free clinic, but you don’t have $150 to drop on Patient First, what do you do? That’s what I need to know, because right now it seems like my only resort is the emergency room.

JOJO (#4,301)

Dear Aurora, You are an angel to me. This article offered me a ray of hope. And sometimes…it is the hope that keeps us going. I am a single, 55 yr old diabetic. Currently, I have a few health issues. One most outstanding issue is my pain. I have consulted with a doctor who has diagnosed by problem atrophied vaginal walls, prolapsed bladder, if no one is familiar with that kind of pain, you are blessed. He has stated that I require surgery to correct the constant pain. My employer cancelled my insurance 4 yrs ago. I have applied to the state for government help……I was denied….My earnings exceeded their limitations. I earned $30k. My reserves have been depleted as I have paid cash for my needed medical care. I live from paycheck to paycheck. Dr. visits, at a discount are $70-$120. Prescriptions are a killer on the pocket book. I have reached out to the pharmaceutical co’s for help…..some do…some do not. I maintain my weight, exercise, eat healthy. My blood sugar tests are excellent. My medication costs are a fortune. Diabetes, diabetic retinopathy, and currently as a result of a radical hysterectomy in 2008, female issues. I arrive at work daily and take bathroom breaks to cry, compose myself and return to my desk. I don’t know what to do or where to go. Sincerely, Lost in California

dolphziggler755 (#4,566)

I have really searched the website which I found quite helpful for everything which I want to learn really amazing knowledge this site has provided.
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I’m Mercy brown by name I have a few testimony to share with you all about myself, I was in a relationship with this guy and for 3years and we were about getting married when we both have misunderstanding with each other and he ask me for a divorce and we both agreed and after 4months I head that he was having an affair with one of my closest friend and I was very upset and worried so a friend of my advice me and told me if I still love my ex and if I really want to have him back so I told her yes, and she ask me to contact Dr. Madurai the spell caster and I did although I never believe on spell so he gave me something when he was casting the spell and ask me to say my wishes on it and after the casting of the spell a receive a phone call from my ex and was ask me at which I did and now we are back together again I’m so happy and I wish not to ever have this mistake again in my life. I will also advice anyone with this kind of issue to contact him for help he is really nice on phone and always there to answer you question giving you the good advice that you need. his email is maduraitemple@yahoo.com

HI my name MICHELLE WILLIAM AM FROM Ottawa, Canada i want you all to hellp me in thanking DR ABULU who help me with my problems. My husband and i have been married for eight years now ,we live happily as good couples until a friend of mine cast a spell on my husband. he abandoned me and his family, he didn’t even want to see me at all because he was under a spell. it was now getting to six months since my husband abandoned me and i was frustrated and don’t know what to do until i meet this great spell caster on line, I tell him my problems and he give me four days assurance that he will come back to me. He help me break the spell that was caste on my husband and to my greatest surprise the fourth day my husband came knocking on my door and beg me for forgiveness. once again thank you DR ABULU you can also contact him through his mail abuluspiritualtemple@yahoo.com his website, http://abuluspiritualtemple.webs.com

The blog was informative and the blood test discount form as financial assistance you just mentioned is something that attracted me, I like my stay here.


asadalikhatri (#5,571)

It’s almost very important when you think about this kind of expanded act and expanded referral that we think about what universal reporting and sanctions process should look like. http://ppihealth.com

asadalikhatri (#5,571)

It’s almost very important when you think about this kind of expanded act and expanded referral that we think about what universal reporting and sanctions process should look like. http://ppihealth.com

asadalikhatri (#5,571)

It’s almost very important when you think about this kind of expanded act and expanded referral that we think about what universal reporting and sanctions process should look like. http://ppihealth.com

Allenwood (#5,007)

The way to happiness course is an absolutely essential element of the Narconon Fresh Start program that intends to make the patients make better life decisions. There are 21 golden rules that are thus followed to lead a morally and ethically good life. The rules are implemented to make their effect visible in the life of individuals following them.

asadalikhatri (#5,571)

It’s almost very important when you think about this kind of expanded act and expanded referral that we think about what universal reporting and sanctions process should look like. http://ppihealth.com

mrd916192 (#4,603)

Hmm nice work doctors really charge a lot that’s so sad…
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Micheal Clark (#6,200)

Keep the balls rolling!! Nice posts you have given for us.yacon weight loss

Live in a civilised country, where healthcare isn’t dependant on gambling. And vote out anyone who proposes shutting down the NHS. Of course, that would depend on philanthropy not being a dirty word.

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I started panting, and my heart was beating out of my chest. It was as if I had just run a mile, when I had actually just walked 20 feet from my bed to the bathroom.zorpia

I started panting, and my heart was beating out of my chest. It was as if I had just run a mile, when I had actually just walked 20 feet from my bed to the bathroom.zorpia

I like the way things were before the affordable care act. I cannot even see a doctor now because the doctor visits are too high.

I was previously last year contributing 45 per paycheck=90 bucks a month, So med, dental and vision is around 36 a paycheck x’s two = around 90 bucks which can be used for something else more important not to mention my office visits with this insurance was between 125 and 175

so guess what?
I never got to see a damn doctor. I don’t have insurance and much rather pay the 195 penalty, at least I’l l be able to see a doctor at the free clinic and pay a sliding scale which averages around 80 bucks a visit but it covers meds, lab and blood work.

This will be a hell of a lot cheaper than keeping this damn insurance so I much rather pay 195 penalties so I can finally get my thyroid checked via biopsy. OH since they were taking out all this money each month for taxes I had to adjust my dependents and end up losing out on 1,000 in income tax refund so this affordable care was a complete nightmare.

As a matter of fact some
people got dropped from full time to part time and some completely lost their jobs. This was a bad idea since Obama didn’t incorporate guidelines that employers had to follow, instead employees lost their jobs or got dropped to part time from working full time.

I cancelled my insurance so I can try using the sliding scale at county clinics, low and behold I was told those didn’t exist because of the affordable care act and said to see if I qualify for those two low income insurance, of course I didn’t and told them that but tried anyway, now I’m really screwed because the monthly payment was 125 each month and I still need to pay a co payment and God forbid having a pre existent illness such as a thyroid problem or else you really cannot get help, no insurance will pay until you wait a year or something, the deductibles are outrageous and really REGRET VOTING FOR OBAMA.

i’ll make sure next time to vote republican so they can limit the excessive career minded welfare, ebt, section 8 folks. This has gotten out of hand. I pay for my own rent, my own food, my own living expenses but the govt cannot even pitch in to help me with my medical cost

but get this.. if i were getting ebt, section 8, welfare, basically leaching off the govt for years and making a career out of it since most are not trying to leave it, because if they try to be a hard worker like me, it doesn’t pay so i can see why most of these people don’t want to leave.

I blame the govt, they don’t give those people an incentive to leave or don’t force them to learn a skill or trade so that they can leave it so we have generations of welfare ebt section 8 people, there is no maximum limit on how long you can keep section 8, not sure about ebt or welfare but wouldn’t be surprised if there were no limits on that as well, no wonder our country is going down the drain.

it pays when you leach off the govt because if I were like them I would too be getting help with my medical condition. For all I know I could have cancer in my throat since I do have an asymmetrical goiter.

Shame on the govt for persecuting hard working people like me while awarding freeloaders. Shame on Obama!


Things were bad, but I had no health insurance, which I thought meant that the only thing to do was try to ignore it, and hope that whatever was wrong with me would go away on its own. samuel

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