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Saturday, February 28, 2009

Medical Care Options When You Don't Have Insurance

One problem that I see come up fairly often (more often lately as people are losing jobs left and right and their associated health insurance coverage) is lack of options for medical care. Here's some ideas if you find yourself in this situation:

  • COBRA. If you become laid off or in some cases, fired, you may be eligible for COBRA coverage. This basically keeps your current health insurance in affect for a set period of time (sometimes up to 18 month). The catch is that you have to pay for this coverage which can be pretty expensive (especially if you just lost your job!).

  • Spouse's insurance plan. You may have been covered by your own employer's health insurance plan but if you lose your job, the first place to look for coverage may be at your spouse's health insurance plan.

  • Get another job that has health insurance. Back when Starbucks used to offer pretty good medical insurance for even part time workers, many people who found themselves without medical insurance would get a part time job at Starbucks just for the insurance coverage. While jobs with great medical benefits are getting fewer and fewer, this may be another option if medical insurance is high on your priority list.

  • Other health insurance plans. You can purchase your own health insurance, although this isn't an inexpensive proposition. You may get a cheaper rate if you go through an association or organization that you belong to (such as the Writer's Guild or Small Business Association) or you can just check in the yellow pages under "insurance, health"). Be sure you completely understand the coverages, co-pays, and percentage that the insurance pays for various things such as doctor visits, hospital stays, and major medical procedures so you aren't surprised by a big bill.

  • Community clinic. There are a range of community clinics available depending on where you live. Some offer low cost doctor visits, some are "free clinics" and offer free or low cost medical care, whereas other clinics may offer free or low cost specialized medical care (ie: pregnancy clinics, immunizations, etc). Most of these clinics base your costs on a sliding fee schedule based on your income.

  • DSHS. In our state DSHS (Department of Social and Health Services aka welfare) offers medical options such as coupons for children's medical care for low income families, various plans for chronic medical care, etc. Simply go to your state's welfare office and see what you qualify for.

  • Emergency medical care. Most hospitals in the US fall under EMTALA; this is a congressional act which states that anyone needing emergency care must be treated regardless of ability to pay. This basically means that if you have an emergency medical situation, get yourself to the ER and get treatment. You won't have to pay then but you will get an armload of bills after the fact which can sometimes then be paid for by the hospital's charity care program.

  • Specialized medical centers. There are a number of medical centers that cater to specific populations such as veterans, American Indians, Shriner's Children's Hospitals, etc. which may be able to treat you if you fall into a covered category. If you are a veteran or have served in the armed forces at all, check with your local VA service center to see if you qualify for care. If you are an American Indian, check with Indian Health Services or your associated tribe to find out more about any health care you are entitled to. If your child has specialized needs, check with your local children's hospital for a referral to a hospital that may provide free or low cost specialized treatment for your child's condition.

  • Overseas Medical Care. Medical tourism is getting to be big business. The reason? You can often get prescriptions, medical care, and even major medical procedures done for a fraction of the cost compared to the US. Places such as India, Philippines, Mexico, Brazil, and other countries with a lower cost of living are doing a booming business treating the medical problems of Americans and Europeans. Google "medical tourism" and remember, buyer beware.

Three things to remember: if you are very ill or dying, get medical care first and worry about the bills later. Second, research your options and turn over every stone looking for help. Third, take care of yourself; preventive medicine is better than medical treatment for something that could have been avoided.


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