What To Do If You Don't Have Health Insurance, Part 1

Mary Ann HodorowiczBy Mary Ann Hodorowicz RD, LDN, MBA, CDE, CEC

The subject of what to do if you don't have health insurance is very near and dear to my heart.  There was an extended period of time when both of my adult sons had no healthcare insurance despite working 60 plus hours per week.  As a diabetes educator, I know just how important it is to get regular health care in order to stay healthy…and this is especially true if you have diabetes.  But paying for medical care, including prescription drugs, can be expensive.  This article is Part 1 of 2, and will review the array of medical and drug assistance programs that exist to furnish needed medical care to persons without health insurance.

The "National Association of State Comprehensive Health Insurance Plans" (www.naschip.org/portal/) was created for individuals who had been, or could be, denied healthcare coverage due to pre-existing conditions. It provides educational opportunities and information for the high-risk health insurance pools that exist in select states to serve those who are considered uninsurable due to pre-existing conditions.  When you qualify for coverage through a health insurance risk pool, you can protect yourself from catastrophic medical bills.  States that participate contract with major insurance carriers to manage the high-risk pool programs and offer plans that are similar to individual health policies offered by these carriers. You can even choose your own deductible. The plans are created to be affordable while providing you with comprehensive healthcare coverage.

Another great online resource is the website "Coverage for All" (www.coverageforall.org).  It provides a state-by-state directory, which provides you with healthcare insurance options in your state based on your eligibility.  These options also come with complete contact information. 

If you have children without coverage, you will want to visit "Insure Kids Now" (www.insurekidsnow.gov/).  This Internet resource is for children without coverage.  Each state has partnered with the Federal government to create this program that provides medical, dental, prescription drug, vaccinations, emergency care, and psychological care for children through your state's Medicaid program and the Children's Health Insurance Program (CHIP) at no cost or very little cost, depending on your income and other criteria.

Many of us are not aware of all the free clinics that exist in our own neighborhoods for people with limited health coverage or no health insurance. The federal Health Resources and Services Administration Agency provides funds to health centers, hospitals, and other care facilities to help offset the cost of care for the uninsured under the "Hill-Burton Law."  Under this law, select hospitals, clinics and other health facilities who received federal funds for modernization and construction are required to provide a specific amount of free or below-cost health care to people unable to pay. Eligibility is based on the size of your family and your income. You apply for Hill-Burton care at the facility where you were or will be treated.  To find a Hills-Burton funded facility near you, go to www.hrsa.gov/gethealthcare/affordable

Also it is important to know that nonprofit hospitals must provide you with emergency medical care regardless of your ability to pay. Often times these facilities will allow a certain percentage of the final medical bill to be written off, or the hospital can help you set up low payment plans based on proof of your income. Some physicians may also be willing to negotiate a lower rate for uninsured, cash-paying patients. This website, www.truecostofhealthcare.org/ provides guidance on how to negotiate a lower rate if you have no health insurance.  

You will want to visit "The Healthcare Blue Book" (www.healthcarebluebook.com).  This is a free consumer guide to help you determine fair prices in your area for healthcare services. If you pay for your own healthcare, have a high deductible, or need a service your insurance does not fully cover, the Blue Book will help you find fair prices for surgery, hospital stays, doctor visits, medical tests and much more. 

There are many financial assistance programs for people with no health insurance in need of prescription coverage, medical care, dental care, mental health needs, and even eye care.  One such program that my own son used to get his prescription drugs at no cost is at www.advocateassistance.com. Their team of patient advocates assists members in obtaining their medications for free and in substantially reducing the cost of certain tests, treatments, and medical procedures that are needed.  Some of these programs focus primarily on prescription drug assistance, as they partner with all the major pharmaceutical companies. And don't forget about the $4 generic drug programs that are popping up everywhere! The $4 generic drug programs are available to those without healthcare or those without prescription coverage on their health plan. Some of the bigger $4 programs include Target, Kroger, Safeway and Sam's Club/Wal-Mart. Many of the larger pharmacies such as CVS, Target, Walgreens, and others offer prescription discounts.

Another great program for no cost medications run by the pharmaceutical companies is "Rx Assistance" (www.rxassist.org).  Other prescription programs include: Rx Hope (www.Rxhope.com), Needy Meds (www.needymeds.org), and Rx Outreach Assistance Program for Discount Prescription Drugs (www.rxoutreach.com).

Keep in mind that area schools of dentistry and medical schools often provide free medical care.  Their students furnish the care under the supervision and direction of licensed healthcare professionals.

Although it is not ideal to be without healthcare insurance, the good news is that there are many, many assistance programs available to help meet your healthcare needs.

Stay tuned for Part 2 of this topic in which the state-based healthcare exchange plans will be reviewed.  These plans are part of the new healthcare reform law known as the Affordable Care Act.  The implementation date is January 1, 2014. 

Read Mary Ann's bio.

Read more of Mary Ann's columns.

Mary Ann is a consultant, speaker, writer and trainer for the health, food and pharmaceutical industries in nutrition, diabetes and insurance reimbursement.  Her clients include healthcare entities, membership associations, research firms, pharmacies, education/training firms, government, websites, academia, media and individual healthcare professionals.  Mary Ann specializes in helping clients establish AADE-accredited DSME programs, MNT programs, shared medical appointments, marketing and insurance reimbursement policies and procedures, and training educators on motivational interviewing and strategies for successful patient behavior change. Mary Ann is on the AADE Board of Directors and has served on numerous committees of the Academy of Nutrition and Dietetics, its practice groups and state affiliates.

For more information about Mary Ann Hodorowicz, RD, MBA, CDE, CEC and Mary Ann Hodorowicz Consulting, LLC, visit www.maryannhodorowicz.com - Nutrition, Diabetes Care & Education, Health Promotion and Insurance Reimbursement for Professionals for the Healthcare and Food Industry.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: July 27, 2015

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...
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