Cash for Medical Care

Cash for Care - 8/22/08

INTRO: You go to the hospital to treat cancer or heart disease. But they refuse to admit you until you pay tens of thousands of dollars up front. Could this nightmare actually happen to you?

1. CAN A HOSPITAL DEMAND A HUGE PAYMENT IN ADVANCE OF TREATING YOU?

A. In many cases, the answer is yes. And this is a growing national trend. Sick people are presented with demands for tens of thousands of dollars, and are turned away if they can't pay. Hospitals are taking these steps because they are facing massive unpaid bills for care.

2. DON'T HOSPITALS HAVE TO PROVIDE CARE TO EVERYONE IN THEIR EMERGENCY ROOMS, BEFORE DEMANDING PAYMENT?

A. Yes, if the condition is a "medical emergency." But treatment of some of the most expensive conditions, such as cancer and heart disease, are often not emergencies. They may be life-threatening, but not emergencies.

3. ARE HOSPITALS DEMANDING UP FRONT PAYMENTS FROM PEOPLE WHO HAVE INSURANCE, OR IS THIS A PROBLEM ONLY FOR THE UNINSURED?

A. Hospitals are demanding up-front payments from people with private health insurance. That's because the co-pays and deductibles which are not covered by insurance can amount to tens of thousands of dollars. And hospitals are afraid that they'll get stuck with the tab. Another problem is that many policies place coverage limits. So if your policy will only cover 12 of the 20 radiation treatments you're going to need, the hospital may require you to pay for the 8 that are not covered, up front.

4. WHAT CAN WE DO TO PROTECT OURSELVES?

A. There are a few steps you can take. First is to carefully review your insurance policy, to make sure you know what is and is not covered. Talk to your insurer about filling the gaps.

Second, know that you can challenge an insurance company's decision not to cover a particular treatment. You can appeal within the company structure, you can contact the state insurance department, and you may even choose to file a lawsuit.

Third, you can get help.

Here are three organizations you may want to contact:

www.patientadvocate.org
1-800-532-5274

Ohio Senior Health Insurance Information Program (OSHIIP)

www.oshiip.org
1-800-686-1578

www.uhcanohio.org
1-800-634-4442

CLOSE: There's something wrong with our health care system when people are forced to pay thousands of dollars up front in order to get care for life threatening illnesses. Legislators in Columbus and Washington must commit to fix our broken health care system, and they should make their commitments up front, before we vote in November.