[BeyondtheRainbow]

I got a call from the billing people at my hospital today. I've been making payments on surgery from 2014 and had that down to about $300 before I had to go IP in August. That had a big co-pay and a few other charges. So now my payment plan is adjusted and is high enough that I'm going to have to re-think my budget to make it.

If/when I go again I'll have another big copay. And if they make me pay that in 12 months it will make my payments far beyond what I can manage, more than 10% of my income. I'm working with a group that helps when you are low-income but they mostly help you get medicaid. I have spend-down Medicaid and it will be used but I still incur a big cost first.

I have no idea what to do. I'll call the low-income people Monday and see if they have any suggestions but I'm not expecting much.

I shouldn't have waited for Rexulti. We should have just gone to clozaril and gone IP the week I saw my pdoc last when there wouldn't have been a co-pay. I just thought something would work out easily for once. Bad guess.

[Mountainbard]

I'm sorry you're in this situation. Hindsight is 20/20 for sure. I hope the group you're working with can help you out with this.

[Unrigged64072835]

Sorry to hear about your predicament. At least you tried something different, so don't fault yourself for that. Hope things work out so you can get the help you need.

I don't understand not having healthcare. How can they just turn you away? How can they make you pay if you can't afford it? What do they do?

[BeyondtheRainbow]

I didn't actually try anything. We hoped to get samples of a new med but that hasn't happened. I had to make a tough decision; my co-pay free time ended a few days after I saw my pdoc and I decided to try to see if we got the med with more time because it would be so much better than clozaril or ECT which is what the hospitalization will be for (clozaril at this point since I've gotten out of depression and well into mixed after months of depression alone). I knew it was a gamble. I just really hoped it would pay off and I'm really not sad I tried it because I want to know I've done everything before I go IP and come off Seroquel and go on Clozaril and I guess I did. I'm just a not sure how I'll afford both IP stays. But it's just life I guess.

Originally Posted by Fharraige

Sorry to hear about your predicament. At least you tried something different, so don't fault yourself for that. Hope things work out so you can get the help you need.

[BeyondtheRainbow]

I do have insurance but it just doesn't cover everything. I have Medicare, government insurance for the elderly or disabled. IP it pays everything but a copay and 20% of doctor fees and OP it pays 80% of everything except labs and one physical per year are free. I just can't afford 2 copays.

This hospital is better equipped than a lot to help with this. When I had no insurance they paid for everything, including surgery. That program is still there and I normally don't qualify b/c I have insurance. But it says if you meet the financial qualifications and have a special circumstance they will consider it. So I'll just hope that they do consider it and reduce my bill or not charge me the 2nd copay. The low-income people may have some other option and I'll call them Monday to see. Otherwise I'll wind up putting it on a credit card and use a balance transfer to pay it off at 0% interest.

I honestly don't know what happens if you honestly can't pay your bill and the hospital won't help. Mine is generally reasonable so now that I know about the financial assistance thing I'm less worried. It used to be that if you were making consistent payments on medical debt that it couldn't be reported to credit agencies or turned over to debt collection but that is no longer the case. It's still harder for it to affect your credit but it eventually will. I guess you keep making payments and hope for the best.

My psych hospital system is is much kinder in general and since I have to do something or feel awful forever I guess I'll just be convincing my pdoc that I need to go in after the first of a month so that my medicaid will pay the maximum (it re-starts every month no matter how much I paid the month before so if I am in at the end of a month and stay through the beginning of the next I have to meet the eligiblity amount twice). Since what I'll be doing means probably feeling pretty horrible I'm really hoping to make it until after Christmas. I've made it this long, I can't see another month mattering that much. And since my income didn't go up at all but my prescription insurance premiums and co-pays did I'll have an even greater need for assistance next year that will hopefully get them to at least reduce what I owe.

I have no idea what other hospitals do in the same circumstances. Our Affordable Care Act was developed with my hospital's systems as one of the models they used for how to make things work and maximize cost efficiency. I go there for many reasons but one of them is that they are cost effective as much as a hospital can be. Through some magic I didn't understand they ate a big chunk of my surgery fees from last year and I know they could have billed me if they wanted to because another provider did until after paying them 33% of the bill and they got tired of constantly calling them to nag about did they do whatever I had previously asked them to do to get the bill paid they gave up and forgave the remainder. (But even then I had paid much more than I would have if they'd not messed up the billing).

I'm freaked out but I do have more options so I should just be thankful for what I've got. I just can't imagine trying to pay what I have to now much less with another admission added. But it will work out somehow.

Originally Posted by rcat

I don't understand not having healthcare. How can they just turn you away? How can they make you pay if you can't afford it? What do they do?

[Cocosurviving]

I've been able to go IP three times and afford my Medicaid co-pay bc I'm not working. But I just got approved for disability and that's a different ball game (I'll lose the Medicaid). I have a family member on it with hospital bills up to there neck. I don't think I'd be able to afford to go IP again either. I hate this is happening to you. I hate what the whole medical insurance systems puts use in the middle of. Do they have 211 in ur city it's a helpline by the United Way? Give them a call.

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[BeyondtheRainbow]

I don't know about 211. I'll check. My small town probably doesn't; the city the hospital is in probably does.

Medicare is tough. It's good if you aren't sick but by definition if you have it you probably are sick. They eventually paid for my ankle surgery (outpatient so I owed 20%), numerous casts, boot, splint and brace, etc. pretty well and the hospital wound up writing off some of it. On the other hand I started PT in Aug of last year and still don't know whether I owe them more than what I paid as a guesstimate to save 20% or not. I'm a month from from being a year out from finishing PT and still the claims haven't processed apparently. IP psych is the hardest. It's cheaper if you choose the HMO route but here (middle of nowhere) the only HMOs for disabled people are crappy and I want freedom to go to the hospital where I go for psych care and those HMOs don't allow this. They also would force me out of IP a lot faster than Medicare will.

If you qualify for spend-down Medicaid that helps a lot. I'm kind of in a blank area where I get spend-down but the amount is so big that it's almost impossible to meet. It was met with my ankle surgery but it got so messed up that I wound up just paying because I couldn't get the right people to coordinate and I was too depressed to fight it out over a few hundred dollars at most. It was met with my IP stay but only for a little bit that isn't going to lower this payment significantly.

Thanks for the 211 information!

Originally Posted by Cocosurviving

I've been able to go IP three times and afford my Medicaid co-pay bc I'm not working. But I just got approved for disability and that's a different ball game (I'll lose the Medicaid). I have a family member on it with hospital bills up to there neck. I don't think I'd be able to afford to go IP again either. I hate this is happening to you. I hate what the whole medical insurance systems puts use in the middle of. Do they have 211 in ur city it's a helpline by the United Way? Give them a call.

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[Cocosurviving]

Originally Posted by BeyondtheRainbow

I don't know about 211. I'll check. My small town probably doesn't; the city the hospital is in probably does.


Medicare is tough. It's good if you aren't sick but by definition if you have it you probably are sick. They eventually paid for my ankle surgery (outpatient so I owed 20%), numerous casts, boot, splint and brace, etc. pretty well and the hospital wound up writing off some of it. On the other hand I started PT in Aug of last year and still don't know whether I owe them more than what I paid as a guesstimate to save 20% or not. I'm a month from from being a year out from finishing PT and still the claims haven't processed apparently. IP psych is the hardest. It's cheaper if you choose the HMO route but here (middle of nowhere) the only HMOs for disabled people are crappy and I want freedom to go to the hospital where I go for psych care and those HMOs don't allow this. They also would force me out of IP a lot faster than Medicare will.


If you qualify for spend-down Medicaid that helps a lot. I'm kind of in a blank area where I get spend-down but the amount is so big that it's almost impossible to meet. It was met with my ankle surgery but it got so messed up that I wound up just paying because I couldn't get the right people to coordinate and I was too depressed to fight it out over a few hundred dollars at most. It was met with my IP stay but only for a little bit that isn't going to lower this payment significantly.


Thanks for the 211 information!

Your welcome and thanks for the Medicare info

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