For Those Without Health Insurance or Poor Coverage Insurance

Discussion in 'Countryside Families' started by clovis, Dec 7, 2006.

  1. clovis

    clovis Well-Known Member

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    I have noticed alot of people on this board have no health insurance or health insurance that doesn't cover very much.

    I too, lived without health insurance for many years, and am very thankful for the coverage provided by my wife's employer. It still costs us $300 a month, but I consider it to be good coverage.

    While living without insurance, I learned the following:

    Doctors are willing to negotiate the cost of services if arranged prior to service.

    For instance, I just had a $2500 open sided MRI with contrast completed for $500. I had to prepay in cash before the service was rendered, and had to sign a note saying I would not turn anything into insurance.

    My good friend just had a colonoscopy completed.....a cost of about $4500 completed for $750.

    My favorite doctor wasn't in our HMO, so to stay with him, the cost was $75 for an office visit. I was able to stay with him for a pre-arranged cost of $35 a visit.

    There used to be a free clinic in the next town over....I still am extremely grateful for the visits they offered for free. They also had a 30% discount set up with the local Kroger pharmacy. I was sooo broke at the time.

    Sometimes doctors have free drug samples for your prescriptions. This has saved us a ton in the past.

    For dental work, I have successfully been able to shop around for great pricing. I was quoted as high as $500 to remove a wisdom tooth, but found a great doctor that pulled the tooth for $100 cash.

    I know that negotiating for medical services does not help in you have an emergency....a broken arm or a bad laceration, but for non emergency stuff this can and will save you a lot of cash.

    I have found that calling or visiting doctors offices, with hat in hand, explaining that I did not have insurance. I would then ask what the cash price was....paid when services rendered. I then have called many doctors in the same field, asking for comparative pricing with the same story. They will often meet or beat that price.

    Many doctors, I have found, have two sets of prices. One for insured patients, and a set for the uninsured.

    With this experience, I no longer just follow doctors orders. They will often refer you to whoever they are hooked up with, or to one of their friends. The doctor that ordered the MRI referred me to the local hospital. The hospitals cost for an MRI? About $6000!!!!!!! Six grand....and I got it done at the newest place in the county for $500 cash.

    Another way to watch your medical expenses is to stop your doctor or dentist from playing the oldest game around. Here is how some doctors play the game: They like to get you in the seat/table/chair, where you are in a "I can't leave" mode, and start asking your approval on services.

    Often, what the doctor will say is something like this: "I am just going to have our lab go ahead and test for ......" Or, "I am going to check your other fillings with a drill..." Or, "I would like to check your walking gait on our new treadmill video system."

    They ask in such a friendly manner, as if the service was free. You don't find out the high cost until you check out to pay. Their defense will ALWAYS be "You agreed to the service when I asked". I got slicked once out of 75 bucks by a dermatologist "so our lab can check your toe nails and rule out a certain type of fungus."

    As to the above, I am not saying to deny services to your doctor on serious matters, like a biopsy, but you should REALLY watch dentists and other specialty practitioners. While much of this is to reduce the physians from liability, quite often is used to pad their bottom line and to make a monsterous profit from your visit.

    Question your doctors about services, and let them know your money matters to you. Tell the doctor that you must know what all charges are before treatment begins!!!! If they ask for approval for services, ask WHY and HOW MUCH!!!!

    Please, constructive comments and questions...do not turn this into a political arguement.

    clove
     
  2. largentdepoche

    largentdepoche Well-Known Member

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    Thanks for the advice! I'm going to boomark this, it's always handy to know!

    Kat
     

  3. mama2littleman

    mama2littleman El Paso

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    Close,

    Excellent information and advice. Thanks for sharing

    Nikki
     
  4. littletree

    littletree Homestead Dreams....

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    This is so timely... we've JUST found ourselves uninsured and I'm 31 weeks pregnant. Due to some medical issues, I have to have a c-section. I had no clue how expensive they were until now. I'm going to call around to some neighboring towns and see if they can beat the quoted price I got. I had no idea you could do that!
     
  5. Lizza

    Lizza Well-Known Member Supporter

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    Don't forget to try your adult and family services office about a possible medical card. Since you are pregnant you may qualify, even if you are above poverty level. I don't know about Washington but in Oregon you can have a pretty high income level to get a medical card when pregnant.

    Good luck!!



     
  6. bare

    bare Head Muderator

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    If you are in Central Washington, you might look into going to Canada for your C section. Lots of folks up here do it to save thousands of dollars. They only take cash in advance.

    Another benefit is your child will have dual citizenship.
     
  7. jerzeygurl

    jerzeygurl woolgathering

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    we dont have insurance, would cost over 800 a month , can put that in the banck and save it for emergencies which we do

    our dr offers discount for cash, which i take, but they act like its some shame that we dont have insurance and like its odd that we could actually pay for it ourselves...

    we paid the hospital up front for delivery and stay

    ask for samples

    also many drug companies offer many of their drugs at discount for the uninsured if you go to them directly
     
  8. clovis

    clovis Well-Known Member

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    Littletree,

    You should really call around and get some quotes. Our local hospital will hardly negotiate on anything other than birthing. Really rubs me the wrong way since the hospital is owned by the county.

    Some close friends of ours was expecting last year. The hospital's normal rate was somewhere close to $6000, and they shopped around and delivered for $3100, prepaid in cash.

    In central Indiana, the baby delivering business is highly competitive, and rates are dropping fast.

    You might have to negotiate with the doctor, the hospital, the anathesiologist, and whoever else is involved seperately. You might check into a privately owned surgery center if one is close by....I am told the local one charges $3000 for insured and $500 for the uninsured. Their anathesiologist will not budge on his price at all, he is firm on $500, I am told. Do NOT be afraid to play one off the other: "Well, I would like you to perform this, but the anathesiologist won't budge on price, so I am still shopping around."

    I would also look into Canada. The currency exchange rate will benifit some...make sure you know before hand if they are talking US or CAN dollars.

    Believe it or not, I read in the Wall Street Journal about an Amish sect in Pennsylvania who sent their members to Mexico via the train for major or costly surgeries. Because they are largely uninsured, medical is a huge expense. A local hospital was being built, and the administrators met with the elders in the church, and set capped prices for different surgeries. One example they gave was that the hospital would not charge more than $5000 to rebuild a knee, no matter how complicated. And to think, I didn't know the Amish believed in advanced medical services!!!

    Clove
     
  9. clovis

    clovis Well-Known Member

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    Also, can you get Cobra coverage? Might be wise to look into it.
    clove
     
  10. Shepherd

    Shepherd Well-Known Member

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    Clovis - thanks for that thread! Great advice. When trying to negotiate with the Doctor's office, did you speak to the Doctor directly or whoever was at the front desk?
     
  11. clovis

    clovis Well-Known Member

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    Often, you will have to deal with the front desk. Most of the doctors I have dealt with don't want to be bothered with negotiating especially if you are a first time patient. Call or visit the office, and explain the situation to the front office person. 99% of the time, they will forward the message to the Doc. I have found that I have to call back in a few days for an answer.

    Don't forget that they may look at you like your high on crack, or a martian. (I don't care what they think of me....it is my money!)

    Often you will hear "I don't think the doctor will agree to a lower price." Tell them to ask anyway. You will be surprised how often they will agree to this. (This is what the office girl said at the MRI center where I had the MRI done.)

    One point of warning....make sure there is an understood price before you go in!!!!

    DO NOT fall for the "come in for a doctor's appointment and we'll talk" routine. This is their way of saying "full price".

    clove
     
  12. FiddleKat

    FiddleKat Mother,Artist, Author Supporter

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    Both DH and I are currently uninsured.
    The doctors office where DD goes, also has a range of doctors from pedi on up.
    We applied for a sliding scale fee, and got it. So instead of paying $75 for a doctors visit, its only $14.
     
  13. littletree

    littletree Homestead Dreams....

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    I've spent the day looking into these ideas... this is incredible! Thank you so much for this thread, Clovis! :angel: :angel: :angel:
     
  14. LvDemWings

    LvDemWings Well-Known Member

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    Your very lucky to have found doctors to treat you. In my area if you don't have insurance you can't get an appointment. If you don't have your complete medical history on file you can't get an appointment. If your medical records are in a state that requires the new doctor/clinic to request them you can't get an appointment or anyone to sign the request.

    You can go to the emergency room because they have to treat you but you'll pay dearly for something that could have been taken care of with a scheduled visit.
     
  15. clovis

    clovis Well-Known Member

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    LvDemWings,

    Can't find a doctor to treat you without insurance? Seems too odd to be true, IMHO. Have you called everyone in the phone book? Everyone? No free clinics in the Buffalo area? If you are so close to Canada, why not go there? (I know nothing about Canada's medical stuff.)

    The reason I ask is because the more I learn about negotiating for medical services, the more I find that this is common practice, and growing more widely accepted every year.

    Just curious.
    clove
     
  16. affenpinschermom

    affenpinschermom Well-Known Member

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    We have found that if you are willing to pay a bill, they'll negotiate. Most people without insurance never do pay their bills, so drs and hospitals have been pretty good about excepting about 50% of what is normally charged or even less.
     
  17. donsgal

    donsgal Nohoa Homestead

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    I do not use traditional medical practitioners when I am in need of treatment. Although "some" medical insurance companies will cover chiropractic, accupuncture, naturopathic medicine, etc., the vast majority will not so this type of coverage is totally useless to me anyway.

    If I do need a medication for some purpose, I have my VA benefits to fall back on although all of my experiences with them have been horror stories and I doubt if I would trust them for any important medical care.

    donsgal
     
  18. Spinner

    Spinner Well-Known Member

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    I'm one of the ones who does not have insurance. I learned the same lessons you did, and learned them the hard way.

    I am still paying on a $2500 bill. When the doctor found out that I don't have insurance, she said, "be sure and remind me that you self pay, next time I won't order all the extras that you didn't need". HUH? Why did she order them if she knew that I didn't need them????

    I also found out that prices vary greatly from state to state. The same test that costs $1200 here, costs $75.00 where DH lives. I went on vacation to visit him and had my test done up there. The money saved on the test paid for the vacation with lots of change left over.
     
  19. clovis

    clovis Well-Known Member

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    I guess I should also explain why negotiating these days is so popular, as I understand it:

    1. The skyrocketing cost of medical care and the soaring cost of insurance is leaving more people without any type of care.

    2. Doctors understand that the days of great paying insurance companies is almost over. The old days of patients with General Motors, Eli Lilly and Allisons outstanding insurance that paid for everything under the sun is gone.

    3. Doctors charge $2500 for an MRI, for instance, and then bill the insurance company for the charge. Insurance companies, largely in HMO and PPO plans, have pre-arranged the amount that they will pay for a particular service. My understanding is that this is sometimes a percentage of the cost that they pay which is capped at a specific amount. The insurance company may have an amount they will pay....lets say it is $700 for that MRI, then the doctor will bill you for 20% of the remaining balance, which would be $360. ($2500-$700=$1800x20%=$360). So the doctor gets $700 plus the $360 you pay, equalling $1060.

    4. It is very expensive for the doctor to bill the insurance company for your services, and the claim may be denied. Insurance companies are becoming notorious for denying claims, and then delaying payment to the doctor.

    5. If the claim is denied, or even if there is a balance owed, the doctor has to collect from you. Difficult and expensive.

    6. It is often better to take $500 cash up front for an MRI, than to wait 120 days to get your money, which may not be the full amount insurance originally agreed upon.

    7. Medicine is getting more competitive all the time, and doctors don't want to lose the added cash. There overhead is very high, as well as their Lexus payments. Why let a million dollar MRI machine sit idle when you have $500 in cold hard cash offered to you?

    8. If you are willing to pay up front, doctors don't have to worry about collecting from you. I used to sell supplies to a woman who was notoriously late paying her bills. My price to her was $150 more what it should have been, but I knew I would wait 180 days or more to get paid. I told her up front, if you pay me when I deliver, I will knock off $150 from this bill. Made no difference to her, she was still always late! Why would a doctor be any different?

    9. Alot of doctors do care, and want to help people with their health issues. Not all...some want to line their pockets more so, but alot of doctors do have a heart.

    10. Doctors know that the majority of people don't know to negotiate services, so they continue to charge full price. When they get someone who does pay cash up front, they are generally happy to oblige.

    clove
     
  20. LvDemWings

    LvDemWings Well-Known Member

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    I've heard there is a free clinic that is open once per month. I can't find a doc that is willing to see me or my kid. We did have insurance for a year and I fought with everyone to get them to see us. It was managed care so the clinic got paid for our enrollment but wouldn't perform any services. Not one would because I couldn't provide our past medical records. I only had shot records. Now that we don't have insurance it hasn't gotten any better. Someone once said that cash was king.. well now its insurance. I may try Canada if one of us gets really sick. Thankfully we are generally healthy.