Singletude: A Positive Blog for Singles

Singletude is a positive, supportive singles blog about life choices for the new single majority. It's about dating and relationships, yes, but it's also about the other 90% of your life--family, friends, career, hobbies--and flying solo and sane in this crazy, coupled world. Singletude isn't about denying loneliness. It's about realizing that whether you're single by choice or by circumstance, this single life is your life to live.

Tuesday, March 4, 2008

Singles and Health Insurance, Part III

As Singletude noted yesterday, uninsured singles do have options for obtaining affordable health insurance that aren't publicized as widely as private, employer-sponsored PPOs. As more single Americans than ever find themselves walking in a shower of medical bills without an umbrella, their research has proven that there are more healthcare choices than Aetna, Blue Cross, and welfare.

But sometimes, for some people, insurance is out of reach, and no amount of flailing and grasping is going to make it any more accessible. If you're one of these sinking singles, read on to learn what you should (or shouldn't) grab onto to keep you afloat.

1. Health Savings Accounts (HSAs)

HSAs have gained a reputation as the wave of the future. Think of them as the IRAs of healthcare. They're administered by insurance companies as part of a low-premium (around $50.00 a month), high-deductible (around $1,000-5,000 a year) plan that allows you (and your employer, if he or she chooses) to set aside tax-sheltered income for medical expenses. When you have a medical bill, you can use the money you've saved toward your annual deductible. After you meet the deductible, you pay nothing more that year. If you don't meet the deductible, your savings roll over for future use. Lots of major insurance companies have jumped on the HSA bandwagon, so they're not hard to find.

2. Medical Benefits/Discount Cards
In other words, scams. You may recognize these as the only healthcare services that need to advertise on TV. That's because real health insurance providers don't need the business; with inflation rates at over 20% a year, they're doing just fine. You can also pinpoint a scam by the absence of the word "insurance." Their ads are sprinkled with other buzz words--health, benefits, medical, coverage, protection, prescription, care--but they never call their product insurance because that could get them sued.

These mysterious benefits that have nothing to do with insurance are actually discount programs, which promise card-carrying members up to 60% off on a variety of services from participating doctors. The problem is there aren't too many participating doctors, and the 60% discount is a hypothetical, like the 50 million jackpot you could win in the next lotto. A 15-20% discount, which is a drop in the bucket for most medical bills, seems to be more standard.

Now, there may be medical discount programs out there that are aboveboard all the way. But to find them, you may have to weed through a lot of phonies and hope none of them trip you up in their lies.

3. Financial Aid

Last year, I had some disturbing symptoms of a serious genetic medical condition, which landed me in the ER...uninsured. A few months later, the bills started trickling in. There was the bill from the ER for warming one of their stiff, narrow beds with my body heat for an hour or two--$500 right there. This was followed by a bill for the tests I'd had, an EKG and some other readout I'd never heard of. On its heals came the bill for the interpretation of those tests by an affiliated cardiologist. And then, just when I thought the last bill had come knocking, another one showed up, this time from the attending physician in the ER. All in all, I owed close to $1,000, and I knew it could've been much worse. Thankfully, the hospital had a financial aid program for the uninsured and ultimately reduced the bill by more than 50%.

If you, too, are swamped with a tsunami of a hospital bill, find out if the hospital can assist you. Lots can. Call the number of the billing department on your statement and ask to schedule an appointment with a financial counselor. Along the way, you may need to prove that you're ineligible for Medicaid, which also provides emergency assistance. If you don't qualify for Medicaid (and unless you're below the poverty line, you won't), the hospital will probably waive or reduce its fee if your income is no more than 400-500% of the federal poverty level (that's in the neighborhood of $40,000-50,000), regardless of your assets. Here's an example of a hospital financial assistance program. Notice that this one also gives a standard 15% discount to those who don't qualify for financial aid, as well as special exemptions for those who incur more than $50,000 in expenses in an emergency. Here's another. And one more.

However, if your hospital balks at reducing your bill, know your legal rights as a patient. Hospital Victims, run by the nonprofit Fairness Foundation, is a web site dedicated to helping the uninsured combat hospital price gouging and negotiate a fee waiver or reduction.

Or maybe it's not a hospital that's got you strapped but a private practitioner. Don't be afraid to call the doctor's office and ask for a discount, especially if you've been a long-term patient. Doctors know that insured patients pay only a fraction of the physician's charges via healthcare providers and so are often willing to extend a comparable discount to the uninsured. Prior to purchasing insurance, I was charged $60-80 a visit by my longtime family doctor though I'm sure his fee was well over $100, and my dentist still does complimentary work for me when I need something minor in addition to my regular cleaning since I have no dental coverage.

4. Low-cost Clinics

As soon as they feel a sore throat and fever creeping up, most people head to a traditional private practice, where they visit their family internist. Instead of this, uh, knee-jerk reaction (no pun intended), why not visit a low-cost clinic? Yes, you’ll wait in line for awhile, but if what you care about is saving money, a clinic is the place to be.

A few years ago, while I was uninsured, a stomach bug moved into my digestive tract and just wouldn’t vacate the premises. About a month into it, I finally acknowledged that I needed some help evicting the intruder and went to the family clinic at a local hospital. They didn’t even require me to fill out copious forms detailing my income, savings, stocks, bonds, CDs, place of birth, grandparents’ nicknames, and contents of my stomach. They just informed me that it would be $40.00 for the first visit, and after that, I could apply for financial aid. Luckily, I didn’t need to do that. I waited an hour or two, saw a doctor, and got a prescription for an antibiotic, which cleared out my little invader posthaste. Simple.

Clinics can be public or private, paid or volunteer, general practice or specialty, open 24/7 or just one day a week. Some of the them, like the one I went to, are affiliated with hospitals, while others are run by small towns, in which a family doctor or nurse practitioner volunteers one or two afternoons a week to treat basic health concerns, administer immunizations, and dispense medication. Others, like Planned Parenthood, which provides gynecological exams, STD testing, birth control, and pregnancy termination, are funded by private, nonprofit organizations. There are clinics that specialize in prenatal care, mental health treatment, pediatrics, and geriatrics, as well as those that treat anyone who walks in the door. Their only common denominator is that they offer healthcare at a fraction of the cost one would pay at a private practice or hospital.

Call your state's Department of Health, your town's Department of Social Services, or your local hospital for more information.

Hopefully, if you’re single and uninsured, by now you’ve found a cost-effective way to get the care you need. But there's still one more thing you can do.

Write to your senators and representatives and let them know that universal healthcare is important to you. Also present your case to your local representatives, who serve in your state legislature. With the federal government dragging its feet on a national health plan, numerous states have taken up the torch and created statewide plans of their own. Let yours know that you want in on healthcare, and you elected them to provide it!

Have you or someone you know resorted to any of the above methods of obtaining affordable health care? If so, what was your/their experience? Have you explored any other alternatives to traditional health insurance to meet your healthcare needs? Would you recommend any of these alternatives to uninsured singles?

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