Dealing with Hospital Costs If You Do Not Have Health Insurance

If you do not have insurance, do everything you can to stay away from the hospital. In an emergency you may not have a choice, but if it is an urgent or elective procedure, investigate the possibility of using an urgicenter or surgicenter before using the hospital. If you have to use a hospital, look at government hospitals first, then community hospitals, then university hospitals, and specialty hospitals last. If you end up in a hospital, remember that no hospital can turn you away for treatment especially if it is an emergency. Keep the following in mind in dealing with hospital costs if you do not have insurance:

• The first thing to do if you need hospitalization, especially for an elective procedure where you can plan ahead, is to determine if you qualify for any insurance program. Are you poor enough to qualify for Medicaid? Are there any government programs that can give you
  assistance? Call your state health office to find out. Do you belong to a group through which you can get some form of health coverage? Do these things before you get into the hospital because if you do them after, even if you get the insurance, it might not cover a cost that was incurred prior to your getting the coverage.
• Always get a second or third opinion about any procedure. Many treatments have alternatives and sometimes you might not even need the procedure at all. Be sure, however, that you do not stay away from a treatment because of the cost, but rather because another well-respected professional determined that it is not necessary.
• Check out government-run clinics and hospitals. These establishments are not only less expensive but will charge you based on your income, that is, on a sliding scale, and will work out payment plans that you can live with.
• The government subsidizes most hospitals, especially teaching hospitals, because they are expected to take care of individuals who cannot pay for what the hospital charges. In these cases, the hospital will charge you on a sliding scale based on income and you can negotiate a payment plan.
• If you have a complicated or rare disease, one that in all likelihood is very expensive to treat, look into participating in clinical trials. In clinical trials, all your expenses will be paid for including, in some cases, your transportation. Be sure you understand what will be
  done and realize that if it is what is known as a double-blind trial, you might not be getting the active treatment but might be getting a fake treatment or placebo and neither you nor your doctor will know until the end. Not all studies are double blind, however. Some are known as open trials, where you and your doctor know exactly what you are getting.
• Avoid unnecessary services like private rooms and special meals if you can.
• If you need medication that can be brought in from the outside, like Tylenol or even some prescription drugs, it might be cheaper to get them from an outside pharmacy than from the hospital pharmacy. Discuss this with your doctor and let the nurses help you with the
  medication regimens.
• Discuss any consultations with other doctors ahead of time and be sure they are absolutely needed so you don’t end up with more physician charges than are necessary. When you get the bill, go over it with a fine-tooth comb. Very few patients do and there have been stories of hospitals charging exorbitant amounts sometimes for services that were not even rendered. You should realize that all bills are negotiable. Start by getting a sense of
  what the hospital charges the government for that service. You can get that information from the AHD web site (www.ahd.com). Then negotiate from there. When you have reached a satisfactory amount, you can work out a payment plan with the hospital that you can live with.