So folks know…
If you ever get a bill like this, request to pay the medicaid rates. They’ll be way lower. Then, from there, you can negotiate some sort of payment schedule.
The hospital workers want to help you, and the hospital wants to get paid something. But you gotta ask them.
Actually, per my understanding, it’s that people in the unexpanded Medicaid states are “too rich” for old-school Medicaid but don’t meet the minimum income threshold for getting ACA subsidies in the individual market.
There are also states that restrict medicaid access regardless of wealth. In MO, you’re not eligible unless you are disabled, pregnant or have dependents under 18 at home.
Yep. NC is one of those. My gf was essentially sidelined by mental and physical illness for the better part of two years, but couldn’t get disability approved and didn’t qualify for healthcare subsidies, soooo. . .
It’ll be fun paying off the debts we accrued from that for the next few years.
And that’s after we started using the hella discounted charity clinics and making use of hospital system Charity Care write-offs.
:-/
So like a 15 year mortgage type payment schedule?
My last site we had someone who paid 25 dollars, interest free for over 30 years. It was one of our oldest accounts that we had to transition to the new system.
Now most systems now have a max number of years and minimum dollar amount. And I am referring to hospital not-for-profit systems. I am under the impression that that for profits operate differently (never worked with anyone in that kind of system) and the physician groups usually do payment agreements up front (but they don’t often do emergency either).
Despite popular belief, most business offices do not want to give accounts to debt collection agencies. I am speaking from limited experience on both sides of the aisle. I had one emergency visit while i was in college written off. I had to provide some paper work, and I kept worrying about it but they wrote the whole thing off. I didn’t really have an income as a student.
My kid had to take an ambulance one time when he was in college. We never got a bill for the ride and it was never submitted through my insurance. I knew this could go against his credit, and called the hospital. They gave the names of the ambulance services, so I started calling around with my credit card in hand. Nobody, nowhere had records for him. Finally, at long last, I stumbled across one person who worked for the city metro ambulance service. She listened to my story and took pity, digging deeper than the other services had. She said there were a couple of John Does that he may have actually been, and that sometimes with students they just list them that way because they know they’re unlikely to get paid and the city has a fund which partially reimburses for uninsured ambulance rides (a lot of this was explained with a proverbial wink and nod). Seemed like an interesting gaming of the system (and highly improper), but then I thought about it; this was DC.
It might seem improper but it can also be practical. How many calls do you think someone in a business office has to make to a college student to get insurance information or a returned call or even parental information so they can get it from them.
I am not really defending the lack of pursuit but I can understand the reason for the short-cut. Especially today when more students are able to stay on their parent’s coverage, there should be better pursuit of making sure the insured are not taking funds designed for the uninsured though. There are a lot programs out there to assist with specific groups, but the funds are typically limited.
I know of businesses that routinely hand off to collection agencies as soon as an account receivable hits 30 days. Others are kind enough to wait till 60. Sure, they have to pay a fee for collection, but they figure now they don’t have to bother with it at all, and otherwise they won’t collect.
I am talking about the hospitals. The clinics and physician practices tend to be more aggressive. Are you talking about hospitals?
Since you mention it, yes I am. Not the hospital itself, one of those evil in-house contractors for blood work or whatever. You know, the kind that bills you separately and doesn’t even bother checking your insurance, despite no one at the hospital telling you you’re seeing a contractor. They should all die in fires.
Oh I hate that. I really wish that practice could end. Anesthesiologist, some Emergency Physicians… basically any non-employee. NICU physicians can fall under this group. Sometimes the news runs with these stories and they act like the worst part is the patient doesn’t know… but even if you do it’s not as if someone is going to risk taking their sick child out of the NICU or suddenly you don’t have a physician. Hospital systems cannot force providers to be employees and the specialist groups will often, as you say, contract out.
I absolutely understand in the world of patients none of this matters. You go to a hospital, you expect to deal with that hospital
The ER visit I had written off was out of state during a holiday weekend. I had three bills from three groups and all required separate financial assistance processes and included an after hours charge… as if emergencies only happen 8-5.
Thanks Obama.
FOR CANCER.
I’ve also heard of cases where people overreport income in those states just to qualify for the ACA subsidies.
One thing I’ve always hated about the let’s cover preventative and screening but not the actual treatment is… who wants to know they have cancer only to find out they can’t actually afford any sort of attempt at treatment?
That’s not…they’re not…serious…are they?
Not sure what you mean. I looked into ACA thinking it may be in my future and it doesn’t work quite that way. You can make to much and not qualify. The subsidies go down the more you make. The best thing would be to lie about how many dependents you have, but I imagine the IRS would catch you there eventually.
I think the point was that the ACA has a minimum requirements, because it assumes that if you have less you would be on Medicare. So, that is why people are overstating their income, because some states hadn’t accepted Medicare. Now, if you are in the state of California, that isn’t an issue.
Also, California pays parental leave.
I was able to take advantage of this for our 2nd kid. Doesn’t pay full salary or anything but it was still really helpful. Go California!