My son is in Utah this week skiing with his girlfriend and her family and got injured last night. He was taken to the hospital and it was determined that he busted his knee (ACL) but because he has no insurance there was not much that they could do for him.
They are flying back tomorrow and he is concerned that he won't be able to get health insurance with his pre-existing condition. He is going to require surgery and therapy. He know that he is going to probably have to pay a high premium for his condition, but I don't even think that they will insure him.
He has a stable job, but they do not offer health insurance and him being young (26) didn't think that he was going to need health insurance anytime soon. He won't qualify for Medicare/Medicaid because he probably makes too much money (not that he makes tons of money, but he has an income). Also, he won't qualify for state assistance. We are in Florida. What happens when people need surgery and do not have insurance? Can he be put on a payment plan or something like that?

First most prviate hospitals don't even have to take him or treat him, i.e. the reason the one in California wouild not do it either.

If he goes to a publicly funded hospital they can not refuse to teat him, he may have to pay a certain amount up front and then make payments.

While he may get some insurance it would not cover this accident even if he did get it. And most companies will not insure you if you have a current surgary pending and not done. ** There are a few high risk policies that may, but not many.

Again even if he buys it, since this is a pre existing condition, it will not be covered by any new policy he would buy.

This is why eveyrone needs health insurance, you insure your car that can be easily replaced with a few 1000 of dollars but your medical bills can be in the 100's of thousands if you get into something serious.

Fr_Chuck, that's for your response. But when he gets back tomorrow, does he go to the state funded hospital or to a doctor? I guess that if he goes to the hospital, they will refer him to a doctor that works with the hospital, right?
Sorry to sound ignorant, but this is new to me, since I have my own insurance and it has never happened to me.

Either, some hospitals have doctors attached, I would find a doctor attached to that hospital and arrange a visit, they would schedule the surgary and all of the pre admitance paperwork. I know here the hospital in Atlanta is Grady, they do all of the homeless and uninsured.
** note why we all pay such high taxes, since we do provide free health care for those that don't pay.
Now I had to go to Grady one time as a police officer, I was hurt in the line of duty, I was given preferred treatment and it was still bad, I would alsomost perfer to go untreated than go back to Grady hospital again,
So not sure how yours will be, but my guess he can expect long waits, the average when I was a officer was about 4 hours to get seen. If you were not in a life threatening case.

If he needs any advice latter about a good company, let me know, I am actually a licensed insurance agent in two states, and I know some companies that may be OK to cover him ( but still would not cover a pre existing condition)

I just called Tampa General Hospital and was told that they would see him at the ER and won't turn him away. There they have a "financial advisor" that will go over the payment details with him because is depending on his income. TGH is the #1 Trauma Center here in Tampa and I have personally been taken there a couple of times and just like a public hospital, it has all kinds of people, but the treatment is #1. My guess is that he is going to wait (but you have to wait in almost any hospital) but eventually he will be seen. His concern is that he is going to end up with $50,000 in hospital bills, but I am sure they put him on a scale and he would only pay a percentage. It is not like he is trying not to pay anything, but he wanted to have an idea of how much it was going to cost him.

Many hospitals these days understand how hard it is to pay when you don't have insurance. Thus they have the advisors. Many hospitals have grants that help cover expenses when a patient can't afford it... many of the fees can be written off if the patient has not insurance... Still other hospitals have charities that help pick up expenses.

This is all something that needs to be discussed with the advisor. Yes, payment plans can be set up. They don't expect you to pay all at once, but all of the income issues need to be discussed with the advisor prior to having anything done so they can pull from their various sources to help with the expenses.

Great advice. Thanks.

J_9 makes a good point about hospital funding. Personally, I would love to see the day when all Americans have health insurance. I found a breast lump a while back and had to go have tests done. Turned out I was fine. I was so worried about how I would pay, but the hospital covered some of it with grants, and I was allowed to make payments on the rest.

The people at the hospital were really nice and took lots of time to listen to my concerns. I am able to make payments that I can afford based on what I make. I hope everything works out for him!

Peggy I am glad that everything worked out for you. I will be taking him to the ER either tonight when he flies in or tomorrow morning, depending on how he feels, but I want to make sure that I am there when they talk to him. I know that he is an adult (26) but he is still very ignorant about health issues and even though he is on his own and paying his own bills, I want to make sure that they do the right thing and help him out.
Good luck to all of you for responding and hava a safe and Happy Holiday (Merry Christmas) Season.

That's good that you want to be there, but he will have to sign a consent for your presence and for them to discuss any health issues with you.

As he is an adult he has the right to privacy with his health treatments and the hospitals do not take this lightly. Just make sure he does consent, in writing, for you to be present when decisions about his health care are taking place.

Oh I know about the privacy issue, and he already told me that he wanted me there, so I don't see any problem with me being there. If the hospital has a problem, then I will just wait in the waiting area... at least he knows that I am there for him. Thanks.

Just make sure that consents are signed. Then you can be with him through the whole thing.

Does Florida require health insurers to offer HIPAA plans as California does? What this program is is that every insurer selling health insurance in California must offer at least one HIPAA plan if they decline coverage under a standard policy.

If they do, your son could apply for coverage, being sure to say "yes" to the question "would you accept HIPAA if you're declined...."? HIPAA plans offered are identical to their standard coverage counterparts, except that the premiums are very high. But if your son is facing surgery and PT afterwards, the high premiums should be dwarfed by savings in hospital bills. Most all plans have a stop-loss provision per calendar year. The earliest effective date for him will be January 1st. Good luck.

You PAY for HIPAA in California? This sounds like a scam to me.

HIPAA.ORG

**EDIT** Whatever you do, please do not pay for HIPAA insurance. HIPAA is your RIGHT to privacy, you don't have to pay for rights.

Update!! I took him to the hospital and they saw him, but since he didn't have any insurance, they said that there wasn't much they could do for him. They did refer him to get an MRI and then go to an orthopedic surgeon (duh!). They said that if he had the MRI done there the bills would be too high and he was better off shopping around different places to see who had the best deal. When he talked to the financial advisor, the guy was really negative just telling him, " I don't know why you are here, since you were seen by a doctor in Uthah. If it was me, I would go straight to an orthopedic doctor." I was livid when I heard that, and he almost discouraged my son to be seen there, but I talked him in to staying. My son was honest with him and told him that he made aprroximately $30,000 a year, even though he has been working only for 6 months, but he has mortgage and other bills to pay and that at the end of the month, all he has left is like $200. So because of that, he doesn't qualify for the county health or charity.
The doctor that he talked to though, said that he might not need surgery, that sometimes those things can get fixed with time and if he is not into professional sports, he could probably live with a little discomfort. Of course, he said that based on the X-Rays that my son brought from Utah, but that an MRI could give them a better idea of how badly his knee is.
So the rest of the week I will be calling MRI and radiology places to see how much a knee MRI is and if they have any kind of program or financial deal.
I still do not understand what HIPAA is.

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Originally Posted by lrhall41

My son is in Utah this week skiing with his girlfriend and her family and got injured last night. He was taken tot he hospital and it was determined that he busted his knee (ACL) but because he has no insurance there was not much that they could do for him.
They are flying back tomorrow and he is concerned that he won't be able to get health insurance with his pre-existing condition. He is going to require surgery and therapy. He know that he is going to probably have to pay a high premium for his condition, but I don't even think that they will insure him.
He has a stable job, but they do not offer health insurance and him being young (26) didn't think that he was going to need health insurance anytime soon. He won't qualify for Medicare/Medicaid because he probably makes too much money (not that he makes tons of money, but he has an income). Also, he won't qualify for state assistance. We are in Florida. What happens when people need surgery and do not have insurance? Can he be put on a payment plan or something like that?

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My wife has a fattyn tumor on her finger and neither of us have health insurance at present but are looking NOW to acquire some could you please help us as to where to look? Thank you, kelly.