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Hospital bills, and paying for them when broke

Jebus314Jebus314 Registered User regular
edited January 2013 in Help / Advice Forum
So I am going to try and keep this concise. I am trying to help out my parent-in-laws. What I need most is to find someone who knows the ins and outs of paying for long term illnesses with a small income and no work provided health insurance. Like who would that be? An accountant? A lawyer? How would I find a reputable one? This is in oregon. ACA will probably be involved somehow.

If you are one of those people, or if you have some experience then let me give some background, and any/all tips are welcome. I wont go into any hospital details since my wife is super private and there is a non zero chance she knows about this forum and my use of it. What I can say is that my father-in-law used to be the majority bread winner, and my mother-in-law has always worked part time. Now my father-in-law can no longer work pretty much any job outside of their house, and will be incurring hospital bills for probably the rest of his life. My mother-in-law's income is not large enough to afford most private insurance (especially considering the massive pre-existing condition my father-in-law has). They obviously don't have enough money to just pay the bills outright. The best solution would be for my mother-in-law to seek full time employment (preferably at a government job with their sweet, sweet benefits), but at 50+ years of age, with no college degree, it's a tough sell. What other options are there for broke people with large hospital bills?

"The world is a mess, and I just need to rule it" - Dr Horrible
Jebus314 on

Posts

  • MushroomStickMushroomStick Registered User regular
    Ask the hospital about financial aid. Depending on the level of need, they may be able to write off a portion of or even all of the bills.

  • Jebus314Jebus314 Registered User regular
    Ask the hospital about financial aid. Depending on the level of need, they may be able to write off a portion of or even all of the bills.

    Is this a general thing? Like should they just call up the billing office and say, we need some financial aid? Is there a specific program involved? Thanks

    "The world is a mess, and I just need to rule it" - Dr Horrible
  • ThanatosThanatos Registered User regular
    You should look into Medicaid and SSI (disability).

  • ceresceres When the last moon is cast over the last star of morning And the future has past without even a last desperate warningRegistered User, Moderator Mod Emeritus
    They may need to find a local advocate and look into government programs that are available on a state or federal level, and also talk to the hospital to find out what kind of aid, if any, they have available. It is a really, really shitty situation to be in.

    And it seems like all is dying, and would leave the world to mourn
  • Mad JazzMad Jazz gotta go fast AustinRegistered User regular
    There are often state and county resources to help with medical expenses as well, it just depends on where you (they) live. Physicians often know a lot of the various options, so that's a place you can start without having to deal with a complete stranger, and you can also ask the hospital. If the billing office isn't the right place, they'll be able to point you in the right direction.

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  • ceresceres When the last moon is cast over the last star of morning And the future has past without even a last desperate warningRegistered User, Moderator Mod Emeritus
    There may also be specific programs or charities or clinical trials or research whatnots depending on exactly what the disease or condition is. These are all things to look into.

    And it seems like all is dying, and would leave the world to mourn
  • schussschuss Registered User regular
    Jebus314 wrote: »
    Ask the hospital about financial aid. Depending on the level of need, they may be able to write off a portion of or even all of the bills.

    Is this a general thing? Like should they just call up the billing office and say, we need some financial aid? Is there a specific program involved? Thanks

    Yes, absolutely. Most hospitals can direct you to a variety of resources or setup a payment plan. Better to have some or all over a period of time than none ever.

  • Mad JazzMad Jazz gotta go fast AustinRegistered User regular
    ceres wrote: »
    ceres wrote: »
    There may also be specific programs or charities or clinical trials or research whatnots depending on exactly what the disease or condition is. These are all things to look into.
    Definitely something to think about, but it's important to know going in to the trial that the goal is explicitly not treatment of subjects, so they're not something to rely on.

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  • ceresceres When the last moon is cast over the last star of morning And the future has past without even a last desperate warningRegistered User, Moderator Mod Emeritus
    Mad Jazz wrote: »
    ceres wrote: »
    ceres wrote: »
    There may also be specific programs or charities or clinical trials or research whatnots depending on exactly what the disease or condition is. These are all things to look into.
    Definitely something to think about, but it's important to know going in to the trial that the goal is explicitly not treatment of subjects, so they're not something to rely on.

    Yeah, they're pretty last-resortish.

    And it seems like all is dying, and would leave the world to mourn
  • The EnderThe Ender Registered User regular
    Thanatos wrote: »
    You should look into Medicaid and SSI (disability).

    ^ This ^

    If your father in law is old enough to be covered by Medicaid, that's by far his best option for paying the medical bills.

    With Love and Courage
  • Jebus314Jebus314 Registered User regular
    First, thanks to everyone for the input so far. Second, I am helping them look into low income solutions and medicaid, but my sense so far is that we may need to get some kind of an expert involved. There is this additional wrinkle in that my father in law received a few hundred thousand in inheritance a few years ago. Currently it is how they are staying afloat, by burning through that reserve shockingly quickly. Ideally they could use some of that money for their nonexistent retirement. However, it seems while the money is still their they probably wont qualify for any decent programs. Which means the most likely outcome is that they spend it all on hospital bills in the next 2-3 years, and then they apply for medicaid when they're truly broke.

    So long story short, whose the expert on these types of things? Basically whose the spacekungfuman of hiding poor peoples money.

    "The world is a mess, and I just need to rule it" - Dr Horrible
  • Mad JazzMad Jazz gotta go fast AustinRegistered User regular
    Seriously, talk to the hospital or talk to their PCP (or whichever doc is spearheading the treatment, if it's not the primary), whoever you feel more comfortable with. If they can't answer these questions for you, they'll be able to point you toward someone who can.

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  • DjeetDjeet Registered User regular
    Has he been denied coverage due to having a pre-existing condition? If so check out the state PCIP program.

  • Raif SeveranceRaif Severance Registered User regular
    I'm not sure if I understand why they haven't gotten insurance privately. Why would they pay all this money out of pocket when they could pay a fraction of it if they bought private insurance with this sizable inheritance?

  • Jebus314Jebus314 Registered User regular
    I'm not sure if I understand why they haven't gotten insurance privately. Why would they pay all this money out of pocket when they could pay a fraction of it if they bought private insurance with this sizable inheritance?

    They have some form of insurance now. It's just that when the condition came around he was on his employers insurance. He had to quit because he can't work, and so he had to get private insurance with this huge condition on the table. So their insurance has unreal deductibles, costs a shit load, and doesn't cover everything he needs. Thus the massive spending. It's unsustainable, but there doesn't seem to be any better options out there for insurance. Thus this thread.

    "The world is a mess, and I just need to rule it" - Dr Horrible
  • Raif SeveranceRaif Severance Registered User regular
    Jebus314 wrote: »
    I'm not sure if I understand why they haven't gotten insurance privately. Why would they pay all this money out of pocket when they could pay a fraction of it if they bought private insurance with this sizable inheritance?

    They have some form of insurance now. It's just that when the condition came around he was on his employers insurance. He had to quit because he can't work, and so he had to get private insurance with this huge condition on the table. So their insurance has unreal deductibles, costs a shit load, and doesn't cover everything he needs. Thus the massive spending. It's unsustainable, but there doesn't seem to be any better options out there for insurance. Thus this thread.

    That makes more sense. As previous people have said their first call should be to the hospital, they are more than willing to work with people about repayment. If there are medications they have trouble paying for then the drug companies usually have some form of patient assistance programs available. I worked at a hospital where they had their own "insurance" where you were charged based upon your income. There may be some sort of financial counselor they can get an appointment with at the hospital they are seen at. If they don't have one there then they may want to go to a different hospital that handles indigent patients.

  • kingofbeachkingofbeach Registered User regular
    I work on the business side of a big hospital and I talk to patients who have trouble paying bills every day. Definitely talk to the hospital about financial assistance, and look into Medicaid, Medicare Disability, and any County Programs. Most hospitals love writing off bills as charity because of the tax benefit, and their financial assistance office has an incentive to help you find a way (insurance) to pay for the bills.

  • kaliyamakaliyama Left to find less-moderated fora Registered User regular
    Underlying all the hospital's solicitousness with insolvent patients is the threat of bankruptcy in the background. Blood from a turnip etc. Chapter 13 may be appropriate depending on the size of the debt. But in any event you can negotiate with them just by calling them up.

    I have no idea what Medicare/Medicaid spend down rules are like, but you should look them up. I am sure that there is some amt of cash exempted from spend down requirements just as there is a household exemption.

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  • WildEEPWildEEP Registered User regular
    One thing I would say is that anytime you get a bill from the hospital, you need to call them at their line and tell them you don't have any insurance and ask them to issue you a new bill.
    A lot of places inflate their costs for insurance companies - when they remove the markup - its decidedly much more affordable.

  • Dr. FrenchensteinDr. Frenchenstein Registered User regular
    yeah my surgery would have been like $12k without insurance, with insurance they just knocked off $6k, before the insurance paid their portion. it's nuts.

  • ThanatosThanatos Registered User regular
    The Ender wrote: »
    Thanatos wrote: »
    You should look into Medicaid and SSI (disability).

    ^ This ^

    If your father in law is old enough to be covered by Medicaid, that's by far his best option for paying the medical bills.
    Medicare is old-person coverage. I assumed that if his father-in-law was 65, this wouldn't be an issue to begin with.

    Medicaid is poor-person coverage, and SSI is disability insurance. SSI is almost certainly the better bet, especially with all that cash in the bank.

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