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How to Get (and Pay for) Healthcare When You Are Uninsured

How to Get (and Pay for) Healthcare When You Are Uninsured

Posted Mar 15, 2016 by Jenifer Dorsey

You don’t have health insurance and need to see a doctor. What do you do?

You will schedule the appointment as usual and let the doctor’s office know that you are paying cash.

It is likely you will be asked to provide payment up front at the time of service. A Health Affairs study published in May 2015 found that only 1 in 5 people were told they could be seen without paying the entire cost of the visit up front.[1] The same study found that an office visit cost an average of $160 for a new patient. If you are unable to pay in full at the time of service you may be able to negotiate a payment schedule with the provider.[2]

Save the emergency room for emergencies

Medical Billing Advocates of America advises that you “steer clear of the hospital emergency room unless you feel your condition is life threatening or that it somehow truly calls for an emergency room setting.”[3] While you may be less likely to owe the ER an up-front payment, you will likely pay far more for such visits.

According to the National Center for Health Statistics, an ER visit can cost upwards of $1,000 for adults.[4] If you do not have an emergency medical situation but need care sooner than a doctor can see you, visit an urgent care clinic instead—the average urgent care center visit costs around $150.[5]

Explore potentially more cost-effective provider options

Other places that uninsured individuals may be able to receive healthcare include walk-in clinics and community clinics. The cost of a walk-in clinic visit can be half that of a regular doctor visit for those paying cash, according to Medical Billing Advocates of America, and a community clinic may provide free or low-cost treatment determined by an income-based sliding scale.[6]

Purchase supplemental products that can help cut out-of-pocket costs

If you are in between Obamacare plans and ineligible for a special enrollment period, you may become temporarily uninsured. When the next open enrollment period begins on Nov. 1, 2016, you can purchase ACA-compliant coverage that will take effect in 2017. In the meantime, you can purchase supplemental products to help you reduce your share of out-of-pocket healthcare costs.

Supplemental products, also known as ancillary products or supplemental health insurance plans, are not ACA compliant and do not serve as minimum essential coverage that meets the Affordable Care Act’s individual shared responsibility provision; however, they can help you pay for healthcare while you are uninsured. Plus, with the exception of short term health plans, you can continue to use them once you buy health insurance that qualifies as minimum essential coverage.

Five common supplemental plans worth your consideration include:

1. TelemedicineGain access to 24/7 healthcare consultations wherever you have telephone access—and, in some cases, Wi-Fi. You pay a flat per-consultation fee. It has been estimated that telemedicine can save consumers $100 or more per doctor visit.[7]

2. Medical gap coverage – Receive lump-sum benefits for covered accidents and critical illnesses. Use the payments however you see fit—for medical bills, prescription medications, living expenses such as groceries and rent, and more. The medical gap plans available through healthedeals.com include Metal Gap and Metal Gap 2.

3. Short term health insurance plans – While you are in between Obamacare plans you can buy a short term plan for as few as 30 days. This temporary coverage provides a range of benefits for unexpected medical care including doctor office visits, emergency room treatment, surgical services and more.

4. Dental insurance – Dental benefits can help reduce what you and your family pay for preventive care (e.g., bi-annual routine dental exams and professional cleanings) as well as basic and major care such as fillings, crowns and root canals.

5. Critical illness coverage – Critical illness plans pay lump-sum benefits upon diagnoses of certain conditions such as stroke, major organ failure, cancer and heart attack. These payments may be used for medical bills, travel to and from appointments, living expenses, childcare and more.

Many of these products come in a range of plan designs and can be customized to suit your healthcare needs and household budget. Some are guaranteed issue, while you may not qualify for others based on factors such as health history. Availability varies by state.

Where can I buy supplemental health plans?

You can buy the supplemental products listed above at healthedeals.com. If you have questions or want assistance in selecting the right options for you, call the number at the top of your screen to speak with a certified advisor.

 


 

[1] Johns Hopkins Bloomberg School of Public Health. “Primary Care Visits Available to Most Uninsured But at a High Price.” May 5, 2015. http://www.jhsph.edu/news/news-releases/2015/primary-care-visits-available-to-most-uninsured-but-at-a-high-price.html

[2] Majerol, Melisa, et al. “The Uninsured: A Primer – Key Facts About Health Insurance and the Uninsured in the Era of Health Reform.” The Henry J. Kaiser Family Foundation. Nov. 13, 2015. http://kff.org/report-section/the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-in-the-era-of-health-reform-what-are-the-financial-implications-of-lacking-insurance/

[3] Palmer, Pam. “How to Get Medical Help When You’re Uninsured.” Medical Billing Advocates of America. http://billadvocates.com/get-medical-help-youre-uninsured/

[4] Neighmond, Patti. “Can’t Get In To See Your Doctor? Many Patients Turn To Urgent Care.” Kaiser Health News. March 8, 2016. http://khn.org/news/cant-get-in-to-see-your-doctor-many-patients-turn-to-urgent-care/

[5] Neighmond, Patti. “Can’t Get In To See Your Doctor? Many Patients Turn To Urgent Care.” Kaiser Health News. March 8, 2016. http://khn.org/news/cant-get-in-to-see-your-doctor-many-patients-turn-to-urgent-care/

[6] Palmer, Pam. “How to Get Medical Help When You’re Uninsured.” Medical Billing Advocates of America. http://billadvocates.com/get-medical-help-youre-uninsured/

[7] Dvorak, Katie. “Study: Telehealth Can Save $100 or More Per Visit.” FierceHealthIT. Dec. 15, 2014. http://www.fiercehealthit.com/story/study-telehealth-can-save-100-or-more-visit/2014-12-15

TELEMEDICINE
The Telemedicine plan is NOT insurance. The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act.

METAL GAP and METAL GAP 2
THIS PLAN IS NOT CONSIDERED TO BE MINIMAL ESSENTIAL COVERAGE AS DEFINED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA. ENROLLING IN AND MAINTAINING THIS PLAN WILL NOT EXEMPT YOU FROM THE SHARED RESPONSIBILITY PAYMENT (TAX) THAT MAY APPLY IF YOU DO NOT HAVE PLAN WITH ACA-COMPLIANT COVERAGE.

SHORT-TERM MEDICAL EXPENSE (STM)
THIS IS A SHORT TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.

DENTAL
THIS PLAN DOES NOT MEET MINIMAL ESSENTIAL COVERAGE REQUIREMENTS FOR PEDIATRIC DENTAL SERVICES AS PART OF THE ESSENTIAL HEALTH BENEFITS IN ACCORDANCE WITH THE AFFORDABLE CARE ACT (ACA) PROVISIONS.

DENTAL
CRITICAL ILLNESS
A CRITICAL ILLNESS INSURANCE PLAN PAYS OUT LUMP-SUM CASH BENEFITS UPON DIAGNOSIS OF CERTAIN COVERED ILLNESSES AS SHOWN IN THE CERTIFICATE. THIS PRODUCT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA.

About The IHC Group
The IHC Group is an organization of insurance carriers and marketing and administrative affiliates that has been providing life, health, disability, medical stop-loss and specialty insurance solutions to groups and individuals for over30 years. Members of The IHC Group include Independence Holding Company (NYSE:IHC), American IndependenceCorp. (NASDAQ: AMIC), Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company. Each insurance carrier in The IHC Group has a financial strength rating of A- (Excellent) from A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations. (An A++ rating from A.M. Best is its highest rating.) Collectively, the companies in The IHC Group provide insurance coverage to more than one million individuals and groups. For more information about The IHC Group, visit www.ihcgroup.com.

About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products through general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit www.HealtheDeals.com.