Medical Care for the Uninsured / Specifically SUrgical Needs

Yes people should know they need insurance. Yes there are ways for people to get insurance even if they are self employed.

This is not a question regarding how she can get insured.

I've learned a lot about the Hospital System here in Austin lately because of a young lady some of us know that has had some issues.

No one is ever turned away from the ER at Seton Northwest. Everyone gets treated. Even if they have a2 8 year history of never paying a dollar toward their services.

Personally I am disgusted with the Medical Profession and how the Insurance Industry has perverted it.

But when they stabilize a patient and identify the problem there is always a referral to a DR that is not as prone to treating someone without knowing how they get paid.

This young lady has multiple Ovarian Cysts, that if ruptured, could poison her/ kill her quite rapidly.

Can anyone enlighten me how the indigent arrange for Surgical needs?

Does she wait for the problem to be life threatening enough to trigger the ER Staff to rush her to surgery?

That seems like a much more expensive alternative to the State then a system that helps her up front.

...
Does she wait for the problem to be life threatening enough to trigger the ER Staff to rush her to surgery?.... Originally Posted by Whispers

You answered your own question sadly enough.

Actually she can always apply for medicaid. If she has no "reported" income coming in, then she would be able to get the insurance and ALL of her surgery needs and Doctors visits would be taken care of. She wouldnt even have a co-pay. It's at least worth a shot at applying, all they can say is no.

Best wishes to this lady!

[quote=Whispers;443871]
This young lady has multiple Ovarian Cysts, that if ruptured, could poison her/ kill her quite rapidly.

Can anyone enlighten me how the indigent arrange for Surgical needs?

Does she wait for the problem to be life threatening enough to trigger the ER Staff to rush her to surgery?

[quote]

Yes very very sadly........I feel for this girl... as I am in similar boat but mine are twisted....very painful but was told I had to wait

If you are a single person and do not have insurance through an employer, and you have pre-existing medical conditions, insurance is difficult to secure. The state run high-risk pools will take you, but the costs are high--depending on your age, premiums can be $500+ per month plus out of pocket costs are another $6000 per year.

The sad fact about Medicaid--single people do not qualify.

There are three main groups of people who are eligible for Medicaid: children under 18 (under 21 in some programs), pregnant women of any age and those in families with small children.

There is a Medicaid program for women who have been diagnosed with certain cancers. http://www.dshs.state.tx.us/bcccs/default.shtm

Here is a link that might be helpful--Medicaid will be expanded to include single adults in 2014--no help for now. In the mean time, we must rely on county programs. In Travis County it is called MAP. You must be willing to jump through a considerable number of hoops to gain coverage. And they are under funding restraints, so not all eligible people are able to get coverage. But patience can pay off, sometimes.

http://www.traviscountyhd.org/no_health_insurance.html

I want health insurance but I can’t afford it. What do I do?
Depending on your income, you might be eligible for Medicaid, the state-federal program for the poor and disabled, which will be expanded sharply beginning in 2014. Low-income adults, including those without children, will be eligible, as long as their incomes didn't exceed 133 percent of the federal poverty level, or $14,404 for individuals and $29,326 for a family of four, according to current poverty guidelines.

Depending on your income, you might be eligible for Medicaid beginning in 2014. Adults with incomes at or below 133% of the federal poverty level are likely eligible ($14,404 per year for individuals and $29,326 per year for a family of four today).

If you live in Travis County, you may be eligible for Central Health’s Medical Assistance Program (MAP). Your income must be at or below $10,830 per year for an individual and $22,050 per year for a family of four to qualify. Elderly and disabled individuals can have a slightly higher income and still qualify. For more information on MAP, visit http://www.centralhealth.net/healthcare_services.html.

Hope this helps.
~~Casey

Single people do qualify for Medicaid they don't care if you are single divorced or married. If you qualify under income they can not not give it to you. How do i know this ? Well before i was a provider i was single and on Medicaid. My 21 year old sister is on Medicaid and she is single. Its all about your income. They are going to want to know how you are paying your bills and getting your daily needs met. This can be done with a letter from a friend or relative saying they assist with your bills and such. If the young lady in question has a child she will be required by Texas state law to provide her child's fathers information and he is required to be put on child support. In most cases you can apply on line and do a phone interview and then they will let you know the information they need to finish your case and mail it to you. Another option is to go down to the Department of Human services and you maybe able to get what they call an emergency appointment and in that case you will be seen the same day and you would want to take a few snacks because you may be there for 4 to 5 hours.

Kaci--maybe you were under 21 when you got your Medicaid? And, yes, if you have a small child and are income qualified you can get Medicaid.

To clarify--
A low-income person over the age of 21 (18 in some cases) DOES NOT qualify for Medicaid unless they have a small child, or are pregnant, or are a woman recently diagnosed with breast or cervical cancer.

Yes there are ways for people to get insurance even if they are self employed. Originally Posted by Whispers

Not without exclusions for pre-existing conditions, and if you have too many of those you cannot obtain private insurance. There are government run high-risk pools, but they are VERY expensive and also exclude coverage for recently diagnosed conditions.

Personally I am disgusted with the Medical Profession and how the Insurance Industry has perverted it. Originally Posted by Whispers

100% agreement, particularly the second portion. The practitioners are mostly quite dedicated. But the business side of it is indeed perverse.

~~Casey

whisper, not trying to be disrepectful in any way and not knowing the details of your friend's case, i can only say that ovarian cysts are extremely common and not life threatening in vast majorit of cases. they frequently rupture, which may be painful and result in minor internal bleeding that is self-limited. if she does go to the er (brack), she'll most likely get a confirmatory pelvic ultrasound and be told to follow up with her gyn. if she can't afford a gyn visit, then she could always just go back to the er for a follow sono. surgery is needed in only special circumstances such has cystic cancers, infected cysts, cysts that bleed excessively, etc.

the medical system is clearly disfunctional. imho, mandatory high deductable health insurance may work. kinda like mandatory car insurance. except driving is a privledge and most people in this country believe health care is a right.

I had to visit the ER several weeks ago and I am uninsured. What I've found out about the system has good points and bad points.

Good point: If you don't have insurance the ER in Texas will knock 63% off the bill and another 15% if you pay the remainder all at once.

Bad point: They don't tell you that you'll get another bill later on from the doctor who treated you.

Good point: Contact the company handling the billing and let them know you don't have insurance and they will usually reduce the amount. I've had 50% taken off several bills by letting them know I was uninsured.

So, what I've deduced is this...insurance companies are interfering somehow with how medical costs are paid. Thus, medical treatment costs are jacked up way high just so they can recover what they need to from insurance companies when they do get paid. Otherwise, why would they be willing to take half off a bill for uninsured? Just a theory.

whisper, not trying to be disrepectful in any way and not knowing the details of your friend's case, i can only say that ovarian cysts are extremely common and not life threatening in vast majorit of cases. they frequently rupture, which may be painful and result in minor internal bleeding that is self-limited. if she does go to the er (brack), she'll most likely get a confirmatory pelvic ultrasound and be told to follow up with her gyn. if she can't afford a gyn visit, then she could always just go back to the er for a follow sono. surgery is needed in only special circumstances such has cystic cancers, infected cysts, cysts that bleed excessively, etc.
Originally Posted by akc

I'm very familiar with the problem as well as the treatments available. Been through it with my SO who experienced a ruptured cyst and was rushed into surgery when she was younger and then a recurrence of them a few years ago that led to surgery again.

They are treating her with medications currently that are having limited effect.

The cysts are twice the number and 4 times the size of what is "normally" seen and she was incapacitated for over a week with severe nausea, became seriously dehydrated and could barely move as a result.

The lack of insurance seems to indicate that they select the treatment options based what she can afford.

I had to visit the ER several weeks ago and I am uninsured. What I've found out about the system has good points and bad points.

Good point: If you don't have insurance the ER in Texas will knock 63% off the bill and another 15% if you pay the remainder all at once.

Bad point: They don't tell you that you'll get another bill later on from the doctor who treated you.

Good point: Contact the company handling the billing and let them know you don't have insurance and they will usually reduce the amount. I've had 50% taken off several bills by letting them know I was uninsured.

So, what I've deduced is this...insurance companies are interfering somehow with how medical costs are paid. Thus, medical treatment costs are jacked up way high just so they can recover what they need to from insurance companies when they do get paid. Otherwise, why would they be willing to take half off a bill for uninsured? Just a theory. Originally Posted by Sternomancer

I definitely have noticed that and it is appalling to experience......

If I go see a Dr and and the bill is $200 I pay my $20 CoPay and they bill my insurance company $160 who pays them the "allowed" $92 for visit. So it costs $112 instead of $200.

Why was the bill for $200?

She went to the Hospital and was seen by a Dr Yesterday and the bill was $200
because she was uninsured it was reduced to $95 and discounted to $72 if she paid it before leaving.

My visit was $112 and hers only $72?

Why?

It sure makes you wonder about the math.

I got an er bill for my little one and there was an extra charge of $200 for comming in after 10pm..

0k i guess im just out of my mind i have had to do this many times and i know it backwards and forwards. I have several friends that are on medicad now that do NOT have children and they are over the age of 21. But ok whatever you say.

Article on Yahoo about getting discounts on medical bills by asking.

http://finance.yahoo.com/news/One-Wa....html?x=0&.v=1

WOW... misinformation abounds.

Medicaid is for the poor (or for the PC crowd, financially challenged). It is available to men, women, children, hermaphrodites, whomever as long as you are poor as hell. By enrolling in Medicaid she can go to any doctor on the plan, any public hospital, etc, etc and all of us get to chip in for her care.

In reality, she should call an GYN and find out what it would cost w/o insurance, cancel her cell phone, cable TV, internet, whatever has to be cancelled to save the money and pay the fee for service rather than leech off of the public. Not that I expect that to happen because personal responsibility is long gone these days.

No one is turned away at any ER, it's the law that anyone requesting treatment at an ER be seen and stabilized (regardless of whether they are a citizen or not, but that's another issue altogether).

Tell her to GO to the Medicaid office (not just call) tomorrow first thing in the morning and plan on spending the whole day there. Explain her situation to each person along the way and get expedited on the review period. Then tell her to call several GYN offices and discuss non-insurance payments and options.

WOW... misinformation abounds.

Medicaid is for the poor (or for the PC crowd, financially challenged). It is available to men, women, children, hermaphrodites, whomever as long as you are poor as hell. By enrolling in Medicaid she can go to any doctor on the plan, any public hospital, etc, etc and all of us get to chip in for her care.

In reality, she should call an GYN and find out what it would cost w/o insurance, cancel her cell phone, cable TV, internet, whatever has to be cancelled to save the money and pay the fee for service rather than leech off of the public. Not that I expect that to happen because personal responsibility is long gone these days.

No one is turned away at any ER, it's the law that anyone requesting treatment at an ER be seen and stabilized (regardless of whether they are a citizen or not, but that's another issue altogether).

Tell her to GO to the Medicaid office (not just call) tomorrow first thing in the morning and plan on spending the whole day there. Explain her situation to each person along the way and get expedited on the review period. Then tell her to call several GYN offices and discuss non-insurance payments and options. Originally Posted by AustinBusinessTraveler

in many cases people have no choice but to leach off the public. Lets face it a lot of providers are barely scraping by. If the have any serious medical condition they are fucked without insurance.
Hell i just had some blood tests that my insurance didnt cover. 5 minutes of blood draw,900 bill.
if she needs any type of surgery even minor that could easily be 10k. large numbers of the population cant afford it. period

Maybe if the GOP wasnt the party of no we could have gotten a HCR bill passed with a real public option. And then less people would have had to "leech off the public"