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Medical Bill Question

Date: Fri, 02/06/2009 - 07:09

Submitted by bea2ls
on Fri, 02/06/2009 - 07:09

Posts: 3840 Credits: [Donate]

Total Replies: 67


Hello, i have no idea if this is the right foroum, someone please correct me/ move this thread if I am wrong. This is about my younger brother. he is currently unemployed, no insurance. He went to the ER last night because of severe stomach pains. He left after 5 hours without seeing a doctor. Does anyone know how to handle this bill? He signed out but never saw a doctor. He still has stomach pains and is scared to go back because of the cost of it. I say he should go regardless and I am sure one of my family members will force him to go. But does anyone know how this works? We live in NJ, he was on medicaid at one point but his ex girlfriend kept throwing out his cards when he moved out so I have no idea if he is still enrolled with it (he does not know neither), they gave him the hospital's charity fund but they want proof of income and he has none at all! he has been out of work for a very long time.. i just do not know how to address the financial aspects of this because i always had insurance and my family does not know neither. we do want him to seek medical care regardless though..


You must have a welfare office in your state right? He should be able to get free health insurance through that source. If he goes to the hospital, they should bbe able to help him get free medical too.

In the mean time he should be able to get free care at the hospital. They can not refuse to treat him but if he ends up having to pay then that's how it would be. Don't let him be stupid in the fact he doesn't have money cause if he has a ruptured spleen or something he could end up dead.


lrhall41

Submitted by on Fri, 02/06/2009 - 07:19

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He can call Medicare/Medicaid and check on his status. May be able to go online and find out too.

My brother and his wife had to do the charity thing after she had a stroke a year or so ago. They lost her salary and he had to take care of her and take a leave from his job.

Their bills were in the many thousands, even with insurance. They applied for charity and received it. If he hasn't been working, put that down on the application. If he has any questions, have him contact the person who gave him the charity forms.

BTW- my brother and his wife filed for charity after the stroke and doctor bills.


lrhall41

Submitted by Bossy4455 on Fri, 02/06/2009 - 07:30

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hello thanks again everyone.. he was not convinced but our parents and i talked it into him and i took him last night. he had his appentics removed in an emergency surgery and i know his blood toxin level is high. i am scared to death :( but i do thank you for your advice, i am sure we will have a lot of questions after this is done.. i have no idea how long they will keep him or anything! we got a call from the nurse at like 3 am and we can go there in person in like an hour or so i will let you know, thanks again.


lrhall41

Submitted by bea2ls on Sat, 02/07/2009 - 04:10

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For the prescription do you have a Wal-Mart or Target near you? They usually have a $4 list of generic medication so that might be an option to look into.

You should really try to look into free care at the hospital. Otherwise send them $10 a month and there is nothing they can really do. Shelter, food, health and things to live are more important right now.


lrhall41

Submitted by pokertramp on Sun, 02/08/2009 - 11:54

( Posts: 512 | Credits: )


Well if he had insurance it would be a followup appointment and would not have to pay a co-pay but his insurance would still be billed for it.

seeing as he doesn't have insurance, he will get billed for it. If he gets insurance before that, then they ill cover it most likely.

I know people can be stubborn I have been there and it almost cost me my life with cancer. Hopefully this is a lesson for him also. I hope all goes well with him and I am sure thing will get better.

I found another place you might want to look into for health insurance go to this website.

http://www.njfamilycare.org


lrhall41

Submitted by pokertramp on Mon, 02/09/2009 - 06:45

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sorry it's me again, the NJ Family care is likely not to work as he is an adult without dependent children (though he has a son, another long drawn out story!)
i know he will not get insurance before than as he cannot get out of bed at this point.. we are just worried he will have to have money on the day of his appointment..
thanks again though, so much.. it is really appreciated. :)


lrhall41

Submitted by bea2ls on Mon, 02/09/2009 - 07:00

( Posts: 3840 | Credits: )


ok, that was our main concern - that they would refuse treatment if he did not have the money. i can handle them billing him and he is going to make calls for the hospital stay, i just wanted to make sure his staples wouldn't get infected if they had to stay in too long or something. thanks so so much, you have no idea how much you helped me.


lrhall41

Submitted by bea2ls on Mon, 02/09/2009 - 07:02

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thanks im just so scared they will refuse him! it is a fear that they will want money ahead of time or nothing, (in which case I guess its back to the ER? I wouldn't even know!!) but this does make me feel better, I thought doctors could refuse treatment? but this is post-surgery treatment and really necessary...) thanks again :)


lrhall41

Submitted by bea2ls on Mon, 02/09/2009 - 08:09

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he called to make the appointment but the woman who answered said he has to wait for the doctor to call him because the doctor makes his own appointments, which is okay. he mentioned the insurance thing to her and she said she has no idea what to tell him or how to handle that since he does not have insurance.. umm, what? i doubt he is the only one to ever call that office without insurance. (its an inner-city office from a doctor who works in an inner city hositpal where we live!) i guess we will wait until the doctor calls back but i am sick with worry!


lrhall41

Submitted by bea2ls on Mon, 02/09/2009 - 08:32

( Posts: 3840 | Credits: )


If you are in a life threatening situation, they cannot refuse treatment, at least that's what my doctor told me, who is also my husbands fishing buddy :lol: He said that,for instantce if you come in a hospital and you are having a heart attack but no insurance, they have to treat you and stabilize you until they can transfer you to another hospital. We have state hospitals here that deal with alot of prople not having insurance.

As far as going to a Doctor, here they will ask you if you have insurance, if not, they tell you what you have to pay when you come in. If you have insurance, they tell you what co-pay you have to pay. We have insurance and my husband had to get some lung function tests. They told him to bring in over three hundred :shock: .

Alot of doctor offices will work with you. When that Doctor calls, if he wants money up front or won't work with you, have him recommend somwhere he can go. Good Luck..karen


lrhall41

Submitted by Bossy4455 on Mon, 02/09/2009 - 08:44

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thanks.. i have no idea what he can pay or how much is expected to pay.. i know he has to go, like he has to have his wound inspected and his staples taken out. the surgeon said to make an appointment with him and that's who we are waiting to hear back from. if he does not treat him should he go back to the ER? i am close to tears and have no idea why i am at work (I am going to get in soo much trouble because i cannot concentrate!)


lrhall41

Submitted by bea2ls on Mon, 02/09/2009 - 08:49

( Posts: 3840 | Credits: )


Take a deep breath and calm down, ther's nothing you can do about anything until you hear back from the Dr. He needs to be upfront with the Dr and tell him he has no insurance.

When my brother had to apply for the charity thing, it was all after the fact that he did it. They then went back to the bills from when she was in the ER and the hospital, and also the Doctors office.

This surgeon may let him make payment sto do this, or he may suggest he go back to the ER.

When my daughter in law didn't have insurance for the kids, she took the little one to the ER. The ER told her to bring him back to have another x-ray of his chest in 6 days because they knew he didn't have insurance.

So calm down, and wait to see what happens..keep us posted!!.KAren


lrhall41

Submitted by Bossy4455 on Mon, 02/09/2009 - 08:57

( Posts: 5854 | Credits: )


rogerwoods, how kind of you to spam my thread while my family is in crisis!
thanks to everyone who has helped i guess all i can do now is wait.. and i guess the worst that will happen is he will go to the ER (will the ER treat him for that? i guess it is important but i do not know if it is life threatening??) As i said, i guess all i can do is wait and update you.. thanks so much.


lrhall41

Submitted by bea2ls on Mon, 02/09/2009 - 09:23

( Posts: 3840 | Credits: )


thanks again everyone - still have not heard from the doctor but i am more relaxed now. i have taken care of him since our family does not live around here and he has mental and learning problems (which is why he has trouble finding and keeping jobs..) no excuses but i am really protective of him. our parents are in town now though and of course he will get the medical care he needs but i wish our health care system was better.. i have insurance from my job and never knew how horrible things can really be without insurance :(
another question is do we wait until we get all bills back to submit a case to charity care or medicaid? he has spoken to them on the phone and they said to make an appointment when he is feeling well enough (he is barely getting out of bed right now)


lrhall41

Submitted by bea2ls on Tue, 02/10/2009 - 08:09

( Posts: 3840 | Credits: )


no word yet from the doctor :( and we are still waiting to hear back from charity care - they said to wait until we get all post-surgery bills before submitting a claim (we did not get any bills yet) and that we have 90 days to submit claim, which is good.
i guess we go to the ER to remove staples? will they even do that? will a clinic do that? i do not know why this is so hard..


lrhall41

Submitted by bea2ls on Wed, 02/11/2009 - 06:01

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I may have missed it, but has the surgeon called you yet? When he calls ask him about this. It may be part of the after care included with his costs.

When I had stomach surgery years ago, they removed the staples as part of the follow-up with the surgery, but, like I said, that was years ago.

Just call a clinic or hospital, if the surgeon won't do it, and ask them if they remove staples for someone without surgery.

There are state hospitals in the next town, along with state clinics that cater to those who don't have insurance.


lrhall41

Submitted by Bossy4455 on Wed, 02/11/2009 - 08:40

( Posts: 5854 | Credits: )


thanks again for your help - nah no word from the surgeon yet.. he gave us a phone number that just beeps and i looked up his office in the phone book but leaving messages there is getting pretty old.
i have off of work tommorow and can help him make calls, he is still pretty sick, not eating solid foods, barely getting out of bed. my parents are filing disability for my father who has been quite ill and had to stop working so i am trying to handle this myself to help them out..


lrhall41

Submitted by bea2ls on Wed, 02/11/2009 - 09:53

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okay i have some updates he got his first bill $1500 but that's not the main one. He is going to welfare this week to check into medicaid. He should have done that at the ER but that's another story.. Charity Care told him to do this first and if he is denied to apply with them. I know Catholic Charities is also an option if Charity Care denies him, too. As I said he is unemployed, so no income really.. he was on mediciad in the past so perhaps they never took him off? any further advice or suggestions?


lrhall41

Submitted by bea2ls on Mon, 02/23/2009 - 06:05

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I work in patient registration in an Emergency room. At the time of service when he first went to the ER he should have been registered as a self pay because he did not have insurance. No ER can refuse service because it would be a HIPAA violation.

They could have checked to see if he qualified for medicaid when he first got there. Since he was admitted for surgery medicaid should have covered the cost of the admission if he was registered correctly. My state is a date of service state. Meaning he would have needed to apply that day or they won't cover it period whether he qualifies or not.

NJ has a medically needy program but I don't believe it would cover him if he wasn't eligible for medicaid. He will get bills and he can setup payment arrangments with the hospital if he contacts them. They normally will allow him to setup an amount he can afford...also most hospitals offer a discount up front for patients with no insurance 20-40% off.


lrhall41

Submitted by on Mon, 02/23/2009 - 19:52

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Thanks for the info, instead of checking for mediciad, they gave him the info for Charity Care and kept encouraging him to call them.. In NJ, Charity care covers only if mediciad does not cover or if you are not eligible ofr mediciad. Basically both times he went to the ER, they directed him to Charity Care instead of even checking for mediciad. they rushed him in kind of fast, to be honest and i do not think they even checked for mediciad :( this is so frustrating!
i appreciate your info, thank you very much.


lrhall41

Submitted by bea2ls on Tue, 02/24/2009 - 07:00

( Posts: 3840 | Credits: )


oh, also that is my biggest concern here. that because they never checked that mediciad will not cover it if he is even approved for them. does anyone know how that works in NJ? contacting them is a nigthmare, he is going in person this week and we will just save questions for than since every phone call there includes a 45 min hold.
but i know that charity care covers what medicaid/insurance won't and it is done after the fact and after the surgery. it is done soley by income (they do not count children in account, as i am pretty sure medicaid does - in other words i do not know if he will even get approved for medicaid because he does not have custody of children, which i always have disagreed with because i do not feel life is worth any less if you do not have a child but whatever).
thanks so, so much for everyone's help and insight! this is so stressful! we were so worried about him that we did not think at the time about the bills :( but again, everyone has been great, thank you.


lrhall41

Submitted by bea2ls on Tue, 02/24/2009 - 07:04

( Posts: 3840 | Credits: )


an update on this: charity care said they will cover what medicaid will not but still recommended he sign up for future health problems. they will cover up to a year (sometimes two years, depending on the hospital) after the surgery.
i am posting this in case it might help anyone in NJ who owes medical bills. they cover what medicaid and/or personal insurance does not. they also cover for those who are uninsured but only if medicaid will not cover them. they have an office in the hospital.


lrhall41

Submitted by bea2ls on Thu, 02/26/2009 - 06:23

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yes it seems to be okay :)
he has an appointment with medicaid office tommorow (it was today but they cancelled him) and i am pretty sure his surgery will not be covered, as it happened but charity care needs to get a no from mediciad before filing his case with them.
thanks to everyone's help, this board is so wonderful.


lrhall41

Submitted by bea2ls on Thu, 02/26/2009 - 06:37

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i have some updates, he went to his appointments but they told him to wait until he got the bill. well, he got the bill yesterday.. it is $62,500. more than half of that is for CAT scans that he preped for but never recieved because his swelling was so bad that they just took him into surgery. I guess he can get that straightened out? Now that he has the bills, I guess he can call charity care (located at the hospital) again. I am very concerned at this point. charity care's webpage states:
Have no health coverage or have coverage that pays only for part of the bill: and
Are ineligible for any private or governmental sponsored coverage (such as Medicaid); and
Meet both the income and assets eligibility criteria listed below.

i have no idea how to interupt this. i am scared it means that he might qualify for medicaid and therefore they will not cover this. (though I am looking at medicaid's webpage now and kind of doubt he would qualify as he is not aged, pregnant, lol, or has custody of children).
i guess it leads to this, if all else fails, would he be able to file bankruptcy? as i said, he is out of work (and has been looking, it's hard out there.. there's more to the job thing, too but it does not fit in this post). but he is out of work and the bill is $62,500. i am working and could not afford anything near to this! i filed bankruptcy due to medical bills but i was in a different situation. i am really stressed about this :/ i am trying to relieve my parents and help him with this myself and i am finding it very hard.
i am sorry this is such a long post thank you everyone for listening and helping.


lrhall41

Submitted by bea2ls on Tue, 03/10/2009 - 06:21

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i am sorry, i have another thing to add.. both times he went to the ER, they encoruaged him to contact charity care when he recieves the bill, they never even registered him for madicaid, and i do not understand why not since i now know that they could have done so. i do not get this :(
i am worried that this might not work, worried about the $40,000.00 cat scan charges, worried that for some reason he will not be able to file for bankruptcy if worse comes to worse. i just do not seem to, i do not know. but thanks again for everyone;'s help..


lrhall41

Submitted by bea2ls on Tue, 03/10/2009 - 06:26

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