US health care question: what happens if…

posted 3 years ago in Wellness
Post # 3
3007 posts
Sugar bee
  • Wedding: May 2013

@MrsPanda99:  Anytime I’ve had to get treatment, I have it put on a payment plan. My plan is a high deductible (which I’ve been on this form for most of my life and works for me since I rarely go to the doctor)

Post # 4
3735 posts
Sugar bee
  • Wedding: September 2014

@MrsPanda99:  I believe in the US that if you are not insured and it is NOT an emergency, they do not have to treat you or you can go on a payment plan like PP said. Not sure how cancer works…

Post # 5
11668 posts
Sugar Beekeeper
  • Wedding: November 1999

@MrsPanda99:  A few different things can happen. 


1. A physician can refuse to treat patients that don’t have insurance. However, if you go to the ER you cannot be refused treatment.  THey will stabilize you and send you home/transfer you to a public hospital.


2. Go into debt 


3. Many hospitals will do payment plans


4. Hospitals may have charity care programs.


5. The government also compensates hospitals extra if they are a DSH (disproportionate share hospital).  This means they get additional payments if they serve a signficantly disproportionate number of low-income patients.


Post # 6
1067 posts
Bumble bee
  • Wedding: September 2014

@MrsPanda99:  I don’t have personal experience with this sort of thing, but I had a close friend that went through some incredibly expensive cancer treatment.  There was quite a large balance that her insurance didn’t cover, and she owed the difference to multiple different providers.

Basically, she had to negotiate with everyone, explain her situation, and pay in installments what she could.

She passed away recently, and I wonder if the debt transferred to her spouse?

Post # 7
4760 posts
Honey bee
  • Wedding: November 1999

@MrsPanda99:  first they take everything you own then they don’t treat you.  It is not unheard of that patients die in the watiting room in an emergency even because they did not have insurance. 

Basically the rule is that they have to treat you in an emergency.  So if you have a degenerative desease like cancer, well you can be totally find and have cancer and it’s not an emergency only when you are throwing up blood from it or whatever symptom you later have then they treat you breiefly.  Of course then it is too late and useless anywho.


Post # 8
320 posts
Helper bee
  • Wedding: May 2013

I used to work for an oncologist and we had many patients who couldn’t afford their treatments 🙁 We did hardship applications which would mean that the company would write off anything for that patient. We also did drug replacement through the pharmaceutical companies and they too, offered assistance. 

Self-pay patients got a 50% discount… but most had high balances with payment plans 🙁 

Post # 9
11668 posts
Sugar Beekeeper
  • Wedding: November 1999

@ANGELaaimt:  I think it’s possible that it does, or at least probably comes off the assets he inherits. I’m not 100% sure on that though.  It’s not necessarily shared debt, hmm….  It’s interesting, though because I had to define a guarantor on my maternity care paperwork. I put myself and not my husband. I wonder if that would change anything if something were to happen to me, since there is no other guarantor assigned?  

Post # 10
10384 posts
Sugar Beekeeper
  • Wedding: September 2010

Some hospitals will treat anyway. A certain % of their budget has writeoffs like that worked in. But, for the most part, no money (like, if you can’t even put it on a payment plan) no treatment. In an emergency, they treat first, bill last….lots of people go bankrupt in those cases.

Fundraising sites for medical treatment are very popular, like A high school friend was in a horrific motorcycle accident while interning for the summer (where he obviously wasn’t given insurance) and his bills are over $250,000 and they have been fundraising for a few months now.

The USA is pretty f&^(ed up in a lot of ways.

Post # 12
2565 posts
Sugar bee
  • Wedding: October 2014

@MrsPanda99:  I know someone who was 100’s of thousands of dollars in debt for chemotherapy, he had gotten a new job right before he was diagnosed and didn’t qualify for insurance through his work yet.  I have no idea how that gets paid off, they can only take so much from you and if you still don’t pay it off then what happens?

Post # 13
819 posts
Busy bee
  • Wedding: October 2009

@MrsPanda99:  I actually had a friend that had testicular cancer. He had health coverage through his work, but since he was missing work due to his illness, he was fired and his health coverage lapsed just before he was to have surgery to remove the cancer. So since he no longer had health coverage and didn’t have the ~$50,000 up front to cover the cost, the doctor refused to do the surgery. If I recall correctly, it was only through a private donor that he was able to have the surgery.

ETA: I realize in my haste to comment and going only by memory, some of my comment was incorrect. I read the newspaper article again to make sure I had it right – He had started a new job and found a lump two weeks before his insurance kicked in. He had the lump removed and biopsed and it turns out it was cancer. Because he missed so much work from the surgery, he was fired and his benefits went with it. To make sure his cancer hadn’t spread, he needed another procedure that costed around $60,000 but the Dr. wanted the money up front. He began petitioning legislators and put in a charity request with the hospital. After a story ran on the news, a local hospital stepped in and covered the cost. He’s an army vet to boot.


Post # 14
8387 posts
Bumble Beekeeper
  • Wedding: April 2013

@MrsPanda99:  This exact situation happened to my father when he got leukemia.  Private hospitals will not admit you, he had to go overseas for treatment.

Post # 15
2675 posts
Sugar bee
  • Wedding: May 2014 - Madison, WI

A friend of mine suffers from multiple chronic conditions. She went years without insurance before getting put on disability. She has 100Ks worth of medical debt. There is nothing they can take from her to get that money back at this point. She has nothing in her name of any value.

One of her doctor’s offices did refuse to treat her if she didn’t pay $100 at each visit. She owed him probably $90K. She got very sick and ended up hospitalized. The doctor came to see her then and asked why she had been missing her appointments, when she explained his office staffed refused to let her see him without payment he was kind enough to tell her not to worry about that anymore. He made a note in her file and she didn’t have to worry about payment. I don’t know what he did about the money she owed but she was never asked again to pay.

She got her medications through an advocacy group who would help her get them at a lower cost.

Right now she’s waiting on grant approval to have her genome sequenced. They have no idea what causes her health problems so it’s a never ending battle. She has spent many nights waiting sometimes up to 13 hours in the ER for treatment. It’s heartbreaking. 

Post # 16
9137 posts
Buzzing Beekeeper
  • Wedding: November 2013 - St. Augustine Beach, FL

@MrsPanda99:  First, the patient will have symptoms but since they are unable to afford to pay out of pocket to see a doctor, they rely on the emergency room which must triage patients to determine who is in need of emergency care and who isn’t.  Those who require emergency care get it whether they can afford to pay or not (but only enough care to stablize the emergency condition and then they can be discharged.)  So since the early signs of cancer are typically mild, they likely won’t get treatment until their symptoms are life threatening.

This means they can spend months or years with no treatment while the cancer continues to grow and spread throughout their body.  Once the patient reaches the point that they could posibly be considered disabled, the hospital will admit them and apply for Medicaid benefits on their behalf in hopes that they will qualify for Medicaid which will “cover” their treatment.

At this point the patient will still get care for emergency conditions but only minimal care for their other symptoms while awaiting a determination from Medicaid.  It’s likely that they are diagnosed with cancer at this point because the hospital will actually run tests while waiting for the Medicaid determination.

If Medicaid is denied, it is immediately appealed but the patient is generally unable to get radiation or chemo until they qualify for Medicaid or choose to pay out of pocket (if they can afford it of course.)  Once approved for Medicaid they get treatment but only from certain specialists since many refuse to provide regular care for patients that solely have Medicaid.

The best example I have witnessed was a man who worked 40+ hour weeks (with no medical benefits plus on his minimum wage he couldn’t afford an individual plan on his own either) and suddenly became lethargic.  He called into work and went to the ER when he noticed he was also bleeding from his rectum.  The ER checked him out and determined the condition was not emergent so he was discharged.

He went to the ER an addition 3-4 times over the next year (triaged and discharged within hours each time) before finally being admitted for severe anemia.  By that point he was disabled and had been out of work for months due to dealing with the symptoms and ER visits.  Tests taken while his Medicaid application was pending showed he had Stage 3 colon cancer and required radiation to reduce the size of the tumor before surgery and before he could start chemo to treat the cancer that had spread while he was getting emergency care only.

He finally got approved for Medicaid and Assistance including food stamps and Social Security disability.  So now instead of paying for preventative care or early treatment options which cost under $1,000, taxpayers get to pay for his radiation, surgery, chemo, food, and living expenses which are easily 100 times the cost of preventative and early treatment.

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