Paying For Health Care When You're Uninsured

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• QWhat if I need cancer treatment but I don't have health insurance?

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  A PearlPoint Cancer Support answered

  A cancer diagnosis can cause financial concerns. If you don’t have health insurance, the following websites and services may be able to assist you in finding and paying for cancer treatment:

  • State Medicaid: www.cms.gov
  • Medicare: www.medicare.gov and www.cms.gov
  • Affordable Care Act: www.healthcare.gov/law/
  • Hill Burton: http://www.hrsa.gov/gethealthcare/affordable/hillburton/
  • Your local health department and local free clinics: http://freeclinics.us/clinics/search

  Many hospitals have options for financial assistance if you don't have health insurance. Ask if there is someone you can talk to about your options for cancer treatment.

• QAre there resources for limited income patients with no coverage?

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  A Dr. Vincent T DeVita Jr , Oncology, answered

  The Together Rx Access Card was created to help people who do not have prescription drug coverage. You can use the card to save on certain brand-name prescription drugs, some generic drugs, and other prescription products. The Together Rx Access Card is not part of Medicare or Medicare Part D. It is not medical insurance, but a special discount card that costs you nothing.
  To get a card, all of the following must be true for you:

  • You are not eligible for Medicare
  • You have no prescription drug coverage (public or private)
  • Your household income is equal to or less than $45,000 for a single person, $60,000 for a family of 2, $75,000 for a family of 3, $90,000 for a family of 4, and $105,000 for a family of 5 (income limits may be higher in Alaska and Hawaii)
  • You are a legal United States resident

  The Web site and telephone assistance are in English and Spanish.
  Together Rx Access Card
  Web site: www.together-rxaccess.com
  Toll-free number: 1-800-444-4106 Other drug discount cards
  There are several other companies and foundations that offer drug discount cards. The cards offer the user discounts on certain brand name prescription drugs. Some offer discounts on a few generic drugs as well. There are different limits and requirements on who can get a card. The cards also discount different drugs. Contact the Partnership for Prescription Assistance or NeedyMeds to find other drug discount cards. One or more of them may be helpful to you, depending on which prescription drugs you take.
  
  These cards are not insurance, and they are not part of Medicare Part D. They offer limited discounts on certain drugs, which can help some people.
  Choosing a drug discount card
  Look at all the costs of the card. Some cards say they are free, but charge prescription shipping and handling fees that can cost you more than the discount. Some discount cards have yearly fees up to $100 or more. And some companies that say they offer free drugs actually charge a processing fee for each prescription. These costs can add up quickly. Find out about shipping fees, annual fees, and processing fees before you sign up for a card. If you're trying to save money, it's probably best not to get a card that wants money from you.
  
  If you find a free card, compare the cost of the medicines that you actually take. Find out if the medicines you take are discounted. If you have more than one card, your pharmacist can often tell you the cheapest way to get your medicine. 
• QWhere can a person get help if they have no health insurance?

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  A Betty Long, RN, MHA , Nursing, answered

  Depending on the age of the patient, there may be alternatives to a fully-insured health insurance plan. Many states still offer basic health insurance coverage for children although funding for these programs is always an issue.   Eligible adults and elderly can qualify (based on financial need) for state-funded medical assistance programs. If your income would not qualify you for these programs, investigate community-sponsored health centers or clinics.  These health centers are often staffed and run by nurse practitioners and nurse practitioner students and they offer discounted or free primary care.  Check out the National Nursing Centers Consortium website for a listing of nurse managed health clinics in your area.

  http://www.nationalnursingcenters.com

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• QHow should I manage my healthcare if I don't have insurance?

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  A Ms. Annette Hubbell, MSN,NASM Elite Trainer,RN , Fitness, answered on behalf of Sigma Nursing

  Taking care of yourself is crucial. Exercise and proper nutrition will assist in achieving your best possible health state. Taking advantage of community health fairs is a great option for obtaining education on the prevention of illness and for receiving basic risk factor screening for conditions such as high blood pressure, diabetes or osteoporosis. Some health fairs may also offer pneumonia or flu vaccines at no cost or at a reduced rate.  Other options include: contacting your county health department or community college for health-related services (such as medical and dental care) that may be offered on a sliding fee scale based on your income, becoming aware of medical facilities that offer mobile mammograms, and colon and prostate cancer screenings at a reduced rate. Of course realize that unforseen events such as an accident or symptoms which hinder your daily functioning may require treatments or specialized testing which can be costly. 

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• QIs there a way to get dentures with no dental insurance?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  The short answer to the question of dentures with no dental insurance is: maybe. The longer answer is: you may be able to get dentures if you are willing to look at several different options.

  • Dental schools sometimes offer low-cost dental care by having a dental student do the work under the supervision of a licensed (and experienced) dentist. This is the dental version of going to a cosmetology school for a haircut: if you are willing to be “practiced” on, you can get your haircut, or your dental care, for less money.
  • The Bureau of Primary Health Care, part of the Health Resources and Services Administration, helps finance community health centers that offer free (or low-cost) medical and dental care. So your dentures may be provided at one of these health centers.
  • United Way is a program that may be able to link you to local free or low-cost dental services. Contact the United Way for more details; if you have Internet access, check out their web site for more information.
  • Finally, don’t forget to look into the options of state- or federally-funded health insurance like Medicaid. For more information, contact the Centers for Medicare and Medicaid Services.
• QHow can I have mastoiditis surgery if I do not have insurance?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Uninsured patients may certainly undergo any functional surgery if medically necessary at the county hospital. Each major city will have county hospitals that are equipped for uninsured patients for emergency and subacute care. Often these facilities will also have a training or residency program associated with them and your care may include medical students, and residency physician. The care will be under the supervision of an attending physician or surgeon.
• QIf I do not have medical insurance, what problems can I face?

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  A Boston Women's Health Book Collective , Administration, answered

  People who do not have medical insurance often face additional challenges in getting the information they need to make the right health care decisions. In the absence of a family doctor or steady health care provider, they need to make even greater efforts to keep track of their health histories, previous tests and screenings, and past treatments. They also need to keep track of the bills sent to them: Double-billing or billing for services that they were told they would not have to pay for is quite common.

  People who do not have medical insurance may be charged more for medical services than people who do. This is because insurance companies negotiate &quotbulk" rates with hospitals, labs, and other facilities. It is perfectly appropriate for you to ask the billing department about the rate paid by a large insurer in your area for your treatment. You can then send a letter to the head of the billing department offering to pay that rate. Many medical facilities are willing to negotiate a lower rate if that means that they will receive at least some of the money they are owed. Offering to pay a lower amount does not always lead to an agreement, but it does work surprisingly often. It is also worth speaking to someone in the billing department who has experience in working with uninsured patients. There are times when you can even arrange to pay a small amount of your bill each month.

• QHow can I have a doctor if I don't have insurance?

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  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  Even if you're one of 50 million Americans without health insurance, it's important to have a doctor. There are also free clinics and community health plans. If you don't have enough money to afford a doctor, you may qualify for Medicaid. But … I don't want to let people off the hook either. Half the people in America who don't have health insurance have some money. They just make the economic decision to not buy it because it's so expensive.
  
  It's important not to sacrifice your health to save money. You can get access to a physician. Go to their office. Talk to them. They'll work something out with you. We're trained to heal. Give us a chance.

• QHow can I pay for dentist visits?

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  A Dr. Saul N. Miller, DDS , Dentist, answered

  If finances are a problem, you may wish to talk to your dentist about payment options and performing treatment in stages. Also, there may be healthcare credit card options available for extended payment.

  If finances are just not available, you may wish to consider low cost or no cost clinic options discussed in some of my other answers. These include:

  • dental schools
  • non-profit healthcare facilities
  • government clinics
  • dental society programs

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