Monday, June 2, 2008

Dealing With Sickle Cell When You Don't Have Insurance

Okay, so we all know what a load of crap the medical system in the USA is. It's even way more difficult to deal with it when you have a chronic illness like sickle cell. This is because you have to always make sure that you have insurance, because if you fall into a period that you don't, 9 times out of 10, that's when you will have a crises. And with the crises comes the bills and the credit collectors. Thank God for caller ID.

When I first got to the US, I was covered with Blue Cross with my mom's job. However, once I hit 21, I got booted off the coverage and I had to look for insurance on my own. It was okay when I had a regular job that covered me, but falling sick alot in 2005 finally took a toll on my employment opportunities and I was without a job, without money, without insurance and falling sick every 2-3 months.

Needless to say, my credit is totally shot. But I'm not worried about it anymore. See when you are sick, and you go to the hospital, the hospital HAS to treat you. It's against the law for them not to give you treatment because you don't have insurance.

When you get admitted, make sure you let your doctor and nurse know that you want to speak to the social worker. The social worker is the key to your getting your financial situation straightened out. A good social worker will help you apply for the right programs that will get your bills paid without you lifting a finger. There are alot of charities out there that cover hospitals, and funds that you won't even know about. As long as you don't have a job and no insurance, you are in like Flynn.

If the social worker is a dumbass, be sure to mention the magic phrase, "Apply for Medicare". Everyone is eligible for Medicare, not just the old folk. You paid into that system (and if not you, your 'rents did, so get yours!). Apply for Medicare and it can retroactively kick in to cover your medical costs. As long as you apply within 90 days of your hospitalization, they will pay for it. It's your responsibility to make sure your paperwork is on point, dot your i's and cross your t's. Answer every question to the best of your ability. Use a current address and phone number (if they can't contact you, they will deny your claim.) You will be asked to show supporting documentation of your brokeness, like a bank statement and submit a letter stating that someone else (boyfriend, family friend, cousin) is supporting you and letting you live with them free of charge or with minimal expenses.

Once you turn in all the paperwork, you will be contacted by the county social worker, who will review your file and pretty much assess if you are eligible. Be honest but not stupid. For example, don't tell her you smoke weed for pain control. If she asks if you contribute anything to the household, the correct answer is yes. Even if all you buy are groceries once in a while, bus passes or tampons, you have to state that you contribute to get a higher overhead.

If you ace that interview, then you will get your Medicare package which has your card and some letters that you have to make copies of and mail to all the people harassing you with bills. They will then retroactively file claims to get the money that you *owe* them from Medicare. The only hangup is that you are allowed a certain amount per hospitalization, and if you go over that Medicare won't pay extra. I think it was $12,000 for California and anything over that got tacked on to me.

So whatever you don't pay, you can get on a payment plan with the creditors. It's better if the plan doesn't add a ridiculous interest rate every month, or if it's less than $500 bucks, that way you have a chance of paying if off. But if it's more than you can handle, just ignore them and they will eventually add it to your credit. Once it's on your credit report, as long as you don't acknowledge it as a legitimate debt, it falls off in 7-8 years (depending on your state). You can contact Experian and add a note to your file that states that it was because of medical expenses.

I know it sucks to have screwy credit, but there is not way that I'm going to get a loan to pay a $50,000 hospital bill. When you do look at the itemized hospital bill, you will seen absolutely inflated prices for everything from IV flushes to lab work. Logistically it doesn't cost that much, but a hospital is like a business and they have to make money too. I just wish they had different rates for those that have insurance versus those that don't.

So make the system work for you. Be sure to renew/reapply for Medicare every year. It's good to have it as a backup in case you do fall out of favor. Another good supplemental insurance can be found at http://www.combined.com/. Get this, these guys will actually pay you when you are admitted. There is a certain amount you get per day per hospitalization. That way you don't have to worry about going back to work just because you are broke. In addition, they have other plans that take care of the extra overhead for being sick, like prescriptions, deductibles and your co-pays. It's alot of paperwork, but then by now you are a paperwork pro.

Just remember when you are feeling overwhelmed by the bills that there is a way out. Tell the creditors to stop harrassing you and contacting you. You don't have to go through this alone and if all else fails, just automatically develop a *fuck 'em* attitude and continue on with your life.

Good luck!

6 comments:

Victor Lehman said...

Thank You for the referal. We at Combined are trying to reduce the amount of paper work associated with claims. That is why Many of our clients mail or better yet FAX us a detailed copy of there bill from the Hospital. This gets your claim started and checks flow faster. Dont just send a Claim Form when a detailed copy of you r bill will improve claim payment time.

Anonymous said...

This is something I never knew.Thank you for educating those of us,who are going thru this.You are,an angel!!! luv 'ic'e

Anonymous said...

Hi there. A question a little off topic: I've been reading your blog and I love it. I'm a nurse in a NYC public hospital and we have a cohort of patients w/SC who I see in the ED at least everyday or everyother day. The hospital has a SC clinic but when it closes the patients come to the ED. They don't have to wait and everyone knows them. So for the next 6-8hrs they are given high doses of Dilaudid/benadryl (at least three rounds) and are released. Okay, the question - are they addicts? I mean I KNOW SC is a horrible disease and reading your blog only drives that home for me. But honestly as a nurse my compassion is waning. The patients wait at the desk 2-3hrs on the dot after the last dose saying they need the next. Seeing them on a daily recurring basis only decreases my compassion as well. I really would like to get your take. thanks.

Vixen said...

Ummmm, Victor, thanks for the update. I'll be sure to let my peeps know!

Ic'e, it's so nice to hear from you again. The only reason this came to my mind is that it's something I've struggled with and I know alot of other people are dealing with. Hopefully you found out some good tips.

Anonymous nurse, okay, great question...this is going to get a post all by itself. Thanks!

Anonymous said...

Nothing like someone who wasn't even born in this country giving advice on how to milk the system...don't like it go back home and stop causing my taxes to go up!!!

Vixen said...

Anonymous Idiot,

Obviously you don't have sickle cell, so I'm wondering why you are even on this website. You must be scope-less with too much time on your hands. Get a life.

You don't have to be born in this country to use the resources. Too bad you are too stupid to know that or use the resources at your disposal. Health care isn't what is causing your taxes to go up, the fucktard president you elected is. FYI I pay taxes, even far more than you do and I'm a citizen with multiple passports. So kiss my ass you fucking moron.

If you don't like that, leave my blog you dumbass!

And NY, NY ISP# 24.191.246.98, Optimum Online (cablevision Systems)----I'll be watching you.

If you are nice, maybe I'll take your contact info off here. Some of my more passionate readers might get the wrong idea that you are dissing me. Trust me, you don't want to piss off a warrior, they might send a virus to yo' ass. If you are still being a noodle, watch what happens troll. I don't play nice.