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tutepani
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 family medical emergency
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Posted on 03-15-13 1:44 PM     Reply [Subscribe]
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We have a family medical emergency. The doctor has scheduled the surgery for my wife next Friday. She doesn’t work so she has individual private health insurance. But, the insurance company said she is not covered for the surgery for next 6 months because she is new with them. I tried few other private companies but they don’t want to accept her application because of her preexisting condition. I checked with the county health but it takes up to 8months to process. Probably, she won’t be qualified for low income health benefits because of my average income(about 50K). I am worried about the surgery as well as the hospital bills. As I said, the hospital and doctor has scheduled the date. Can hospital cancel the surgery because of the insurance coverage ? How to pay the bills if the insurance won’t cover (most probably NOT) the bills ? I think she is not going to benefited from the social workers, the county, Hill Burton Free and Reduced Cost care because of my income. I thing they ONLY take care of the low income people (below Poverty level). I also heard about the settlement and monthly payments. Thank you for your advice in advance.


 
Posted on 03-15-13 1:58 PM     [Snapshot: 30]     Reply [Subscribe]
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You are working and must have insurance, why did not you added her in your policy? 
Some privet insurance are worthless.

 
Posted on 03-15-13 2:01 PM     [Snapshot: 32]     Reply [Subscribe]
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I don't have the insurance either, will be eligible for next year.


 
Posted on 03-15-13 2:13 PM     [Snapshot: 43]     Reply [Subscribe]
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If all else fails, then perhaps this is an option. Divorce her on paper so she becomes low income below poverty. Then she can live in your house because there is no law that says divorced people cannot live together. After the insurance kicks in get married again.

 
Posted on 03-15-13 2:17 PM     [Snapshot: 53]     Reply [Subscribe]
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1. how important is the surgery? if its not an emergency surgery then you may cancel it, hospital cant force your wife to do surgery.
2. can the surgery be done in nepal or india?
 
Posted on 03-15-13 2:22 PM     [Snapshot: 76]     Reply [Subscribe]
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It is illegal for any hospital to deny treatment. More often than not, these hospitals do have payment options. You could also try making a formal request for the treatment cost to be waived (a compatriot got her request approved when she didn't have health insurance during her OPT period) but I'm not sure you'd succeed based on your income level. 

Good luck. 

 
Posted on 03-15-13 2:35 PM     [Snapshot: 113]     Reply [Subscribe]
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I am not experp on this but, isn't this new healthcare law banned insurance company to deny coverage or enrollment because of preexisting condition. Or that hasn't kicked in.
 
Posted on 03-15-13 2:50 PM     [Snapshot: 138]     Reply [Subscribe]
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I am not really sure about this but i do not think they will hold relatives responsible for payment of the bills. Since your wife is having the operation, she will be held responsible for the payment, not you. But they can never deny emergency medical treatment.

I think what will happen is your wife will have the operation and they will bill her. If she tells them she does not have the money, they will work out a plan with her of whatever she can afford. This will be the same as paying insurance for the rest of your life, instead of insurance company, one will be paying the hospital. If she cannot pay at all, i think eventually county will come in and help.

I am not sure about this but one thing is they can never deny emergency medical treatment.
 
Posted on 03-15-13 4:34 PM     [Snapshot: 243]     Reply [Subscribe]
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 @ tutepani I feel bad for your situation. The best thing for you I this situation will be to go to NEPAL and get the surgery done. Last year my wife was in the Hospital for 3 days after surgery the bill was around $17k even after insurance I had to pay around $1k. So if you can you should think about going to NEPAL even with the traveling cost it will be cheaper.
JUST A SUGGESTION.
 
Posted on 03-15-13 5:19 PM     [Snapshot: 280]     Reply [Subscribe]
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As far as I know family income is considered as being applicable to husband, wife and eligible underage kids. I've seen a case where one of my khaire colleague's bau aama went thru kagaji divorce because bau had alzimer and needed treatment/care and at the same time he also had ghar jagga and bank balance which him mom ended up owning. Just another way the thing was taken care of.

 
Posted on 03-15-13 5:51 PM     [Snapshot: 327]     Reply [Subscribe]
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One of my friends family in similar situation as yours went to thailand for operation.

I pray things work out fine for you.
 
Posted on 03-15-13 9:20 PM     [Snapshot: 447]     Reply [Subscribe]
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You don't have insurance either? What do you mean? You earn 50K and you don't have. Man u need to have family insurance if ur earning 50K or more. No one knows what will happen next.
I am paying $360/moth for whole family. I can save it (its not mandatory but I am taking it).
I don't know what to tell.
1. They won't deny for surgery but they will send bill later. For non insured, bill will be way high.
2. They might or might not charge you directly. But they will definately charge your wife. If your wife is having ssn and if she fails to pay bill then credit score will get screwed. You can request to lower bill by requesting financial prob or you can go for installement.
3. Going to Nepal/India is another cost and more importantly if your wife is sick and surgery is needed then you should do it.
4. Divorcing all those takes time and your wife is in immediate need of care.

Lesson learned:
If you can afford, never skip auto/health insurance. No one knows what will happen next else we have to say "May God Have Mercy On You".

 
Posted on 03-15-13 9:37 PM     [Snapshot: 457]     Reply [Subscribe]
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 Why are you so scared? if it's normal surgery, like as it happen with women for eg, ovary related or something, cost for non-insured would be around 6000-7000, heart bypass surgery would be around 20,000(just an standard estimate.)
I am hoping it's not that serious, if not, the cost would be around 6000-7000 which I can think you can easily handle it based on your income. You should be concerned of the cost of how long your wife is gonna be in hospital, that'll get you billed really high. Even if you couldn't pay it all at once, portion of your monthly pay can be taken away, sort of like monthly payment. They can make arrangement that way. But for now, just be worried about your wife, your bill will get paid eventually,.. time passes fast. 
And, it's ridiculous to expect insurance co. covering you the month you are into their policies. Do one thing after this crisis is over. Ask your local congressman, search law about health coverage plan in the state you are living, because it varies state by state. I hope your wife feel better soon. 


 
Posted on 03-16-13 2:14 PM     [Snapshot: 701]     Reply [Subscribe]
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 I really appreciate to all you guys.  Probably, I will go for the surgery then talk with the hospital for the payment settlement and monthly payment option as Bittertruth said. And one thing, i have learn the lession, don't skip the insurance if you are eligible for it to save the money as free hib said. Divorce isn't a option for me to get a low income benefits and it takes a time to process as well, I could think to go to nepal /india if it's a last option for me. Thank you all
 
Posted on 03-16-13 3:10 PM     [Snapshot: 733]     Reply [Subscribe]
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 why dont u talk with one of social worker in that hospital .i'm 100% sure they r going to give u good advices and suggestions.they have lots of options.but first things do the surgery for ur wife.dont worry brother WE R HERE FOR U.........all is well...every hospital has a social workers for deals like this kinds of situations.bro talk with them and explain it honestly.
 
Posted on 03-17-13 7:50 PM     [Snapshot: 926]     Reply [Subscribe]
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 My own personal experience. Surgery can get really expensive in US. I had surgery of mine clavicle bone last year. According to doctor, it was a minor surgery. But guess what, the cost was over $20,000. I was injured in car accident. and did not have health insurance. So, the auto insurance covered upto $20,000. I ended up paying $1700. I am still paying it. I have set up a monthly plan and pay around $100 bucks each month. The good thing of this kind of hospital plan is the money does not multiply. There is no interest rate at all. So, whatever I pay every month goes towards my principal. All I am trying to say is even if your surgery gets costly, set up a payment plan as people above suggested and pay it every month. You make decent money. It should not be a big deal for you.

Yes, the bottom line is always have health insurance and good auto insurance if you can afford it! After that incident, I have learned a big lesson. I was damn lucky to have survived that accident :)

 


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