BAD NEWS

[Nottawayfer]

The problem I face is that I make too much money to qaulify for any governemnt medical assistance and, since I only work part time, I am not eligible for medical insurance through my job. I don't make enough to afford to buy insurance on my own. So I am the person the medical profession dreads--the self pay.

I think part of the problem is that a part-time worker is not considered eligible for medical assistance because they make too much money? Some how there seems to be a problem with the system. I've seen that happen a lot in Arizona. Someone makes $9 an hour and makes too much to be on the State's medical. Who can live on $9 an hour? I don't get it. Maybe some day that will change. We need to go to legislature to do that though. It's hard to go to legislature when you work full time. Did they plan it that way???

If I were you, I would talk with the finance department at the hospital to see if you can get reduced fees. You know they overcharge like crazy. They will work with you, especially if they know you are willing to pay. Most non-insured just fly especially if they don't have any property to put a lien against.

Edited June 27, 2007 by Nottawayfer

[Shellon]

Prayers continue here, Mo.

Love ya

Shellon and Kelly

[rhino]

So I am the person the medical profession dreads--the self pay.

Currently I am hovering at the quarter million mark and that is after paying over $22,000 out of my own pocket, I say this not as a "pity party" but so you will understand that they have to find doctors, and testing facilities who will work with me financially.

They are probably charging you maybe triple as self pay ... you should be able to negotiate that down to much less. Just say NO! :)

But really, I knew someone that did a liver transplant from Dad to small child, they owed a ton. I asked wife what she learned ... that was what she brought up, don't just pay what they tell you. That was 12 years ago, but I think it is worth a shot. Maybe ask what the charges would be if you'd had insurance. Then tell them you will pay that.

Someone smarter than me I might know a better way to negotiate it :) but I bet they are charging triple.

(edited for grammar nazis )

Edited June 27, 2007 by rhino

[templelady]

Some of my creditors have indeed knocked anywhere from 20-50% off, but with being in a medical facility continually since Feb 10, 9 different doctors more tests than I can count in no less than 5 different sites it truly is staggering how fast the money racks up. Thanks all for your suggestions. Does anyone know how to go about finding out what the Medicare/Medicaid maximums are in terms of amounts paid for certain tests, procedures etc.??? I would help if I could authoritivly aanounce that I knew just how much of a disparity there was in what was being charged.

On a more positive note they did manage to get me an appt. on July 3rd for the cat scan. The results will take longer because of the holiday backlog but at least we are on the path.

[bowtwi]

I paid out of pocket for my health care for about 6 years - just got health insurance a few months back. They always charged me 80% of what the insured people were charged. If I paid in full the day of the service, they knocked off another 5%, so I ended up paying 75% of what the insured were charged.

Once I received a bill in the mail for the other 25% of "normal fees" as if I had only partially paid my bill. I called the office manager and they removed it from the bill and I never heard from them again.

My understanding is that Medicaid pays 80% of what's charged. Not all health care providers accept this, but many of those that do, say it's because they prefer knowing they'll get 80% from Medicaid over hoping the patient will pay 100%.

[Suda]

(((((Mo)))))

Continuing to pray for you. Your optimism is so inspiring. You just keep putting one foot in front of the other, literally, and keep getting better. Such a joy to hear about!

Suda

[tonto]

Mo, you're in our prayers. Keep us posted on your CT results.

Love,

Tonto & T-Bone

[excathedra]

((((((((((((( many prayers mo ))))))))))))))

[JavaJane]

Some of my creditors have indeed knocked anywhere from 20-50% off, but with being in a medical facility continually since Feb 10, 9 different doctors more tests than I can count in no less than 5 different sites it truly is staggering how fast the money racks up. Thanks all for your suggestions. Does anyone know how to go about finding out what the Medicare/Medicaid maximums are in terms of amounts paid for certain tests, procedures etc.??? I would help if I could authoritivly aanounce that I knew just how much of a disparity there was in what was being charged.

On a more positive note they did manage to get me an appt. on July 3rd for the cat scan. The results will take longer because of the holiday backlog but at least we are on the path.

www.cms.gov is the website to find the information you want... look under the fee for service section... It can be a pain to navigate through the site. If you need help, PM me and I will do what I can to search out fees for you.

Praying here as well...

Love,

Jane

I paid out of pocket for my health care for about 6 years - just got health insurance a few months back. They always charged me 80% of what the insured people were charged. If I paid in full the day of the service, they knocked off another 5%, so I ended up paying 75% of what the insured were charged.

Once I received a bill in the mail for the other 25% of "normal fees" as if I had only partially paid my bill. I called the office manager and they removed it from the bill and I never heard from them again.

My understanding is that Medicaid pays 80% of what's charged. Not all health care providers accept this, but many of those that do, say it's because they prefer knowing they'll get 80% from Medicaid over hoping the patient will pay 100%.

There is a fee schedule set up for each Medicaid in each state which tells you what they will pay for each service provided by a physician or facility. However, each doctor can charge whatever they want to charge within their office.... But, medicaid will only pay the amount in their fee schedule. Medicare has a similar structure, as do most insurance carriers. The whole system is corrupt. Usually, Medicaid pays so little that most doctors consider medicaid patients to be "pro bono" the payment won't even cover the doctor's costs!

Edited June 28, 2007 by JavaJane

[BikerBabe]

Hey Mo. Aren't doctors, their tests and all the other crap that goes along with it fun? *sigh* I finally got on Social Security and Medicaid, so I'm going thru it all now for my Crohn's and Fibro and the related medical probs that go with all things auto immune.

All I can say is to hang in there. I know how strong you are and stubborn, that alone tells me you *will* walk out of there and back into the life you had to put on hold for awhile. If I could do it, so can you.

I was down to 76 lbs again by the time I finally got all the paperwork, doc visits and referrals, all the fun stuff the Gov. requires done and now 8 months later I'm at 104 pounds, totally out of pain and am watching my wheelchair and cane gathering dust in the closet. I am back on my bike and riding for miles to get around town, just like I did years ago before this latest flare started. I still miss having a car, but there's nothing like the feel of the wind in my face as I fly down the street on my bike, feeling like a teenager again.

Not gonna tell you it's gonna be easy, you know from past experience it's not. You also know the end result is worth all the pain and struggle at first that gets us to our goal of having our lives back. Keep your eye on the goal and you will be there before you know it. You will be in my prayers as you work your way there. Love ya Lady. BIG *hugs* and hope to see you in chat once you are back home and feel up to stopping in.